Una revisión sistemática de la terapia endovascular en pacientes con accidente cerebrovascular isquémico

Abstract

Objective: Systematically review the evidence of endovascular therapy compared with standard management.
Inclusion criteria: Randomized clinical trials that include adult patients older than 18 years, have suffered an ischemic stroke managed with endovascular therapy compared to medical management.
Methods: The search is performed in the following databases: MEDLINE, the Central Registry of Controlled Trials (CENTRAL); PubMed, HINARI, EMBASE; Cochrane Injury Group and reference list of articles.
Results: Thrombectomy was associated with decreased mortality (OR 0.78, 95% CI 0.63-0.95 p = 0.01), increased revascularization rate (OR 6.16, CI 95%: 4.39-8.64 p = <0.0001), improvement in functional outcome (OR 1.78, 95% CI: 1.52 - 2.08 p = <0.0001). There was no difference in the recurrence of cerebral ischemia or the appearance of intracerebral hemorrhage (OR 0.86, 95% CI 0.51 - 1.47 p = 0.59, OR 1.13, 95% CI %: 0.79 - 1.62 p = 0.5, respectively).
Conclusions: Endovascular therapy compared with the treatment of fibrinolysis improves functional prognosis.