Thrombectomy vs. medical management for large vessel occlusion strokes with minimal symptoms

Anagnostopoulos,Iason-Stefanos; Georgakopoulou,Vasiliki Epameinondas; Trakas,Ilias; Papalexis,Petros; Trakas,Nikolaos; Spandidos,Demetrios A.; Fotakopoulos,George

doi:10.3892/etm.2023.12076

Thrombectomy vs. medical management for large vessel occlusion strokes with minimal symptoms

Authors:
- Iason-Stefanos Anagnostopoulos
- Vasiliki Epameinondas Georgakopoulou
- Ilias Trakas
- Petros Papalexis
- Nikolaos Trakas
- Demetrios A. Spandidos
- George Fotakopoulos
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Affiliations: Medical School, University of Ioannina, 45500 Ioannina, Greece, Department of Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece, Unit of Endocrinology, First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece, Department of Biochemistry, Sismanogleio Hospital, 15126 Athens, Greece, Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece, Department of Neurosurgery, General University Hospital of Larisa, 41221 Larisa, Greece
Published online on: June 23, 2023 https://doi.org/10.3892/etm.2023.12076
Article Number: 377
Copyright: © Anagnostopoulos et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Patients with acute ischemic stroke (AIS) presenting mild symptoms with a low National Institutes of Health Stroke Scale (NIHSS) score ≤8 and also found to have an intracranial large vessel occlusion (LVO) undergo endovascular thrombolysis (ET) or medical management alone. The current study aimed to evaluate the safety and effectiveness of medical management vs. ET therapy among patients with mild AIS symptoms (NIHSS score ≤8) accompanied by LVO. The present meta‑analysis included articles involving mild AIS, LVO, thrombectomy/ET and medical management alone published in full‑text form (from 1980 to 2022). Collected variables included: First author name, covered study period, publication year, the total number of patients and age, number of males, presence of diabetes mellitus, hypertension, atrial fibrillation, prior ischemic stroke, location, NIHSS of admission, modified Rankin scale, bleeding, morbidity and mortality. After the initial search and applying all exclusion and inclusion criteria, eight articles were left in the final article pool. The total number of patients who underwent ET was 569, compared with 1097 with medical management for LVO strokes with minimal symptoms. The findings of the present meta‑analysis study point out that ET management may be associated with a high risk of bleeding and mortality in patients with LVO presenting with mild symptoms (NIHSS score ≤8).

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