Effects of endovascular therapy on acute ischemic stroke: An updated meta-analysis of randomized controlled trials

Objects: To clarify the effects of endovascular therapy (ET) for acute ischemic stroke (AIS) patients, we conducted an updated meta-analysis using data from randomized controlled trials (RCTs). Methods: We searched major electronic databases for RCTs comparing ET with intravenous thrombolysis (IVT) or other standard treatments for AIS patients. Eligible and high-quality RCTs were included in the meta-analysis. The overall estimates were demonstrated as an odds ratio (OR) with 95% confidence interval (CI) and P value. Results: Thirteen high-quality trials met the inclusion criteria and were analyzed. Patients treated by ET were more likely to have good functional outcomes (OR, 1.70; 95% Cl, 1.32-2.19; P < 0.0001) and lower mortality rates (OR, 0.77; 95% Cl, 0.60-0.98; P = 0.03) at 90 days than patients treated by IVT or standard treatment. There was no significant difference in the rate of symptomatic intracerebral hemorrhage [slCH] (OR, 1.18; 95% Cl, 0.73-1.91; P = 0.50). Conclusions: ET is superior to both IVT and standard treatment in providing functional improvement and reducing the mortality rate at 90 days, while not increasing the risk of slCH for the treatment of AIS.