Endovascular therapy versus best medical treatment for symptomatic intracranial atherosclerotic stenosis: A systematic review and meta-analysis.

• Tác giả: Katharina Feil, Frantzeska Frantzeskaki, Odysseas Kargiotis, George Magoufis, Annerose Mengel, Panayiotis D Mitsias, Lina Palaiodimou, Evangelos Panagiotopoulos, Klearchos Psychogios, Apostolos Safouris, Tatiana Sidiropoulou, Stavros Spiliopoulos, Maria-Ioanna Stefanou, Marios Themistocleous, Aikaterini Theodorou, Georgios Tsivgoulis, Ulf Ziemann
• Ngôn ngữ: eng
• Thông tin xuất bản: England : European stroke journal , 2025
• Bộ sưu tập: NCBI
• ID: 711130

Tóm tắt

 INTRODUCTION: Evidence on endovascular therapy (EVT) for symptomatic intracranial stenosis (sICAS) from randomized-controlled clinical trials (RCTs) is conflicting. While prior RCTs on percutaneous transluminal angioplasty and stenting (PTAS) demonstrated harm or no benefit over best medical treatment (BMT), recent data suggest that submaximal balloon angioplasty with BMT may be superior to BMT alone. PATIENTS AND METHODS: A systematic review and meta-analysis of RCTs was conducted to evaluate the safety and efficacy of elective EVT plus BMT compared to BMT alone for sICAS. RESULTS: Six RCTs (5 on PTAS and 1 on balloon-angioplasty) comprising 1606 patients were included. EVT increased the risk of any stroke or death (RR = 2.68
  95% CI: 1.72-4.19
  DISCUSSION AND CONCLUSION: EVT is associated with adverse early outcomes, without reducing the risk of long-term stroke recurrence or mortality compared to BMT. Further research is warranted to identify high-risk subgroups who may benefit from EVT for sICAS and refine interventions to minimize periprocedural risks.