Endovascular Treatment of Large Vessel Occlusion Strokes Caused by Infective Endocarditis: A Systematic Review, Meta-Analysis, and Case Presentation
Thromboembolic events such as acute ischemic strokes are frequently seen in patients with infective endocarditis (IE). It is generally recommended that the administration of intravenous thrombolytics is avoided in these patients as they might encounter a higher risk of intracranial hemorrhages. In t...
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MDPI AG
2022-12-01
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| Online Access: | https://www.mdpi.com/2075-1729/12/12/2146 |
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| author | Ashkan Mowla Saeed Abdollahifard Saman Sizdahkhani Erfan Taherifard Fatemeh Kheshti Kasra Khatibi |
| author_facet | Ashkan Mowla Saeed Abdollahifard Saman Sizdahkhani Erfan Taherifard Fatemeh Kheshti Kasra Khatibi |
| author_sort | Ashkan Mowla |
| collection | DOAJ |
| description | Thromboembolic events such as acute ischemic strokes are frequently seen in patients with infective endocarditis (IE). It is generally recommended that the administration of intravenous thrombolytics is avoided in these patients as they might encounter a higher risk of intracranial hemorrhages. In this setting, particularly with a large vessel occlusion (LVO), a mechanical thrombectomy may be an alternative option. In this systematic review and meta-analysis, we aimed to investigate the outcomes and safety of mechanical thrombectomies for LVO stroke patients secondary to IE. A search strategy was developed and we searched PubMed, Scopus, Web of Sciences, and Embase using the words “infective endocarditis”, “stroke”, and “mechanical thrombectomy”. Including 6 studies and 120 patients overall, this study showed that a mechanical thrombectomy might reduce the National Institute of Health Stroke Scale (NIHSS), with a weighted mean difference of −3.06 and a 95% CI of −4.43 to −1.70. The pooled rate of symptomatic intracranial hemorrhages and all-cause mortality were also determined to be 15% (95% CI: 4–47%) and 34% (95% CI:14–61%), respectively. The results of this study showed that a mechanical thrombectomy might be an effective and reasonably safe option for the treatment of LVO strokes caused by IE. However, more large-scale studies are needed to consolidate these results. |
| first_indexed | 2024-03-09T16:11:01Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-09T16:11:01Z |
| publishDate | 2022-12-01 |
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| series | Life |
| spelling | doaj.art-72c7aecec9294f44a3837b32d1208db22023-11-24T16:14:20ZengMDPI AGLife2075-17292022-12-011212214610.3390/life12122146Endovascular Treatment of Large Vessel Occlusion Strokes Caused by Infective Endocarditis: A Systematic Review, Meta-Analysis, and Case PresentationAshkan Mowla0Saeed Abdollahifard1Saman Sizdahkhani2Erfan Taherifard3Fatemeh Kheshti4Kasra Khatibi5Division of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA 90089, USASchool of Medicine, Shiraz University of Medical Sciences, Shiraz P.O. Box 71348-14336, IranDivision of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA 90089, USAMPH Department, Shiraz University of Medical Sciences, Shiraz P.O. Box 71348-14336, IranSchool of Medicine, Shiraz University of Medical Sciences, Shiraz P.O. Box 71348-14336, IranDivision of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA 90089, USAThromboembolic events such as acute ischemic strokes are frequently seen in patients with infective endocarditis (IE). It is generally recommended that the administration of intravenous thrombolytics is avoided in these patients as they might encounter a higher risk of intracranial hemorrhages. In this setting, particularly with a large vessel occlusion (LVO), a mechanical thrombectomy may be an alternative option. In this systematic review and meta-analysis, we aimed to investigate the outcomes and safety of mechanical thrombectomies for LVO stroke patients secondary to IE. A search strategy was developed and we searched PubMed, Scopus, Web of Sciences, and Embase using the words “infective endocarditis”, “stroke”, and “mechanical thrombectomy”. Including 6 studies and 120 patients overall, this study showed that a mechanical thrombectomy might reduce the National Institute of Health Stroke Scale (NIHSS), with a weighted mean difference of −3.06 and a 95% CI of −4.43 to −1.70. The pooled rate of symptomatic intracranial hemorrhages and all-cause mortality were also determined to be 15% (95% CI: 4–47%) and 34% (95% CI:14–61%), respectively. The results of this study showed that a mechanical thrombectomy might be an effective and reasonably safe option for the treatment of LVO strokes caused by IE. However, more large-scale studies are needed to consolidate these results.https://www.mdpi.com/2075-1729/12/12/2146infective endocarditislarge vessel occlusionstrokemechanical thrombectomy |
| spellingShingle | Ashkan Mowla Saeed Abdollahifard Saman Sizdahkhani Erfan Taherifard Fatemeh Kheshti Kasra Khatibi Endovascular Treatment of Large Vessel Occlusion Strokes Caused by Infective Endocarditis: A Systematic Review, Meta-Analysis, and Case Presentation Life infective endocarditis large vessel occlusion stroke mechanical thrombectomy |
| title | Endovascular Treatment of Large Vessel Occlusion Strokes Caused by Infective Endocarditis: A Systematic Review, Meta-Analysis, and Case Presentation |
| title_full | Endovascular Treatment of Large Vessel Occlusion Strokes Caused by Infective Endocarditis: A Systematic Review, Meta-Analysis, and Case Presentation |
| title_fullStr | Endovascular Treatment of Large Vessel Occlusion Strokes Caused by Infective Endocarditis: A Systematic Review, Meta-Analysis, and Case Presentation |
| title_full_unstemmed | Endovascular Treatment of Large Vessel Occlusion Strokes Caused by Infective Endocarditis: A Systematic Review, Meta-Analysis, and Case Presentation |
| title_short | Endovascular Treatment of Large Vessel Occlusion Strokes Caused by Infective Endocarditis: A Systematic Review, Meta-Analysis, and Case Presentation |
| title_sort | endovascular treatment of large vessel occlusion strokes caused by infective endocarditis a systematic review meta analysis and case presentation |
| topic | infective endocarditis large vessel occlusion stroke mechanical thrombectomy |
| url | https://www.mdpi.com/2075-1729/12/12/2146 |
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