Effect of leukoaraiosis on collateral circulation in acute ischemic stroke treated with endovascular therapy: a meta-analysis
Abstract Background and objective The recruitment of collateral circulation correlates with a balance of the microvasculature. Uncertainty remains to be made about the association of leukoaraiosis with leptomeningeal collaterals. To explore the effect of leukoaraiosis on leptomeningeal collaterals i...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Neurology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12883-023-03266-8 |
| _version_ | 1797811444175077376 |
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| author | Wang Chen Yijie Qin Shuna Yang Lei Yang Yutong Hou Wenli Hu |
| author_facet | Wang Chen Yijie Qin Shuna Yang Lei Yang Yutong Hou Wenli Hu |
| author_sort | Wang Chen |
| collection | DOAJ |
| description | Abstract Background and objective The recruitment of collateral circulation correlates with a balance of the microvasculature. Uncertainty remains to be made about the association of leukoaraiosis with leptomeningeal collaterals. To explore the effect of leukoaraiosis on leptomeningeal collaterals in patients treated with endovascular therapy. Methods Observational studies exploring the correlation between leukoaraiosis and leptomeningeal collaterals in large vessel occlusion treated with endovascular therapy were searched from PubMed, EMBASE, and Cochrane Libraries databases. Two independent reviewers retrieved eligible literature, extracted purpose-related data, and utilized the Newcastle–Ottawa Scale to evaluate the risk of bias. A Mantel–Haenszel method was used to calculate the odds ratio (OR). Meta-regression and subgroup analyses were conducted to clarify heterogeneity. Results Data from 10 studies with 1606 patients were extracted for pooled analysis. Compared to non-severe leukoaraiosis, patients with severe leukoaraiosis showed significant relevance to poor leptomeningeal collaterals (OR, 2.13; 95% confidence interval [1.27–3.57]; P = 0.004). Meta-regression indicated that sample size (coefficient = -0.007299, P = 0.035) and the number of female patients (coefficient = -0.0174709, P = 0.020) were sources of heterogeneity. Furthermore, all of the countries (USA versus France versus China, Q = 3.67, P = 0.159), various assessment scales of leukoaraiosis (the Fazekas scale versus Non-Fazekas scales, Q = 0.77, P = 0.379), and different imaging methods of leukoaraiosis (computed tomography versus magnetic resonance imaging, Q = 2.12, P = 0.146) and leptomeningeal collaterals (computed tomography angiography versus digital subtraction angiography, Q = 1.21, P = 0.271) showed no contribution to the effect size. Conclusion Severe leukoaraiosis is associated with poor leptomeningeal collaterals in patients treated with endovascular therapy. Further studies may focus on whether the finding applies to different stroke subtypes. |
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| format | Article |
| id | doaj.art-e94494eca73943a28af43705eb1a99f5 |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-03-13T07:23:47Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-e94494eca73943a28af43705eb1a99f52023-06-04T11:31:56ZengBMCBMC Neurology1471-23772023-06-012311910.1186/s12883-023-03266-8Effect of leukoaraiosis on collateral circulation in acute ischemic stroke treated with endovascular therapy: a meta-analysisWang Chen0Yijie Qin1Shuna Yang2Lei Yang3Yutong Hou4Wenli Hu5Department of Neurology, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Emergency, Rizhao People’s HospitalDepartment of Neurology, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Neurology, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Neurology, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Neurology, Beijing Chaoyang Hospital, Capital Medical UniversityAbstract Background and objective The recruitment of collateral circulation correlates with a balance of the microvasculature. Uncertainty remains to be made about the association of leukoaraiosis with leptomeningeal collaterals. To explore the effect of leukoaraiosis on leptomeningeal collaterals in patients treated with endovascular therapy. Methods Observational studies exploring the correlation between leukoaraiosis and leptomeningeal collaterals in large vessel occlusion treated with endovascular therapy were searched from PubMed, EMBASE, and Cochrane Libraries databases. Two independent reviewers retrieved eligible literature, extracted purpose-related data, and utilized the Newcastle–Ottawa Scale to evaluate the risk of bias. A Mantel–Haenszel method was used to calculate the odds ratio (OR). Meta-regression and subgroup analyses were conducted to clarify heterogeneity. Results Data from 10 studies with 1606 patients were extracted for pooled analysis. Compared to non-severe leukoaraiosis, patients with severe leukoaraiosis showed significant relevance to poor leptomeningeal collaterals (OR, 2.13; 95% confidence interval [1.27–3.57]; P = 0.004). Meta-regression indicated that sample size (coefficient = -0.007299, P = 0.035) and the number of female patients (coefficient = -0.0174709, P = 0.020) were sources of heterogeneity. Furthermore, all of the countries (USA versus France versus China, Q = 3.67, P = 0.159), various assessment scales of leukoaraiosis (the Fazekas scale versus Non-Fazekas scales, Q = 0.77, P = 0.379), and different imaging methods of leukoaraiosis (computed tomography versus magnetic resonance imaging, Q = 2.12, P = 0.146) and leptomeningeal collaterals (computed tomography angiography versus digital subtraction angiography, Q = 1.21, P = 0.271) showed no contribution to the effect size. Conclusion Severe leukoaraiosis is associated with poor leptomeningeal collaterals in patients treated with endovascular therapy. Further studies may focus on whether the finding applies to different stroke subtypes.https://doi.org/10.1186/s12883-023-03266-8Cerebral small vessel diseaseLeukoaraiosisLarge vessel occlusionCollateral circulationEndovascular therapyMeta-analysis |
| spellingShingle | Wang Chen Yijie Qin Shuna Yang Lei Yang Yutong Hou Wenli Hu Effect of leukoaraiosis on collateral circulation in acute ischemic stroke treated with endovascular therapy: a meta-analysis BMC Neurology Cerebral small vessel disease Leukoaraiosis Large vessel occlusion Collateral circulation Endovascular therapy Meta-analysis |
| title | Effect of leukoaraiosis on collateral circulation in acute ischemic stroke treated with endovascular therapy: a meta-analysis |
| title_full | Effect of leukoaraiosis on collateral circulation in acute ischemic stroke treated with endovascular therapy: a meta-analysis |
| title_fullStr | Effect of leukoaraiosis on collateral circulation in acute ischemic stroke treated with endovascular therapy: a meta-analysis |
| title_full_unstemmed | Effect of leukoaraiosis on collateral circulation in acute ischemic stroke treated with endovascular therapy: a meta-analysis |
| title_short | Effect of leukoaraiosis on collateral circulation in acute ischemic stroke treated with endovascular therapy: a meta-analysis |
| title_sort | effect of leukoaraiosis on collateral circulation in acute ischemic stroke treated with endovascular therapy a meta analysis |
| topic | Cerebral small vessel disease Leukoaraiosis Large vessel occlusion Collateral circulation Endovascular therapy Meta-analysis |
| url | https://doi.org/10.1186/s12883-023-03266-8 |
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