The Efficacy and Safety of Endovascular Treatment on Large Vessel Occlusion of Intracranial Atherosclerosis Versus Embolism: A Meta-Analysis.
FenFei Zeng, QiHong Pan, XuTao Wang et al.
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In 30 seconds
This meta-analysis compared endovascular treatment outcomes for acute ischemic stroke due to intracranial atherosclerosis-related large vessel occlusion (ICAS-LVO) versus embolic-LVO. It included 2,748 patients across 14 studies identified in a search of literature published through August 2021. ICAS-LVO was associated with a significantly lower rate of intracranial hemorrhage after treatment. Recanalization, favorable outcome, and mortality at 90 days were similar between groups, while rescue therapy and stent implantation rates were significantly lower in ICAS-LVO.
Key findings
- Across 14 studies involving 2,748 patients, intracranial hemorrhage after endovascular treatment was significantly less frequent in ICAS-LVO than in embolic-LVO.
- Recanalization rates and favorable outcomes at 90 days were similar between ICAS-LVO and embolic-LVO.
- Mortality at 90 days was similar between the two groups.
- Rescue therapy and stent implantation were significantly less frequent in ICAS-LVO than in embolic-LVO.
Why it matters
Stroke mechanism may be relevant when interpreting endovascular treatment outcomes. These pooled findings suggest that patients with ICAS-LVO had comparable 90-day outcomes to those with embolic-LVO, despite differences in hemorrhage and procedural adjuncts. The reported variation in rescue therapy and stent use also underscores uncertainty about how endovascular management is applied across these occlusion types.
What to keep in mind
The meta-analysis pooled 14 studies, and the abstract does not report study-level design or quality details; the findings therefore depend on the included literature.