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    Effectiveness and safety of mechanical thrombectomy for acute ischaemic stroke in Latin American countries: A systematic review

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    Mohammadnezhad_et_al_JoSaCD (503.8Kb)
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    Publication date
    2023-04
    Author
    Gonzalez Aquines, Alejandro
    Cordero-Perez, A.C.
    Mohammadnezhad, Masoud
    Bochenek, T.
    Gongora-Rivera, F.
    Keyword
    Systematic review
    Mechanical thrombectomy
    Stroke
    Latin America
    Rights
    © 2022 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
    Peer-Reviewed
    Yes
    Open Access status
    openAccess
    
    Metadata
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    Abstract
    To describe the use, effectiveness, and safety outcomes of mechanical thrombectomy (MT) for acute ischemic stroke (AIS) in Latin American countries. Studies reporting MT outcomes for AIS in Latin America were identified in CINAHL, MEDLINE, Web of Science, SciELO, EMBASE, and LILACS databases. Synthesis was conducted according to effectiveness (recanalization rates) and safety measures (mortality and functional independence at 90 days). Seventeen studies were included, mainly from public and university hospitals. MT utilization varied from 2.6% to 50.1%, while successful recanalization ranged from 63% to 95%. Functional independence 90 days after stroke (a modified Rankin scale score of 0 to 2) was achieved in less than 40% across most studies. Mortality rates were below 30%; studies with posterior circulation strokes reported higher mortality rates. The randomized trial reported better health outcomes for functional independence among patients in the MT group (OR 2.28; 95% CI, 1.41 - 3.69), favoring MT over standard care. The included studies had great methodological heterogeneity due to differences in study design, the MT time window, and stroke location. The only randomized trial showed improved functional independence and lower mortality rates with MT than with standard care. The rest of the studies reported similar findings to available literature. Efforts to improve stroke care are reflected in improved patient outcomes in the region. Future studies should consider standard time window criteria and reduce the risk of bias by including representative samples and comparison groups.
    URI
    http://hdl.handle.net/10454/19324
    Version
    Published version
    Citation
    Gonzalez-Aquines A, Cordero-Perez AC, Mohammadnezhad M et al (2023) Effectiveness and safety of mechanical thrombectomy for acute ischaemic stroke in Latin American countries: A systematic review. Journal of Stroke and Cerebrovascular Diseases. 32(4): 106972.
    Link to publisher’s version
    https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106972
    Type
    Article
    Collections
    Health Studies Publications

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