Efficacy and safety of emergent microsurgery in acute ischaemic stroke patients after intravenous thrombolysis and mechanical thrombectomy failures – a systematic review

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11140%2F25%3A10498380" target="_blank" >RIV/00216208:11140/25:10498380 - isvavai.cz</a>

Alternative codes found

RIV/00216224:14110/25:00143795

Result on the web

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=RP5kx~zPDR" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=RP5kx~zPDR</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.48095/cccsnn202583" target="_blank" >10.48095/cccsnn202583</a>

Result language

angličtina

Original language name

Efficacy and safety of emergent microsurgery in acute ischaemic stroke patients after intravenous thrombolysis and mechanical thrombectomy failures – a systematic review

Original language description

Aim: This systematic review aimed to verify the role of emergent microsurgical embolectomy and extracranial-intracranial bypass as third-line treatments in cases of intracranial large-vessel occlusion after failure of standard treatment. Materials and methods: We extensively searched eight sources of published and unpublished literature. Two reviewers independently performed titles, abstracts, and full text analyses, and then performed critical appraisal and data extraction from selected studies using standardised tools. We narratively synthesised the findings of the included studies. Results: The search identified eight relevant articles, including 12 patients with emergent large-vessel occlusion (carotid terminus or middle cerebral artery), and standard treatment failure who underwent microsurgery within 24 h from symptom onset. Microsurgical embolectomy was performed in four cases (33%), extracranial-intracranial bypass in five cases (42%), their combination in two cases (16%), and manipulative intraoperative recanalization in one case (8%). National Institutes of Health Stroke Scale score ranged pre-operatively from 7 to 25 points and postoperatively (1-7 days after surgery) from 1-18 points. Functional independence (modified Rankin Scale score 0-2) was achieved in nine patients (75%) at 3-12 months postoperatively. Conclusion: Emergent microsurgical embolectomy, extracranial-intracranial bypass, or a combination of these methods appear to be a safe and potentially effective third-line treatment for patients with emergent occlusion of large vessels in the anterior cerebral circulation.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30103 - Neurosciences (including psychophysiology)

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2025

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Česká a slovenská neurologie a neurochirurgie

ISSN

1210-7859

e-ISSN

1802-4041

Volume of the periodical

88

Issue of the periodical within the volume

2

Country of publishing house

CZ - CZECH REPUBLIC

Number of pages

6

Pages from-to

83-88

UT code for WoS article

001509250900001

EID of the result in the Scopus database

2-s2.0-105009491732