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

Kód výsledku v 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>

Nalezeny alternativní kódy

RIV/00216224:14110/25:00143795

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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 Materials and methods: We extensively searched eight sources of published and unpublished literature.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.

Název v anglickém jazyce

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

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30103 - Neurosciences (including psychophysiology)

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2025

Kód důvěrnosti údajů

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

Název periodika

Česká a slovenská neurologie a neurochirurgie

ISSN

1210-7859

e-ISSN

1802-4041

Svazek periodika

88

Číslo periodika v rámci svazku

2

Stát vydavatele periodika

CZ - Česká republika

Počet stran výsledku

6

Strana od-do

83-88

Kód UT WoS článku

001509250900001

EID výsledku v databázi Scopus

2-s2.0-105009491732