title: Outcomes of mechanical endovascular therapy for acute ischemic stroke: a clinical registry study and systematic review.
abstract: OBJECTIVE
  Recanalization is a powerful predictor of stroke outcome in patients with arterial occlusion. Intravenous recombinant tissue plasminogen activator is limited by its recanalization rate, which may be improved with mechanical endovascular therapy (MET). However, the benefit and safety of MET remain to be determined. The aim of this study was to give reliable estimates of efficacy and safety outcomes of MET.
  
  
  METHODS
  We analyzed data from our prospective clinical registry and conducted a systematic review of all previous studies using MET published between January 1966 and November 2009.
  
  
  RESULTS
  From April 2007 to November 2009, 47 patients with acute stroke were treated with MET at Bichat Hospital. The literature search identified 31 previous studies involving a total of 1066 subjects. In the meta-analysis, including our registry data, the overall recanalization rate was 79% (95% CI, 73-84). Meta-analysis of clinical outcomes showed a pooled estimate of 40% (95% CI, 34-46; 27 studies) for favorable outcome, 28% (95% CI, 23-33; 28 studies) for mortality, and 8% (95% CI, 6-10; 27 studies) for symptomatic intracranial hemorrhage. The likelihood of a favorable outcome increased with the use of thrombolysis (OR, 1.99; 95% CI, 1.23-3.22) and with proportion of patients with isolated middle cerebral artery occlusion (OR per 10% increase, 1.14; 95% CI, 1.04-1.25).
  
  
  CONCLUSIONS
  MET is associated with acceptable safety and efficacy in stroke patients, and it may be a therapeutic option in those presenting with isolated middle cerebral artery occlusion.
authors: Department of Neurology and Stroke Centre, Bichat University Hospital, INSERM U-698 and Paris-Diderot University, 46, rue Henri Huchard, 75018 Paris, France.
authors: Aymeric
authors: A
authors: Rouchaud
authors: Mikael
authors: M
authors: Mazighi
authors: Julien
authors: J
authors: Labreuche
authors: Elena
authors: E
authors: Meseguer
authors: Jean-Michel
authors: JM
authors: Serfaty
authors: Jean-Pierre
authors: JP
authors: Laissy
authors: Philippa C
authors: PC
authors: Lavallée
authors: Lucie
authors: L
authors: Cabrejo
authors: Céline
authors: C
authors: Guidoux
authors: Bertrand
authors: B
authors: Lapergue
authors: Isabelle F
authors: IF
authors: Klein
authors: Jean-Marc
authors: JM
authors: Olivot
authors: Halim
authors: H
authors: Abboud
authors: Olivier
authors: O
authors: Simon
authors: Elisabeth
authors: E
authors: Schouman-Claeys
authors: Pierre
authors: P
authors: Amarenco
mesh_terms: D057510:Endovascular Procedures / Q000009:adverse effects; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis / Q000628:therapy; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis* / Q000628:therapy*; D015912:Thrombolytic Therapy; D016896:Treatment Outcome