title: Efficacy and safety of endovascular treatment versus intravenous thrombolysis for acute ischemic stroke: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  Although endovascular therapy (ET) is increasingly used in patients with moderate to severe acute ischemic stroke, its efficacy and safety remains controversial. We performed a meta-analysis aiming to compare the benefits and safety of endovascular treatment and intravenous thrombolysis in the treatment of acute ischemic stroke.
  
  
  METHODS
  We systematically searched PubMed, Embase, Science direct and Springer unitil July, 2013. The primary outcomes included good outcome (mRS ≤ 2) and excellent outcome (mRS ≤ 1) at 90 days or at trial end point. Secondary outcomes were occurrence of symptomatic hemorrhage and all-cause mortality.
  
  
  RESULTS
  Using a prespecified search strategy, 5 RCTs with 1106 patients comparing ET and intravenous thrombolysis (IVT) were included in the meta-analysis. ET and IVT were associated with similar good (43.06% vs 41.78%; OR=1.14; 95% CI, 0.77 to 1.69; P=0.52;) and excellent (30.43% vs 30.42%; OR=1.05; 95% CI, 0.80 to 1.38; P=0.72;) outcome. For additional end points, ET was not associated with increased occurrence of symptomatic hemorrhage (6.25% vs. 6.22%; OR=1.03; 95% CI, 0.62 to 1.69; P=0.91;), or all-cause mortality (18.45% vs. 17.35%; OR=1.00; 95% CI, 0.73 to 1.39; P=0.99;).
  
  
  CONCLUSIONS
  Formal meta-analysis indicates that there are similar safety outcomes and functional independence with endovascular therapy and intravenous thrombolysis for acute ischemic stroke.
authors.affiliation: Department of Neurosurgery, Jinling Hospital, Nanjing University, Nanjing, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Lin
authors.forename: Nan
authors.initials: N
authors.lastname: Li
authors.forename: Kang
authors.initials: K
authors.lastname: Wang
authors.forename: Xin
authors.initials: X
authors.lastname: Zhao
authors.forename: Bai-Qiang
authors.initials: BQ
authors.lastname: Li
authors.forename: Lei
authors.initials: L
authors.lastname: Sun
authors.forename: Yi-Xing
authors.initials: YX
authors.lastname: Lin
authors.forename: Jie-Mei
authors.initials: JM
authors.lastname: Fan
authors.forename: Miao
authors.initials: M
authors.lastname: Zhang
authors.forename: Hai-Chen
authors.initials: HC
authors.lastname: Sun
mesh_terms: D002545:Brain Ischemia / Q000628:therapy*; D057510:Endovascular Procedures; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007275:Injections, Intravenous; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000628:therapy*; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents