title: Endovascular versus Non-Interventional Therapy for Cervicocranial Artery Dissection in East Asian and Non-East Asian Patients: a Systematic Review and Meta-analysis.
abstract: Endovascular methods have been increasingly applied in treating cervicocranial artery dissection (CCAD). Anti-thrombotic therapy, which is used in non-interventional care of CCAD patients, has differential effects in East Asian patients. Therefore, we aimed to compare the clinical outcomes of endovascular versus non-interventional therapy for CCAD in East Asians and non-East Asians. A search was performed for studies comparing endovascular and non-interventional approaches to CCAD patients. Rates of recovery, disability, and mortality were used to assess these approaches in East Asian and non-East Asian patients. Subgroup analyses were conducted for CCAD patients with ruptured dissections. Eleven East Asian studies and five non-East Asian studies were included. The subgroup analyses for CCAD patients with ruptured dissections on mortality (East Asian odds ratio [OR] [95% confidence interval [CI]]: 0.24 [0.08-0.71], P = 0.01; I(2) = 34%) and good recovery (East Asian OR [95% CI]: 3.79 [1.14-12.60], P = 0.03; I(2) = 54%) revealed that endovascular therapy is significantly superior to non-interventional therapy for East Asians. No differences in treatment effect upon mortality, disability, or good recovery outcomes were found for the CCAD populations-at-large nor for non-East Asian CCAD patients with ruptured dissections. Endovascular therapy appears to be superior to non-interventional therapy for East Asian CCAD patients with ruptured dissections.
authors.affiliation: Department of Rehabilitation Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Rongzhong
authors.initials: R
authors.lastname: Huang
authors.affiliation: Department of Rehabilitation Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Lingchuan
authors.initials: L
authors.lastname: Niu
authors.affiliation: Department of Rehabilitation Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Rehabilitation Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Gongwei
authors.initials: G
authors.lastname: Jia
authors.affiliation: Department of Rehabilitation Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Lang
authors.initials: L
authors.lastname: Jia
authors.affiliation: Department of Rehabilitation Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Yule
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Rehabilitation Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Jiang
authors.affiliation: Institute of Ultrasound Imaging, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Rehabilitation Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Lehua
authors.initials: L
authors.lastname: Yu
mesh_terms: D000328:Adult; D017130:Angioplasty / Q000379:methods*; D020215:Carotid Artery, Internal, Dissection / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D057510:Endovascular Procedures / Q000379:methods*; D005202:Asia, Eastern; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006406:Hematoma / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome; D017539:Tunica Intima / Q000293:injuries / Q000601:surgery; D014711:Vertebral Artery / Q000293:injuries / Q000601:surgery
chemical_list: D005343:Fibrinolytic Agents