Efficacy and safety of emergent microsurgical embolectomy in
patients with acute ischemic stroke after the failure of
intravenous thrombolysis and mechanical thrombectomy - a
systematic review protocol

J 2020

Efficacy and safety of emergent microsurgical embolectomy in patients with acute ischemic stroke after the failure of intravenous thrombolysis and mechanical thrombectomy - a systematic review protocol

KLUGAR, Miloslav, Jiří FIEDLER, Radim LÍČENÍK and S. OSTRÝ

Basic information

Original name

Efficacy and safety of emergent microsurgical embolectomy in patients with acute ischemic stroke after the failure of intravenous thrombolysis and mechanical thrombectomy - a systematic review protocol

Authors

KLUGAR, Miloslav (203 Czech Republic, belonging to the institution), Jiří FIEDLER (203 Czech Republic), Radim LÍČENÍK (203 Czech Republic, belonging to the institution) and S. OSTRÝ (203 Czech Republic)

Edition

Ceska a slovenska neurologie a neurochirurgie, Prague, CZECH MEDICAL SOC, 2020, 1210-7859

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30103 Neurosciences

Country of publisher

Czech Republic

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 0.350

RIV identification code

RIV/00216224:14110/20:00116478

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.14735/amcsnn2020416

UT WoS

000566715200012

Keywords in English

brain ischemia; embolectomy; thrombectomy; microsurgery; middle cerebral artery; tissue plasminogen activator

Abstract

V originále

Introduction: Intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator within 4.5 h since onset of symptoms is the first line treatment in acute ischaemic stroke (AIS). In case of emergent large vessel occlusion (ELVO), IVT is insufficient with 13-33% of early recanalization of middle cerebral artery (MCA) only. Endovascular mechanical thrombectomy (MT) within 6 h since the onset of symptoms has increased the rate of recanalization and improved clinical outcomes significantly. If appropriate and if there are no contraindications, IVT is followed by MT. This combination therapy is the second line therapy and the best currently available treatment for patients with AIS and MCA occlusion. Successful recanalization is one of the predictors of favourable outcomes as well as negative predictive marker of mortality. The third line option, microsurgical embolectomy, has been discussed for the treatment of patients with AIS and MCA occlusion after failed MT. The objective of this review will be to evaluate the efficacy and safety of ME in patients with AIS and MCA occlusion, after the failure of IVT and MT on revascularization within 8, 16 and 24 h. Methods: The initial search will be conducted using the MEDLINE and EMBASE databases. The extensive search will involve the listed databases for published literature (MEDLINE, EMBASE, BMC, Cinahl, Scopus, and WoS) and unpublished literature (Open Grey, MedNar, Cos Conference Papers Index, and ProQuest). Following the Joanna Briggs Institute methodology, two independent reviewers will analyse the titles, abstracts and full texts, and then perform critical appraisal of methodological quality and data extraction from selected studies using the standardized tools. Narrative synthesis of the findings from the included studies, structured around the type of intervention, target population characteristics, and type of outcome will be performed. Funnel plots will be used to detect and/or correct publication bias.

Citovat

KLUGAR, Miloslav, Jiří FIEDLER, Radim LÍČENÍK and S. OSTRÝ. Efficacy and safety of emergent microsurgical embolectomy in patients with acute ischemic stroke after the failure of intravenous thrombolysis and mechanical thrombectomy - a systematic review protocol. Ceska a slovenska neurologie a neurochirurgie. Prague: CZECH MEDICAL SOC, 2020, vol. 83, No 4, p. 416-420. ISSN 1210-7859. Available from: https://dx.doi.org/10.14735/amcsnn2020416.

@article{1680302,
   author = {Klugar, Miloslav and Fiedler, Jiří and Líčeník, Radim and Ostrý, S.},
   article_location = {Prague},
   article_number = {4},
   doi = {http://dx.doi.org/10.14735/amcsnn2020416},
   keywords = {brain ischemia; embolectomy; thrombectomy; microsurgery; middle cerebral artery; tissue plasminogen activator},
   language = {eng},
   issn = {1210-7859},
   journal = {Ceska a slovenska neurologie a neurochirurgie},
   title = {Efficacy and safety of emergent microsurgical embolectomy in patients with acute ischemic stroke after the failure of intravenous thrombolysis and mechanical thrombectomy - a systematic review protocol},
   url = {https://www.csnn.eu/en/journals/czech-and-slovak-neurology-and-neurosurgery/2020-4-5/efficacy-and-safety-of-emergent-microsurgical-embolectomy-in-patients-with-acute-ischemic-stroke-after-the-failure-of-intravenous-thrombolysis-and-mechanical-thrombectom},
   volume = {83},
   year = {2020}
}

TY  - JOUR
ID  - 1680302
AU  - Klugar, Miloslav - Fiedler, Jiří - Líčeník, Radim - Ostrý, S.
PY  - 2020
TI  - Efficacy and safety of emergent microsurgical embolectomy in patients with acute ischemic stroke after the failure of intravenous thrombolysis and mechanical thrombectomy - a systematic review protocol
JF  - Ceska a slovenska neurologie a neurochirurgie
VL  - 83
IS  - 4
SP  - 416-420
EP  - 416-420
PB  - CZECH MEDICAL SOC
SN  - 12107859
KW  - brain ischemia
KW  - embolectomy
KW  - thrombectomy
KW  - microsurgery
KW  - middle cerebral artery
KW  - tissue plasminogen activator
UR  - https://www.csnn.eu/en/journals/czech-and-slovak-neurology-and-neurosurgery/2020-4-5/efficacy-and-safety-of-emergent-microsurgical-embolectomy-in-patients-with-acute-ischemic-stroke-after-the-failure-of-intravenous-thrombolysis-and-mechanical-thrombectom
L2  - https://www.csnn.eu/en/journals/czech-and-slovak-neurology-and-neurosurgery/2020-4-5/efficacy-and-safety-of-emergent-microsurgical-embolectomy-in-patients-with-acute-ischemic-stroke-after-the-failure-of-intravenous-thrombolysis-and-mechanical-thrombectom
N2  - Introduction: Intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator within 4.5 h since onset of symptoms is the first line treatment in acute ischaemic stroke (AIS). In case of emergent large vessel occlusion (ELVO), IVT is insufficient with 13-33% of early recanalization of middle cerebral artery (MCA) only. Endovascular mechanical thrombectomy (MT) within 6 h since the onset of symptoms has increased the rate of recanalization and improved clinical outcomes significantly. If appropriate and if there are no contraindications, IVT is followed by MT. This combination therapy is the second line therapy and the best currently available treatment for patients with AIS and MCA occlusion. Successful recanalization is one of the predictors of favourable outcomes as well as negative predictive marker of mortality. The third line option, microsurgical embolectomy, has been discussed for the treatment of patients with AIS and MCA occlusion after failed MT. The objective of this review will be to evaluate the efficacy and safety of ME in patients with AIS and MCA occlusion, after the failure of IVT and MT on revascularization within 8, 16 and 24 h. Methods: The initial search will be conducted using the MEDLINE and EMBASE databases. The extensive search will involve the listed databases for published literature (MEDLINE, EMBASE, BMC, Cinahl, Scopus, and WoS) and unpublished literature (Open Grey, MedNar, Cos Conference Papers Index, and ProQuest). Following the Joanna Briggs Institute methodology, two independent reviewers will analyse the titles, abstracts and full texts, and then perform critical appraisal of methodological quality and data extraction from selected studies using the standardized tools. Narrative synthesis of the findings from the included studies, structured around the type of intervention, target population characteristics, and type of outcome will be performed. Funnel plots will be used to detect and/or correct publication bias.
ER  -

KLUGAR, Miloslav, Jiří FIEDLER, Radim LÍČENÍK and S. OSTRÝ. Efficacy and safety of emergent microsurgical embolectomy in patients with acute ischemic stroke after the failure of intravenous thrombolysis and mechanical thrombectomy - a systematic review protocol. \textit{Ceska a slovenska neurologie a neurochirurgie}. Prague: CZECH MEDICAL SOC, 2020, vol.~83, No~4, p.~416-420. ISSN~1210-7859. Available from: https://dx.doi.org/10.14735/amcsnn2020416.

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