Rescue Endovascular Treatment of Patients With Emergent Large Vessel Occlusion Attributed to Intracranial Atherosclerosis: A Systematic Review and Meta?Analysis

Background Patients with acute stroke presenting large vessel occlusion secondary to intracranial atherosclerosis (ICAS?LVO) may require rescue therapy (RT) in addition mechanical thrombectomy achieve and maintain successful recanalization. We performed a systematic review meta?analysis of comparative studies that reported outcomes RT patients ICAS?LVO evaluate its safety efficacy. Methods Databases searched include PubMed, CINAHL Complete, Scopus from database date inception through August 17, 2021. included the compared who did not undergo or those embolic (non–ICAS?LVO). Meta?analysis using random?effects model was used combine estimates reporting odds ratios (ORs) 95% CIs. Results A total 9 nonrandomized were included: 5 versus non?RT analysis non?ICAS LVO analysis. Rescue treatments intra?arterial antiplatelets, angioplasty, stenting, combination treatments. Compared ICAS?LVO, associated an increased favorable 90?day outcome (OR, 3.19 [95% CI, 1.91–5.32]; I 2 = 14%) decreased mortality 0.35 0.16–0.76]; 21%). In LV, incidence differ between non–ICAS?LVO 0.97 0.58–1.64; 50%]; OR, 1.22 0.90–1.66; 0%], respectively). Conclusions treatment is likely better ICAS?LVO. The receive be comparable