The most common type of stroke is one in which a large artery in the brain gets blocked by a blood clot and there are dozens of Cochrane reviews of various treatments for these ischaemic strokes. One of these reviews, looking at the effects of endovascular thrombectomy and intra-arterial interventions, was updated in June 2021 and lead author, Melinda Roaldsen from the Arctic University of Norway in Tromsø, briefly describes the new findings in this podcast.
Mike: Hello, I'm Mike Clarke, podcast editor for the Cochrane Library. The most common type of stroke is one in which a large artery in the brain gets blocked by a blood clot and there are dozens of Cochrane reviews of various treatments for these ischaemic strokes. One of these reviews, looking at the effects of endovascular thrombectomy and intra-arterial interventions, was updated in June 2021 and lead author, Melinda Roaldsen from the Arctic University of Norway in Tromsø, briefly describes the new findings in this podcast.
Melinda: In acute ischaemic stroke, endovascular thrombectomy and intra-arterial thrombolysis are used to try to re-open the blocked blood vessel before major brain damage has occurred, with the hope of leading to improved recovery. Therefore, we did this review to find out if adding these interventions to medical treatment would lead to better outcomes for patients and it's clear that they do.
We searched for randomised trials that compared the combination of an endovascular intervention with medical treatment versus medical treatment alone in patients with definite ischaemic stroke, and found 19 eligible studies. These had recruited a total of nearly 3800 patients, most of whom had a large artery blockage in the brain, and almost all the trials had tested the use of endovascular thrombectomy within six hours of the onset of symptoms. Bringing together the results from all but one of the trials, we found that people in the endovascular thrombectomy group had better functional outcomes after 90 days and were less likely to die in that time period.
This shows that endovascular interventions are a safe and effective treatment which increase the chance of survival with a good functional outcome. This evidence needs to be considered in practice and endovascular thrombectomy needs to become more readily available for larger parts of the population.
Mike: If you would like to look deeper into the evidence in this review and its findings, you can find it online. Just go to Cochrane Library dot com and search 'endovascular thrombectomy' to find it.