The Meta-analysis Of The Comparison Of Bridging With Intravenous Thrombolysis Versus Direct Endovascular Thrombectomy For Acute Ischemic Stroke

OBJECTIVE: Acute ischemic stroke is a common disabling and even fatal disease in China.This research intends to find out the advantages and disadvantages of bridging therapy and direct thrombectomy for the treatment of acute ischemic stroke through meta-analysis.METHODS: The studies on bridging therapy and direct thrombectomy for acute ischemic stroke patients in the major databases were searched.The articles were screened according to the screening process,and then the related data were extracted for meta-analysis.RESULTS: A total of 22 studies were included.A total of 3253 patients in the bridging group and 2195 patients in the direct thrombectomy group.The meta-analysis showed compared with the patients in the direct thrombectomy group,the bridging group has a high successful recanalization rate(OR:1.23,95%CI:1.07-1.41,p=0.004)and proportion of good prognosis was higher(OR;1.41;95%CI:1.25-1.59,p<0.00001),and the mortality rate was lower(OR:0.63;95%CI:0.54-0.73,p<0.00001),there was no significant difference in the proportion of symptomatic intracranial hemorrhage(OR:1.00,95%CI:0.77-1.29,p=0.98).CONCLUSION: In patients with acute ischemic stroke who meet certain conditions,bridging therapy can increase the rate of successful recanalization,improve clinical prognosis,reduce mortality,and not increase the proportion of symptomatic intracranial hemorrhage compared with direct thrombectomy.