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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Acute Ischemic Stroke Treatment in Infective Endocarditis: Systematic Review
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Acute Ischemic Stroke Treatment in Infective Endocarditis: Systematic Review

机译：感染性心内膜炎中急性缺血性卒中治疗：系统评价

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Background: Ischemic stroke is a frequent neurologic complication of infective endocarditis. This systematic review aims to evaluate the efficacy and safety of thrombectomy in comparison to thrombolysis and to combined treatment in patients with infective endocarditis associated acute ischemic stroke. Methods: A systematic literature review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The review included case reports, cases series, cross-sectional studies, case control studies, randomized controlled trials or nonrandomized controlled trials, which reported the treatment of endocarditis-related acute ischemic stroke with mechanical thrombectomy, intravenous or intra-arterial thrombolysis in adult patients. Data sources: Scielo, b-on, Pubmed and Cochrane, from inception to April 2019. Reference lists were also checked. We compared the efficacy (independence, neurological improvement) and safety (intracranial bleeding, death) of acute ischemic stroke treatment with thrombolysis, thrombectomy and combined therapy. Results: Through systematic review 37 articles describing 52 patients met criteria. The risk of intracranial hemorrhage was 4.14 times higher in patients treated with intravenous thrombolysis (P=.001) and 4.67 times higher in patients treated with combined treatment (P=.01). There was trend for independence (P=.09) and neurological improvement (P=.07) in favor of thrombectomy, when comparing this group to the group treated with intravenous thrombolysis. Conclusions: With the limitation of the low quality of the available evidence, thrombectomy in infective endocarditis associated stroke appears to be safer than thrombolysis, or combined treatment. These results may be useful to guide clinical decisions, in selected patients.
机译：背景：缺血性中风是感染性心内膜炎常见的神经系统并发症。本系统综述旨在评估血栓切除术与溶栓及联合治疗在感染性心内膜炎相关急性缺血性卒中患者中的疗效和安全性。方法：按照系统评价和荟萃分析指南的首选报告项目进行系统文献综述。该综述包括病例报告、病例系列、横断面研究、病例对照研究、随机对照试验或非随机对照试验，这些试验报告了机械血栓切除术、静脉或动脉内溶栓治疗成人患者心内膜炎相关急性缺血性中风的方法。数据来源：Scielo、b-on、Pubmed和Cochrane，从成立到2019年4月。还检查了参考清单。我们比较了溶栓、取栓和联合治疗急性缺血性卒中的疗效（独立性、神经功能改善）和安全性（颅内出血、死亡）。结果：通过系统回顾，描述52例患者的37篇文章符合标准。静脉溶栓治疗组颅内出血风险高4.14倍（P=0.001），联合治疗组颅内出血风险高4.67倍（P=0.01）。与静脉溶栓组相比，血栓切除组的独立性（P=0.09）和神经功能改善（P=0.07）有利于血栓切除术。结论：由于现有证据质量较低，感染性心内膜炎相关卒中的血栓切除术似乎比溶栓或联合治疗更安全。这些结果可能有助于指导选定患者的临床决策。

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