Rescue Treatment of Thromboembolic Complications during Endovascular Treatment of Cerebral Aneurysms: A Meta-Analysis

Article Figures & Data

Table 1:

Rescue therapy outcomes with GP IIb/IIIa inhibitors versus fibrinolytics

Outcome	GP IIb/IIIa Inhibitor % (95% CI)	I²	Fibrinolytic % (95% CI)	I²	P Value
Postoperative clinical stroke	14.0 (8.0–23.0)	65	27.0 (11.0–51.0)	53	.20
Postoperative infarct on imaging	28.0 (19.0–39.0)	56	39.0 (19.0–63.0)	0	.42
Postoperative hemorrhage	7.0 (4.0–10.0)	0	14.0 (6.0–31.0)	26	.12
Perioperative morbidity from stroke/hemorrhage	11.0 (7.0–16.0)	10	29.0 (13.0–55.0)	55	.04
Perioperative mortality from stroke/hemorrhage	6.0 (4.0–9.0)	0	12.0 (5.0–25.0)	0	.16
Long-term good neurologic outcome	82.0 (78.0–86.0)	0	65.0 (42.0–83.0)	43	.07
Long-term morbidity	16.0 (11.0–21.0)	13	35.0 (17.0–58.0)	43	.04
Recanalization rate	72.0 (64.0–78.0)	49	50.0 (28.0–73.0)	37	.08

Table 2:

Rescue therapy outcomes with GP IIb/IIIa inhibitors: abciximab versus tirofiban/eptifibatide

Outcome	Abciximab % (95% CI)	I²	Tirofiban/Eptifibatide % (95% CI)	I²	P Value
Postoperative clinical stroke	14.0 (8.0–25.0)	50	13.0 (4.0–33.0)	77	.86
Postoperative infarct on imaging	28.0 (19.0–39.0)	44	37.0 (9.0–76.0)	81	.67
Postoperative hemorrhage	7.0 (4.0–10.0)	0	14.0 (6.0–31.0)	26	.12
Perioperative morbidity from stroke/hemorrhage	12.0 (8.0–18.0)	4	8.0 (4.0–16.0)	3	.30
Perioperative mortality from stroke/hemorrhage	6.0 (4.0–10.0)	0	6.0 (3.0–12.0)	0	.16
Long-term good neurologic outcome	85.0 (79.0–89.0)	0	78.0 (69.0–85.0)	0	.15
Long-term morbidity	14.0 (9.0–21.0)	15	18.0 (11.0–29.0)	19	.37
Recanalization rate	66.0 (58.0–74.0)	32	83.0 (68.0–91.0)	60	.05

Table 3:

Rescue therapy outcomes with GP IIb/IIIa inhibitors: IA versus IV administration

Outcome	IA GP IIb/IIIa % (95% CI)	I²	IV GP IIb/IIIa % (95% CI)	I²	P Value
Postoperative clinical stroke	14.0 (7.0–26.0)	70	14.0 (8.0–26.0)	0	.94
Postoperative infarct on imaging	33.0 (20.0–50.0)	58	23.0 (13.0–36.0)	28	.30
Postoperative hemorrhage	5.0 (3.0–9.0)	0	7.0 (3.0–15.0)	18	.66
Perioperative morbidity from stroke/hemorrhage	10.0 (7.0–15.0)	0	13.0 (6.0–27.0)	34	.57
Perioperative mortality from stroke/hemorrhage	6.0 (4.0–10.0)	0	8.0 (4.0–14.0)	0	.53
Long-term good neurologic outcome	83.0 (76.0–88.0)	0	78.0 (69.0–85.0)	10	.37
Long-term morbidity	14.0 (10.0–21.0)	0	17.0 (11.0–25.0)	2	.56
Recanalization rate	77.0 (66.0–85.0)	58	70.0 (57.0–80.0)	33	.36