The impact of COVID 19 on the outcomes of thrombectomy in stroke patients: A systematic review and meta‐analysis

Abstract

We aimed to conduct the current meta‐analysis to provide better insight into the efficacy of mechanical thrombectomy (MT) in managing COVID‐19 patients suffering from a stroke. An electronic search was conducted through eight databases for collecting the current evidence about the efficacy of MT in stroke patients with COVID‐19 until 18 December 2021. The results were reported as the pooled prevalence rates and the odds ratios (ORs), with their corresponding 95% confidence intervals (CI). Out of 648 records, we included nine studies. The prevalence of stroke patients with COVID‐19 who received MT treatment was with TICI ≥2b 79% (95%CI: 73–85), symptomatic intracranial haemorrhage 6% (95%CI: 3–11), parenchymal haematoma type 1, 11.1% (95%CI: 5–23), and mortality 29% (95%CI: 24–35). On further comparison of MT procedure between stroke patients with COVID 19 to those without COVID‐19, we found no significant difference in terms of TICI ≥2b score (OR: 0.85; 95%CI: 0.03–23; p = 0.9). However, we found that stroke patients with COVID‐19 had a significantly higher mortality rate than stroke patients without COVID‐19 after MT procedure (OR: 2.99; 95%CI: 2.01–4.45; p < 0.001). Stroke patients with COVID‐19 can be safely and effectively treated with MT, with comparable reperfusion and complication rates to those without the disease.

Mechanical Thrombectomy in Acute Ischemic Stroke COVID-19 and Non-COVID-19 Patients: A Single Comprehensive Stroke Center Study

“…Our laboratory analysis was in accordance with these studies. When analyzing the outcome of mechanical thrombectomy procedures, our report showed similar results to some studies regarding a favorable recanalization mTICI score (>2B), which was comparable in COVID-19 and non-COVID-19 groups, as reported earlier [ 11 , 36 , 37 ]. Studies, including ours, did not find a correlation between procedure-related complications such as sICH or SAH [ 11 , 12 , 36 , 37 ], and occurrence of ICH was comparable with large studies [ 38 ].…”

“…When analyzing the outcome of mechanical thrombectomy procedures, our report showed similar results to some studies regarding a favorable recanalization mTICI score (>2B), which was comparable in COVID-19 and non-COVID-19 groups, as reported earlier [ 11 , 36 , 37 ]. Studies, including ours, did not find a correlation between procedure-related complications such as sICH or SAH [ 11 , 12 , 36 , 37 ], and occurrence of ICH was comparable with large studies [ 38 ]. The modified Rankin Scale score, as a rank of functional independence after AIS, showed no difference between our groups, as previously reported [ 37 ], although some studies reported higher mortality rate in COVID-19 patients [ 25 , 36 ].…”

“…Studies, including ours, did not find a correlation between procedure-related complications such as sICH or SAH [ 11 , 12 , 36 , 37 ], and occurrence of ICH was comparable with large studies [ 38 ]. The modified Rankin Scale score, as a rank of functional independence after AIS, showed no difference between our groups, as previously reported [ 37 ], although some studies reported higher mortality rate in COVID-19 patients [ 25 , 36 ]. Larger groups of patients should be investigated to establish the correlation between SARS-CoV-2 infection and higher mortality after acute ischemic stroke.…”

Coronavirus disease 2019 and acute cerebrovascular events: a comprehensive overview

“…Comparing TICI ≥2b scores between COVID-19 and non-COVID-19 stroke patients treated with MT, they found no significant difference. However, mortality after MT surgery was substantially higher in COVID-19 stroke patients compared to non-COVID-19 stroke patients ( 84 ). The recanalization status, NIHSS score at 24 h after MT, and sICH were predictors of mortality after MT in patients with AIS ( 81 ).…”

Etiologies, Evaluation, and Differential Diagnosis of Dysphonia

“…This approach can be remarkably useful in the evaluation process since some details cannot be obtained by rigid or flexible endoscopic approaches. Stroboscopy-based surveillance might also be useful in evaluating patients suffering from related malignancies (21,22).…”