{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T09:01:38Z","timestamp":1780736498260,"version":"3.54.1"},"reference-count":64,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>While several studies have compared the feasibility and safety of mechanical thrombectomy (MT) for distal large-vessel occlusion (LVO) strokes in patients, few studies have compared MT with intravenous thrombolysis (IVT) alone. The purpose of this systematic review was to compare the effectiveness and safety between MT and standard medical management with IVT alone for patients with distal LVOs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      PubMed, Google Scholar, Embase, Scopus, Web of Science, Ovid Medline, and Cochrane Library were searched in order to identify studies that directly compared MT with IVT for distal LVOs (anterior cerebral artery A\n                      <jats:sub>2<\/jats:sub>\n                      , middle cerebral artery M\n                      <jats:sub>3\u20134<\/jats:sub>\n                      , and posterior cerebral artery P\n                      <jats:sub>2\u20134<\/jats:sub>\n                      ). Primary outcomes of interest included a modified Rankin Scale (mRS) score of 0 to 2 at 90 days posttreatment, occurrence of symptomatic intracerebral hemorrhage (sICH), and all-cause mortality at 90 days posttreatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Four studies representing a total of 381 patients were included in this meta-analysis. The pooled results indicated that the proportion of patients with an mRS score of 0 to 2 at 90 days (OR 1.16, 95% CI 0.23\u20135.93; p = 0.861), the occurrence of sICH (OR 2.45, 95% CI 0.75\u20138.03; p = 0.140), and the mortality rate at 90 days (OR 1.73, 95% CI 0.66\u20134.55; p = 0.263) did not differ between patients who underwent MT and those who received IVT alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The meta-analysis did not demonstrate a significant difference between MT and standard medical management with regard to favorable outcome, occurrence of sICH, or 90-day mortality. Prospective clinical trials are needed to further compare the efficacy of MT with IVT alone for distal vessel occlusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2021.4.focus21139","type":"journal-article","created":{"date-parts":[[2021,7,1]],"date-time":"2021-07-01T07:33:57Z","timestamp":1625124837000},"page":"E5","source":"Crossref","is-referenced-by-count":37,"title":["Mechanical thrombectomy versus intravenous thrombolysis for distal large-vessel occlusion: a systematic review and meta-analysis of observational studies"],"prefix":"10.3171","volume":"51","author":[{"given":"Muhammad","family":"Waqas","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathleen C.","family":"Kuo","sequence":"additional","affiliation":[{"name":"Jacobs School of Medicine and Biomedical Sciences, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rimal H.","family":"Dossani","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ammad A.","family":"Baig","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Modhi","family":"Alkhaldi","sequence":"additional","affiliation":[{"name":"Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin M.","family":"Cappuzzo","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elad I.","family":"Levy","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"},{"name":"Canon Stroke and Vascular Research Center, University at Buffalo;"},{"name":"Jacobs Institute, Buffalo, New York; and"},{"name":"Radiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adnan H.","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"},{"name":"Canon Stroke and Vascular Research Center, University at Buffalo;"},{"name":"Jacobs Institute, Buffalo, New York; and"},{"name":"Radiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"24","key":"r1","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"2285","DOI":"10.1056\/NEJMoa1415061","article-title":"Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke","volume":"372","author":"Saver JL","year":"2015","unstructured":"Saver JL, Goyal M, Bonafe A,  Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. 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