Intraprocedural Angiographic Signs Observed During Endovascular Thrombectomy in Patients With Acute Ischemic Stroke A Systematic Review

Objective In the real-world practice of endovascular thrombectomy (EVT) for acute ischemic stroke (AIS), the analysis of intraprocedural angiographic signs (IPASs) still challenges neurointerventionists. This review provides insights into the significance of these subtle changes for predicting underlying etiology, technical feasibility, and patient prognosis, thus promoting the potential real-time application of these signs. Methods A systematic literature search was conducted using PubMed, Ovid Medline/Embase, and Cochrane. The search focused on studies published between January 1995 and August 2020 that reported findings related to intraprocedural angiographic manifestations in endovascular recanalization therapy for AIS. Results We identified 12 IPASs in 22 studies involving 1,683 patients. The IPASs were assigned into 3 subsets according to their clinical meanings. Conclusion The systematic analysis of IPAS in clinical trials and practice will lead to a better understanding of treatment effects, responses, and mechanisms during EVT. Studies of larger cohorts using more robust statistical methods are needed.

Automated summary

This review highlights the challenges neurointerventionists face in analyzing intraprocedural angiographic signs during endovascular thrombectomy for acute ischemic stroke. By identifying 12 IPASs in 22 studies involving 1,683 patients and categorizing them into 3 subsets based on clinical meanings, the study emphasizes the importance of systematic analysis in understanding treatment effects, responses, and mechanisms during EVT. Larger cohort studies using robust statistical methods are needed for further research.