Intrathecal Fibrinolysis for Aneurysmal Subarachnoid Hemorrhage: Evidence From Randomized Controlled Trials and Cohort Studies

The role of intrathecal fibrinolysis for the treatment of patients with aneurysmal subarachnoid hemorrhage (aSAH) has been widely investigated; however, the results have been contradictory. In our study, we conducted a meta-analysis to evaluate the safety and efficacy of intrathecal (intracisternal...

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Bibliographic Details
Published in:Frontiers in neurology 2019-08, Vol.10, p.885-885
Main Authors: Lu, Xiaocheng, Ji, Chengyuan, Wu, Jiang, You, Wanchun, Wang, Wei, Wang, Zhong, Chen, Gang
Format: Article
Language:English
Subjects:
aneurysmal subarachnoid hemorrhage
delayed ischemic neurological deficit
intracisternal fibrinolysis
intraventricular fibrinolysis
meta-analysis
Neurology
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Summary:The role of intrathecal fibrinolysis for the treatment of patients with aneurysmal subarachnoid hemorrhage (aSAH) has been widely investigated; however, the results have been contradictory. In our study, we conducted a meta-analysis to evaluate the safety and efficacy of intrathecal (intracisternal or intraventricular) fibrinolysis for aSAH. PubMed, Web of Science, Embase, Medline, and the Cochrane library databases were searched up to February 1, 2019. The outcomes analyzed were neurologic recovery, delayed ischemic neurologic deficit (DIND), mortality, and the incidence of chronic hydrocephalus and hemorrhage. A total of 21 studies comprising 1,373 patients were analyzed, including nine randomized controlled trials (RCTs) and 12 non-RCTs. The results showed that intracisternal fibrinolysis significantly decreased poor neurologic outcomes (RR = 0.62, 95% CI = 0.50-0.76, < 0.001) and reduced the incidence of DIND (RR = 0.52, 95% CI = 0.41-0.65, P
ISSN:1664-2295
1664-2295
DOI:10.3389/fneur.2019.00885