The review included 22 studies (n=147): 14 case series (n=139, sample size range two to 34) and eight single-case reports. Out of a maximum of 4 points for quality, 13 studies scored 1 point, four scored 2 points, three scored 3 points and two scored 4 points. Among the case series, five studies enrolled consecutive patients, eight studies based patient selection on a priori criteria and four studies conducted blinded outcomes assessment. All studies had an adequate duration of follow-up.
Outcomes within procedure group: The odds of death were significantly higher among patients in whom the procedure did not restore arterial flow than among those in whom it did (OR 2.4, 95% CI: 1.14, 5.03, p=0.02). The odds of a good functional outcome were significantly higher in the latter group (OR 3.94, 95% CI: 1.90, 8.17, p=0.002) and this finding remained statistically significant after adjustment for initial NIHSS score.
Other findings were also reported in the review, including the results of subgroup analyses.
Outcomes in procedure group versus matched cohort: A good functional outcome was significantly more likely in the procedure group (n=84) than in the matched cohort (n=84) (unadjusted OR 4.4, 95% CI: 1.9, 10.00, p<0.001; adjusted OR 14.9, 95% CI: 4.4, 50.0, p<0.001). There was a non-significant trend for 90-day mortality to be higher in the matched cohort (n=70) than in the procedure group (n=116) (adjusted OR 2.2, 95% CI: 0.98, 5.1, p=0.06).