Open Access

Impact of collateral circulation status on favorable outcomes in thrombolysis treatment: A systematic review and meta-analysis

  • Authors:
    • Alimu Wufuer
    • Atikaimu Wubuli
    • Peierdun Mijiti
    • Jun Zhou
    • Shabier Tuerxun
    • Jian Cai
    • Jianhua Ma
    • Xiaoning Zhang
  • View Affiliations

  • Published online on: November 10, 2017     https://doi.org/10.3892/etm.2017.5486
  • Pages:707-718
  • Copyright: © Wufuer et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Collateral circulation affects the prognosis of patients with acute ischemic stroke (AIS) treated by thrombolysis. The present study performed a systematic assessment of the impact of the collateral circulation status on the outcomes of patients receiving thrombolysis treatment. Relevant full‑text articles from the Cochrane Library, Ovid, Medline, Embase and PubMed databases published from January 1, 2000 to November 1, 2016 were retrieved. The quality of the studies was assessed and data were extracted by 2 independent investigators. The random‑effects model was used to estimate the impact of good vs. poor collateral circulation, as well as baseline characteristics, on the outcome within the series presented as risk ratios. Subgroup analyses explored the potential factors that may interfere with the effects of the collateral circulation status on the outcome. A total of 29 studies comprising 4,053 patients were included in the present meta‑analysis. A good collateral circulation status was revealed to have a beneficial effect on favorable functional outcome (modified Rankin scale, 0‑3 at 3‑6 months; P<0.001) and a higher rate of recanalization (P<0.001) compared with poor collateral circulation. Good collateral circulation was also associated with a lower rate of symptomatic intracranial hemorrhage (P<0.01), a lower rate of mortality (P<0.01) and a smaller infarct size (P<0.01). In conclusion, good collateral circulation was demonstrated to have a favorable prognostic value regarding the outcome for patients with AIS receiving thrombolysis treatment. Assessment of collateral circulation and penumbra area during pre‑treatment imaging within an appropriate time‑window prior to thrombolytic therapy will therefore improve the identification of AIS patients who may benefit from thrombolysis treatment.

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January 2018
Volume 15 Issue 1

Print ISSN: 1792-0981
Online ISSN:1792-1015

2016 Impact Factor: 1.261
Ranked #50/128 Medicine Research and Experimental
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APA
Wufuer, A., Wubuli, A., Mijiti, P., Zhou, J., Tuerxun, S., Cai, J. ... Zhang, X. (2018). Impact of collateral circulation status on favorable outcomes in thrombolysis treatment: A systematic review and meta-analysis. Experimental and Therapeutic Medicine, 15, 707-718. https://doi.org/10.3892/etm.2017.5486
MLA
Wufuer, A., Wubuli, A., Mijiti, P., Zhou, J., Tuerxun, S., Cai, J., Ma, J., Zhang, X."Impact of collateral circulation status on favorable outcomes in thrombolysis treatment: A systematic review and meta-analysis". Experimental and Therapeutic Medicine 15.1 (2018): 707-718.
Chicago
Wufuer, A., Wubuli, A., Mijiti, P., Zhou, J., Tuerxun, S., Cai, J., Ma, J., Zhang, X."Impact of collateral circulation status on favorable outcomes in thrombolysis treatment: A systematic review and meta-analysis". Experimental and Therapeutic Medicine 15, no. 1 (2018): 707-718. https://doi.org/10.3892/etm.2017.5486