2025 American Academy of Neurology Abstract Website

Kenzo Ogasawara¹, Ocilio Goncalves², Saul Dominici³, Beatriz Araújo⁴, Marcelo Costa⁵, Kelson Almeida⁶
¹Department of Medicine, Bahiana School of Medicine and Public Health, ²Deparment of Medicine, Federal University of Piauí, ³Deparment of Medicine, Federal University of Maranhão, ⁴Deparment of Medicine, Nove de Julho University, ⁵Department of Medicine, Wright State University Boonshoft, ⁶Department of Medicine, Federal University of Piauí

Objective:

To assess the impact of chronic kidney disease on efficacy and safety outcomes in acute ischemic stroke patients treated with endovascular thrombectomy.

Background:

There is a lack of evidence in the literature regarding how chronic kidney disease (CKD) impacts efficacy and safety outcomes in acute ischemic stroke (AIS) patients treated with endovascular thrombectomy.

Design/Methods:

This systematic review and meta-analysis were performed and reported following the Cochrane Collaboration Handbook for Systematic Reviews of Interventions and the PRISMA 2020. PubMed, Embase and Cochrane databases were used to perform the selection. The R software (version 4.4.1.) was used to perform the meta-analysis. The risk ratio (95% confidence interval) and the Mantel-Haenszel method of random-effects model were chosen to assess binary outcomes, while Higgins test (I²) was used to assess heterogeneity. The outcomes evaluated were successful reperfusion, intracranial hemorrhage, in-hospital death and modified Rankin Scale (mRS) score of 0-2 in 90 days.

Results:

Of 656 studies found in databases, 7 were included. This meta-analysis showed that successful reperfusion was not different between groups (RR 0.96; 95% CI 0.92-1.01; I² = 36%), as well as intracranial hemorrhage was the same between both groups (RR 1.05; 95% CI 0.80-1.39; I² = 60%) However, in-hospital mortality was higher in CKD patients compared to non-CKD patients (RR 1.62; 95% CI 1.51-1.77; I² = 0%) and mRS 0-2 in 90 days was less prevalent in CKD patients than non-CKD patients (RR 0.70; 95% CI 0.60-0.82; I² = 38%).

Conclusions:

Chronic kidney disease (CKD) is a risk factor for in-hospital mortality and it worsens mRS score in 90 days between acute ischemic stroke (AIS) patients treated with endovascular thrombectomy. Still, the disease showed no significant influence in successful reperfusion and intracranial hemorrhage events.