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Diagnostic accuracy of CT angiography and CT perfusion imaging for detecting distal medium vessel occlusions: Protocol for a systematic review and meta-analysis

dc.contributor.authorSousa, JA
dc.contributor.authorSondermann, A
dc.contributor.authorBernardo-Castro, S
dc.contributor.authorVarela, R
dc.contributor.authorDonato, H
dc.contributor.authorSargento-Freitas, J
dc.date.accessioned2023-09-11T15:39:37Z
dc.date.available2023-09-11T15:39:37Z
dc.date.issued2023
dc.description.abstractBackground: Distal medium vessel occlusions (DMVOs) represent 25-40% of all acute ischemic strokes (AIS). DMVO clinical syndromes are heterogenous, but as eloquent brain regions are frequently involved, they are often disabling. Since current intravenous fibrinolytic therapies may fail to recanalize up to two-thirds of DMVOs, endovascular treatment is progressively being considered in this setting. Nevertheless, the optimal imaging method for diagnosis remains to be defined. Stroke centers that use computed tomography as a routine stroke imaging approach rely on either isolated computed tomography angiography (CTA) or combined perfusion (CTP) studies. Despite a simplified non-CTP-dependent approach seeming reasonable for large vessel occlusion AIS diagnosis, CTP may still hold advantages for DMVOs workup. Therefore, this systematic review aims to compare the diagnostic performance of CTA and CTP in detecting DMVOs. Methods: We will perform a systematic search in PubMed, EMBASE, Web of Science Core Collection, and Cochrane Central Register of Controlled Trials. In addition, grey literature and ClinicalTrials.gov will be scanned. We will include any type of study that presents data on the diagnostic accuracy of CTA and/or CTP for detecting DMVOs. Two authors will independently review retrieved studies, and any discrepancies will be resolved by consensus or with a third reviewer. Reviewers will extract the data and assess the risk of bias in the selected studies. Data will be combined in a quantitative meta-analysis following the guidelines provided by the Cochrane Handbook for Systematic Reviews of Interventions. We will assess cumulative evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Discussion: This will be the first systematic review and meta-analysis that compares two different imaging approaches for detecting DMVOs. This study may help to define optimal acute ischemic stroke imaging work-up. Trial registration: PROSPERO registration: CRD42022344006.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationPLoS One. 2023 Apr 10;18(4):e0284116.pt_PT
dc.identifier.doi10.1371/journal.pone.0284116pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.4/2340
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectAngiografia por Tomografia Computorizadapt_PT
dc.subjectAcidente Vascular Cerebralpt_PT
dc.subjectMeta-análisept_PT
dc.subjectRevisão Sistemáticapt_PT
dc.titleDiagnostic accuracy of CT angiography and CT perfusion imaging for detecting distal medium vessel occlusions: Protocol for a systematic review and meta-analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue4pt_PT
oaire.citation.startPagee0284116pt_PT
oaire.citation.titlePLOS ONEpt_PT
oaire.citation.volume18pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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