{"id":"https://openalex.org/W4394599241","doi":"https://doi.org/10.1212/wnl.0000000000204408","title":"Extracranial-intracranial (EC-IC) Bypass Versus Medical Therapy Alone in Patients with Symptomatic Artery Occlusion: A Systematic Review and Meta-analysis (P8-5.030)","display_name":"Extracranial-intracranial (EC-IC) Bypass Versus Medical Therapy Alone in Patients with Symptomatic Artery Occlusion: A Systematic Review and Meta-analysis (P8-5.030)","publication_year":2024,"publication_date":"2024-04-09","ids":{"openalex":"https://openalex.org/W4394599241","doi":"https://doi.org/10.1212/wnl.0000000000204408"},"language":"en","primary_location":{"id":"doi:10.1212/wnl.0000000000204408","doi":"https://doi.org/10.1212/wnl.0000000000204408","is_oa":false,"landing_page_url":"https://doi.org/10.1212/wnl.0000000000204408","pdf_url":null,"source":{"id":"https://openalex.org/S79704628","display_name":"Neurology","issn_l":"0028-3878","issn":["0028-3878","1526-632X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Neurology","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5059399373","display_name":"Marianna Gerardo Hidalgo Santos Jorge Leite","orcid":"https://orcid.org/0000-0001-5816-1438","observed_orcids":["https://orcid.org/0000-0001-5816-1438"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Marianna Gerardo Hidalgo Santos Jorge Leite","raw_affiliation_strings":["Santa Marcelina College of Medicine"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Santa Marcelina College of Medicine","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5044251466","display_name":"Artur Menegaz de Almeida","orcid":"https://orcid.org/0009-0004-3869-7373","observed_orcids":["https://orcid.org/0009-0004-3869-7373"]},"institutions":[{"id":"https://openalex.org/I32725510","display_name":"Universidade Federal de Mato Grosso","ror":"https://ror.org/01mqvjv41","country_code":"BR","type":"education","lineage":["https://openalex.org/I32725510"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Artur Menegaz de Almeida","raw_affiliation_strings":["Federal University of Mato Grosso"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Federal University of Mato Grosso","institution_ids":["https://openalex.org/I32725510"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5005839508","display_name":"Maria Eduarda Cavalcanti Souza","orcid":"https://orcid.org/0000-0002-7244-6461","observed_orcids":["https://orcid.org/0000-0002-7244-6461"]},"institutions":[{"id":"https://openalex.org/I71437568","display_name":"Universidade de Pernambuco","ror":"https://ror.org/00gtcbp88","country_code":"BR","type":"education","lineage":["https://openalex.org/I71437568"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Maria Eduarda Cavalcanti Souza","raw_affiliation_strings":["University of Pernambuco"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Pernambuco","institution_ids":["https://openalex.org/I71437568"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5015897227","display_name":"Lucca Moreira Lopes","orcid":"https://orcid.org/0000-0002-2770-2198","observed_orcids":["https://orcid.org/0000-0002-2770-2198"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Lucca Lopes","raw_affiliation_strings":["Sciences Medical School of Santos"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Sciences Medical School of Santos","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5094581831","display_name":"Vict\u00f3ria Morbach","orcid":"https://orcid.org/0009-0003-0326-647X","observed_orcids":["https://orcid.org/0009-0003-0326-647X"]},"institutions":[{"id":"https://openalex.org/I145689991","display_name":"Universidade Feevale","ror":"https://ror.org/05gefd119","country_code":"BR","type":"education","lineage":["https://openalex.org/I145689991"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Vict\u00f3ria Morbach Siebel","raw_affiliation_strings":["Feevale University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Feevale University","institution_ids":["https://openalex.org/I145689991"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5093110103","display_name":"Renan Yuji Ura Sudo","orcid":"https://orcid.org/0000-0001-8117-2784","observed_orcids":["https://orcid.org/0000-0001-8117-2784"]},"institutions":[{"id":"https://openalex.org/I187420256","display_name":"Universidade Federal da Grande Dourados","ror":"https://ror.org/0310smc09","country_code":"BR","type":"education","lineage":["https://openalex.org/I187420256"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Renan Yuji Ura Sudo","raw_affiliation_strings":["Federal University of Great Dourados"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Federal University of Great Dourados","institution_ids":["https://openalex.org/I187420256"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":4,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.08444491,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"102","issue":"7_supplement_1","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10816","display_name":"Cerebrovascular and Carotid Artery Diseases","score":0.951200008392334,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10816","display_name":"Cerebrovascular and Carotid Artery Diseases","score":0.951200008392334,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10926","display_name":"Peripheral Artery Disease Management","score":0.02889999933540821,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10227","display_name":"Acute Ischemic Stroke Management","score":0.016499999910593033,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/extracranial-intracranial-bypass","display_name":"extracranial-intracranial bypass","score":0.9980000257492065},{"id":"https://openalex.org/keywords/symptomatic-carotid-stenosis","display_name":"symptomatic carotid stenosis","score":0.7630000114440918},{"id":"https://openalex.org/keywords/medical-therapy","display_name":"medical therapy","score":0.7229999899864197},{"id":"https://openalex.org/keywords/stroke-prevention","display_name":"stroke prevention","score":0.7149999737739563},{"id":"https://openalex.org/keywords/disabling-stroke","display_name":"disabling stroke","score":0.7179999947547913},{"id":"https://openalex.org/keywords/mortality","display_name":"mortality","score":0.703000009059906},{"id":"https://openalex.org/keywords/modified-rankin-scale","display_name":"modified Rankin Scale","score":0.8450000286102295},{"id":"https://openalex.org/keywords/functional-outcome","display_name":"functional outcome","score":0.49000000953674316},{"id":"https://openalex.org/keywords/hemodynamic-insufficiency","display_name":"hemodynamic insufficiency","score":0.6600000262260437},{"id":"https://openalex.org/keywords/medical-versus-surgical-treatment","display_name":"surgical versus medical treatment","score":0.4099999964237213},{"id":"https://openalex.org/keywords/randomized-controlled-trials","display_name":"randomized controlled trials","score":0.45100000500679016},{"id":"https://openalex.org/keywords/meta-analysis-of-trials","display_name":"meta-analysis of trials","score":0.48100000619888306},{"id":"https://openalex.org/keywords/risk-of-bias","display_name":"risk of bias","score":0.3059999942779541}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7918256521224976},{"id":"https://openalex.org/C95190672","wikidata":"https://www.wikidata.org/wiki/Q815382","display_name":"Meta-analysis","level":2,"score":0.72026526927948},{"id":"https://openalex.org/C2776268601","wikidata":"https://www.wikidata.org/wiki/Q968808","display_name":"Occlusion","level":2,"score":0.582160234451294},{"id":"https://openalex.org/C2994510025","wikidata":"https://www.wikidata.org/wiki/Q179661","display_name":"Medical therapy","level":2,"score":0.5559242963790894},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.3322979211807251},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.322068989276886}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1212/wnl.0000000000204408","doi":"https://doi.org/10.1212/wnl.0000000000204408","is_oa":false,"landing_page_url":"https://doi.org/10.1212/wnl.0000000000204408","pdf_url":null,"source":{"id":"https://openalex.org/S79704628","display_name":"Neurology","issn_l":"0028-3878","issn":["0028-3878","1526-632X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Neurology","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":1.0}],"study_designs":[{"id":"https://openalex.org/study-designs/systematic-review","display_name":"Systematic Review"},{"id":"https://openalex.org/study-designs/meta-analysis","display_name":"Meta-Analysis"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W4413783524","https://openalex.org/W4386046683","https://openalex.org/W2171083321","https://openalex.org/W3014827009","https://openalex.org/W1823949795","https://openalex.org/W2187287378","https://openalex.org/W2124657976","https://openalex.org/W2051545837","https://openalex.org/W1771986524","https://openalex.org/W1984832271"],"abstract_inverted_index":{"Objective:":[0],"We":[1],"aimed":[2],"to":[3,33,51,59,71,81,101,164,173,267,304,318,326,332,339,345,351],"perform":[4],"a":[5,83,247,274],"systematic":[6],"review":[7],"and":[8,37,114,153,231,296],"meta-analysis":[9],"of":[10,55,133,158,261,278],"EC-IC":[11,306],"bypass":[12,30,307],"outcomes":[13,132,265,311],"in":[14,41,108,282,287,309],"patients":[15,155],"with":[16,105,138],"radiologically":[17],"confirmed":[18],"atherosclerotic":[19,42],"occlusion":[20],"or":[21],"hemodynamic":[22],"insufficiency":[23],"from":[24,171],"artery":[25,43],"occlusion.":[26,44],"Background:":[27],"The":[28,167],"extracranial-intracranial":[29],"is":[31],"intended":[32],"prevent":[34],"subsequent":[35],"stroke":[36,190,204,280],"its":[38,46],"associated":[39],"events":[40],"However,":[45],"first":[47],"large":[48],"trial":[49],"failed":[50,80],"show":[52],"an":[53],"advantage":[54],"the":[56,64,73,89,94,103,131,139,262,288,299],"procedure":[57],"compared":[58],"regular":[60],"medical":[61],"treatment.":[62],"In":[63,75],"following":[65],"years":[66],"only":[67],"some":[68],"studies":[69,295],"attempted":[70],"solve":[72],"matter.":[74],"addition,":[76],"previous":[77],"promising":[78],"trials":[79,122],"reach":[82,246],"conclusion":[84],"for":[85,119,130,147,259,301],"various":[86],"reasons,":[87],"leaving":[88],"four-decade-long":[90],"controversy":[91],"unsolved.":[92],"Considering":[93],"most":[95],"recent":[96],"data":[97],"available,":[98],"we":[99],"sought":[100],"compare":[102],"intervention":[104],"non-surgical":[106],"treatment":[107],"this":[109],"population.":[110],"Design/Methods:":[111],"PubMed,":[112],"EMBASE,":[113],"Cochrane":[115],"databases":[116],"were":[117,156,162,291],"searched":[118],"randomized":[120],"controlled":[121],"(RCTs).":[123],"A":[124],"random":[125],"effects":[126],"model":[127],"was":[128,136,145,257],"used":[129,146],"interest.":[134],"Heterogeneity":[135,293],"examined":[137],"I":[140,186,200,214,228,241],"2":[141,187,201,215,229,242],"statistics.":[142],"R":[143],"software":[144],"statistical":[148,255],"analysis.":[149],"Results:":[150],"3":[151],"RCTs":[152,303],"1,896":[154],"included,":[157],"whom":[159],"921":[160],"(48,57%)":[161],"assigned":[163],"surgical":[165],"intervention.":[166],"mean":[168],"age":[169],"ranged":[170],"52":[172],"58":[174],"years.":[175],"Mortality":[176],"(2,41%":[177],"vs.":[178,192,206,220,235],"2,79%;":[179],"RR":[180],"0.90;":[181],"95%":[182,196,210,224],"CI":[183,197,211,225],"0.51\u20131.60;":[184],"p=0.721;":[185],"=29%),":[188],"disabling":[189,279],"(4,5%":[191],"1,9%;":[193],"OR":[194,208,222,237],"2.32;":[195],"0.79\u20136.78;":[198],"p=0.125;":[199],"=0%),":[202,230],"fatal":[203],"(1,6%":[205],"0,7%;":[207],"1.65;":[209],"0.12\u201322.44;":[212],"p=0.706;":[213],"=47%),":[216],"mRS":[217,232],"0\u20131":[218],"(72%":[219],"68%;":[221],"1.30;":[223],"0.85\u20132.00;":[226],"p=0.228;":[227],"0\u20132":[233],"(84%":[234],"87%;":[236],"0.70;":[238],"0.41\u20131.22;":[239],"p=0.208;":[240],"=0%)":[243],"did":[244],"not":[245],"statistically":[248],"significant":[249],"difference":[250,256],"between":[251],"groups.":[252],"Conclusions:":[253],"No":[254],"observed":[258],"any":[260],"5":[263],"assessed":[264],"due":[266],"limited":[268],"available":[269],"data.":[270],"While":[271],"trends":[272],"suggest":[273],"slightly":[275],"higher":[276],"risk":[277],"post-surgery":[281],"individual":[283],"studies,":[284],"confidence":[285],"intervals":[286],"pooled":[289],"analysis":[290],"wide.":[292],"among":[294],"limitations":[297],"emphasize":[298],"need":[300],"larger":[302],"understand":[305],"role":[308],"stroke-related":[310],"prevention.":[312],"Disclosure:":[313],"Miss":[314,328,341],"Leite":[315],"has":[316,324,330,337,343,349],"nothing":[317,325,331,338,344,350],"disclose.":[319,327,333,340,346,352],"Mr.":[320,334,347],"Menegaz":[321],"de":[322],"Almeida":[323],"Souza":[329],"Moreira":[335],"Lopes":[336],"Siebel":[342],"Sudo":[348]},"counts_by_year":[],"updated_date":"2026-11-08T12:12:28.789561","created_date":"2024-04-10T00:00:00"}
