Efficacy And Safety Of Intravenous Thrombolysis Treatment For Acute Cerebral Infarction With Intracranial Aneurysm: A Meta-analysis

Objective:To evaluate the clinical efficacy and safety of intravenous thrombolytic therapy among patients with acute cerebral infarction complicated with intracranial aneurysm within the time window of thrombolytic therapy,in order to provide evidence-based evidence for the selection of clinical thrombolytic patients and the decision-making of thrombolytic therapy.Methods:We searched databases including Pubmed,EMBASE,Metsrt data,MEDLINE,Cochrane Library databases,CBM,Wan Fang Data,CNKI and Google scholar.The literature is screened according to the inclusion and exclusion criteria,data extraction and literature quality assessment were performed,Revman 5.3 and stata15.1 software were used for meta-analysis to compare the efficacy and safety of intravenous thrombolysis in patients with acute cerebral infarction between intracranial aneurysm group and without intracranial aneurysm group.Results:A total of 10 retrospective cohort study were 2133 cases of patients.The meta-analysis results showed that compared with patients with acute cerebral infarction in the intracranial aneurysm group and without intracranial aneurysm group,there was no statistically significant difference in the effective rate（RR=0.96,,95%CI[0.66-1.40],P=0.829）,the good prognosis rate of 3 months（RR=1.02,95%CI[0.88-1.17],P=0.836）,the risk of intracerebral hemorrhage（RR=1.16,95%CI[0.80-1.70],P=0.428）,the risk of symptomatic intracerebral hemorrhage（OR=1.25,95%CI[0.57-2.77],P=0.576）,the risk of subarachnoid hemorrhage（OR=1.04,95%CI[0.25-4.32],P=0.961）,and the risk of death during hospitalization（OR=0.75,95%CI[0.21-2.66],P=0.653）after intravenous thrombolysis.Conclusion:Intravenous thrombolytic therapy can improve the clinical symptoms and prognosis of patients with acute cerebral infarction with or without non-giant intracranial aneurysm.Intravenous thrombolytic therapy does not increase the risk of bleeding in patients with acute cerebral infarction complicated with non-giant intracranial aneurysm.Within the time window,intravenous thrombolysis may be an safe and effective treatment for acute cerebral infarction with non-giant intracranial aneurysm.