Abstract
BACKGROUND: Wake-up stroke represents a significant challenge in acute treatment and care. Thrombolysis has been extensively studied in the wake-up stroke population. However, mechanical thrombectomy in wake-up stroke exclusively has not been well studied. We performed a systematic review and meta-analysis to assess the clinical and functional outcomes of patients undergoing mechanical thrombectomy for wake-up stroke. METHODS: We performed a systematic review of the literature using publically accessible databases. Data extraction was completed using Nested Knowledge AutoLit software. Outcomes of interest included modified Rankin Scale (mRS) 0-2, mortality, symptomatic intracerebral hemorrhage (sICH), and thrombolysis in cerebral infarction (TICI) score 2b/3. Statistical analysis was performed using R software version 4.1.2. RESULTS: A total of 12 studies were included in our study with a total of 510 patients included. Patients with wake-up stroke were found to have good functional outcome (mRS 0-2) in 46.2% of patients and successful reperfusion (TICI 2b/3) was seen in 83.5% of patients. Mortality was observed in 20.4% of patients with sICH seen in 8.3%. CONCLUSION: Mechanical thrombectomy for patients with wake-up stroke was found to have favorable rates of good functional outcomes and relatively low rates of adverse events.