| Autor: |
Jayyusi F; Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan., AlBarakat MM; Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan., Al-Rousan HH; Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan., Alawajneh MM; Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan., Alkasabrah AR; Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan., Abujaber M; Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan., Aldabbas ME; Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan., Abuelsamen M; Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan., Alshgerat Y; Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan., Sayuri Y; Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan., Alhertani N; Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan., BaniAmer M; Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan., Shari I; Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan., Brašić JR; Department of Psychiatry, New York City Health and Hospitals/Bellevue, New York, NY 10016, USA.; Department of Psychiatry, New York University Grossman School of Medicine, New York University Langone Health, New York, NY 10016, USA.; Section of High-Resolution Brain Positron Emission Tomography Imaging, Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. |
| Abstrakt: |
Although free-floating thrombus (FFT) poses a significant risk of stroke or transient ischemic attack (TIA), optimal management strategies are uncertain. To determine the state-of-the-art of medical interventions for FFT, we conducted a systematic review of the efficacy of various medical interventions and factors influencing FFT resolution and recurrence. A comprehensive search of Embase, PubMed, and ScienceDirect identified 61 studies encompassing 179 patients with FFT-related stroke or TIA treated with anticoagulants, antiplatelets, or their combinations. Primary outcomes assessed were stroke recurrence and thrombus resolution. Statistical analyses (Fisher's exact test, chi-square test, Mann-Whitney test, and Kruskal-Wallis test) utilized significance set at p < 0.05. Over a median follow-up of 7 months, thrombus resolution occurred in 65% of patients, while 11.2% experienced recurrence, primarily as TIAs. Cardioembolism was significantly less common in resolved cases ( p = 0.025). Combination therapy (antiplatelets, anticoagulants, and statins) significantly enhanced clot resolution (OR 11.4; 95% CI 1.436-91.91; p = 0.021) compared to monotherapies. Ulcerated plaque was a significant predictor of recurrence (OR 8.2; 95% CI 1.02-66.07; p = 0.048). These findings underscore the superiority of combination therapy in FFT management and highlight the need for targeted interventions in patients with ulcerated plaques to mitigate recurrence risk. |
