What do systematic reviews say?

Conservative treatment vs endovascular coiling

• Treatments for unruptured intracranial aneurysms 2021 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 80 participants
  Very low

Microsurgical clipping vs endovascular coiling

• Treatments for unruptured intracranial aneurysms 2021 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 104 participants
  Very low

Dual vs one antiplatelet agent

Dual probably leads to lower stroke compared with one antiplatelet agent (moderate certainty).

• Multiple versus fewer antiplatelet agents for preventing early recurrence after ischaemic stroke or transient… 2020 · Cochrane Headline outcomes only
  RR 0.71 [0.62, 0.8]
  13 studies · 13637 participants
  Moderate

Multiple vs fewer antiplatelet agents

Multiple probably leads to lower stroke compared with fewer antiplatelet agents (moderate certainty).

• Multiple versus fewer antiplatelet agents for preventing early recurrence after ischaemic stroke or transient… 2020 · Cochrane Headline outcomes only
  RR 0.73 [0.66, 0.82]
  14 studies · 16707 participants
  Moderate

Standard‐dose VKA plus single antiplatelet agent vs one antiplatelet agent

It is very uncertain whether standard‐dose VKA plus single antiplatelet agent changes stroke compared with single antiplatelet agent (very low certainty).

• Antiplatelet and anticoagulant agents for secondary prevention of stroke and other thromboembolic events in people… 2020 · Cochrane Headline outcomes only
  RR 0.14 [0.01, 2.6]
  1 study · 40 participants
  Very low

Standard‐dose VKA plus single antiplatelet agent vs dual antiplatelet agent

It is very uncertain whether standard‐dose VKA plus single antiplatelet agent changes stroke compared with dual antiplatelet agent (very low certainty).

• Antiplatelet and anticoagulant agents for secondary prevention of stroke and other thromboembolic events in people… 2020 · Cochrane Headline outcomes only
  RR 5 [0.26, 98]
  1 study · 40 participants
  Very low

Dual antiplatelet therapy vs one antiplatelet agent

It is very uncertain whether dual antiplatelet agent changes stroke compared with single antiplatelet agent (very low certainty).

• Antiplatelet and anticoagulant agents for secondary prevention of stroke and other thromboembolic events in people… 2020 · Cochrane Headline outcomes only
  RR 0.14 [0.01, 2.6]
  1 study · 40 participants
  Very low

Anticoagulant drugs: VKA high dose vs vitamin K antagonist (VKA)

High‐dose VKA showed no clear difference in strokea compared with standard‐dose VKA (low certainty).

• Antiplatelet and anticoagulant agents for secondary prevention of stroke and other thromboembolic events in people… 2020 · Cochrane Headline outcomes only
  RR 1.37 [0.26, 7.12]
  2 studies · 223 participants
  Low

Standard‐dose VKA plus single antiplatelet agent vs vitamin K antagonist (VKA)

Standard‐dose VKA plus single antiplatelet agent showed no clear difference in strokea compared with standard‐dose VKA (low certainty).

• Antiplatelet and anticoagulant agents for secondary prevention of stroke and other thromboembolic events in people… 2020 · Cochrane Headline outcomes only
  RR 4.45 [0.48, 41]
  1 study · 82 participants
  Low

NOAC (rivaroxaban) vs vitamin K antagonist (VKA)

NOAC (rivaroxaban) probably leads to higher strokea compared with standard‐dose VKA (moderate certainty).

• Antiplatelet and anticoagulant agents for secondary prevention of stroke and other thromboembolic events in people… 2020 · Cochrane Headline outcomes only
  RR 14.13 [1.87, 106.81]
  3 studies · 425 participants
  Moderate

Intervention not reported

The intervention leads to lower all strokes (high certainty).

• Factor Xa inhibitors versus vitamin K antagonists for preventing cerebral or systemic embolism in patients with atrial… 2018 · Cochrane Headline outcomes only
  OR 0.89 [0.81, 0.97]
  13 studies · 67449 participants
  High

Endovascular therapy plus conventional medical treatment vs conventional medical treatment alone

Endovascular therapy plus conventional medical treatment probably leads to higher death or stroke compared with conventional medical treatment alone (moderate certainty).

• Endovascular therapy versus medical treatment for symptomatic intracranial artery stenosis 2023 · Cochrane Headline outcomes only
  RR 2.93 [1.81, 4.75]
  4 studies · 989 participants
  Moderate

RIC vs non‐RIC treating ischaemic stroke

• Remote ischaemic conditioning for preventing and treating ischaemic stroke 2018 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 175 participants
  Very low

RIC vs non‐RIC

• Remote ischaemic conditioning for preventing and treating ischaemic stroke 2018 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 189 participants
  Low

Dual vs one antiplatelet agent

Dual leads to lower ischaemic stroke compared with one antiplatelet agent (high certainty).

• Multiple versus fewer antiplatelet agents for preventing early recurrence after ischaemic stroke or transient… 2020 · Cochrane Headline outcomes only
  RR 0.7 [0.61, 0.81]
  2 studies · 10051 participants
  High

Multiple vs fewer antiplatelet agents

Multiple leads to lower ischaemic stroke compared with fewer antiplatelet agents (high certainty).

• Multiple versus fewer antiplatelet agents for preventing early recurrence after ischaemic stroke or transient… 2020 · Cochrane Headline outcomes only
  RR 0.73 [0.64, 0.83]
  3 studies · 13121 participants
  High

Endovascular therapy plus conventional medical treatment vs conventional medical treatment alone

Endovascular therapy plus conventional medical treatment probably leads to higher ipsilateral stroke compared with conventional medical treatment alone (moderate certainty).

• Endovascular therapy versus medical treatment for symptomatic intracranial artery stenosis 2023 · Cochrane Headline outcomes only
  RR 3.26 [1.94, 5.48]
  4 studies · 989 participants
  Moderate

Endovascular therapy plus conventional medical treatment vs medical treatment

Endovascular treat ment plus medical treatment showed no clear difference in stroke or TIAMedian compared with medical treatment alone (moderate certainty).

• Percutaneous transluminal angioplasty and stenting for vertebral artery stenosis 2022 · Cochrane Headline outcomes only
  RR 0.65 [0.39, 1.06]
  2 studies · 234 participants
  Moderate

Chlormethiazole vs placebo

• Gamma aminobutyric acid (GABA) receptor agonists for acute stroke 2018 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 1367 participants
  Moderate

Diazepam vs placebo

The review found no eligible studies for this question.

• Gamma aminobutyric acid (GABA) receptor agonists for acute stroke 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found