Trial reportNeurology2009
Good clinical outcome after ischemic stroke with successful revascularization is time-dependent.
Trial report in Neurology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05403593 (Registry of Emergent Large VeSsel OCclUsion DuE to IntraCranial AtherosclerosiS), which is not on this map. Cited by 200 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Registry of Emergent Large VeSsel OCclUsion DuE to IntraCranial AtherosclerosiS
Who cites it
200 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Physician Transfer Versus Patient Transfer for Mechanical Thrombectomy in Patients With Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2024Pooled it
- Safety and Efficacy of Solitaire Stent Thrombectomy: Individual Patient Data Meta-Analysis of Randomized Trials.Stroke · 2016Pooled it
- Intravenous versus intra-arterial thrombolysis in ischemic stroke: a systematic review and meta-analysis.PloS one · 2015Pooled it
- Meta-analysis of pre-clinical studies of early decompression in acute spinal cord injury: a battle of time and pressure.PloS one · 2013Pooled it
- Guideline
- Edaravone dexborneol for ischemic stroke with sufficient recanalization after thrombectomy: a randomized phase II trial.Nature communications · 2025Trial
- [Efficacy of intravenous thrombolysis for acute severe cerebral infarction and risk factors of poor prognosis: a randomized controlled trial in 152 cases].Nan fang yi ke da xue xue bao = Journal of Southern Medical University · 2021Trial
- Influence of a combined CT/C-arm system on periprocedural workflow and procedure times in mechanical thrombectomy.European radiology · 2017Trial
- Time to endovascular reperfusion and degree of disability in acute stroke.Annals of neurology · 2015Trial
- Outcomes following sonothrombolysis in severe acute ischemic stroke: subgroup analysis of the CLOTBUST trial.International journal of stroke : official journal of the International Stroke Society · 2014Trial
- Mechanical thrombectomy with the penumbra 3D separator and lesional aspiration: technical feasibility and clinical outcome.Clinical neuroradiology · 2014Trial
- Evaluation of interval times from onset to reperfusion in patients undergoing endovascular therapy in the Interventional Management of Stroke III trial.Circulation · 2014Trial
- Time to angiographic reperfusion and clinical outcome after acute ischaemic stroke: an analysis of data from the Interventional Management of Stroke (IMS III) phase 3 trial.The Lancet. Neurology · 2014Trial
- Emergency cervical internal carotid artery stenting in combination with intracranial thrombectomy in acute stroke.AJNR. American journal of neuroradiology · 2014Trial
- Laser speckle imaging allows real-time intraoperative blood flow assessment during neurosurgical procedures.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2013Trial
- Endovascular therapy after intravenous t-PA versus t-PA alone for stroke.The New England journal of medicine · 2013Trial
- Mechanical thrombectomy in acute stroke: prospective pilot trial of the solitaire FR device while under conscious sedation.AJNR. American journal of neuroradiology · 2013Trial
- Higher degrees of recanalization after mechanical thrombectomy for acute stroke are associated with improved outcome and decreased mortality: pooled analysis of the MERCI and Multi MERCI trials.AJNR. American journal of neuroradiology · 2011Trial
- Early changes of tissue perfusion after tissue plasminogen activator in hyperacute ischemic stroke.Stroke · 2011Trial
- Prognostic value of the hyperdense middle cerebral artery sign in patients undergoing mechanical thrombectomy.Medicine · 2026Article
140 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundTrials of IV recombinant tissue plasminogen activator (rt-PA) have demonstrated that longer times from ischemic stroke symptom onset to initiation of treatment are associated with progressively lower likelihoods of clinical benefit, and likely no benefit beyond 4.5 hours. How the timing of IV rt-PA initiation relates to timing of restoration of blood flow has been unclear. An understanding of the relationship between timing of angiographic reperfusion and clinical outcome is needed to establish time parameters for intraarterial (IA) therapies.
methodsThe Interventional Management of Stroke pilot trials tested combined IV/IA therapy for moderate-to-severe ischemic strokes within 3 hours from symptom onset. To isolate the effect of time to angiographic reperfusion on clinical outcome, we analyzed only middle cerebral artery and distal internal carotid artery occlusions with successful reperfusion (Thrombolysis in Cerebral Infarction 2-3) during the interventional procedure (<7 hours). Time to angiographic reperfusion was defined as time from stroke onset to procedure termination. Good clinical outcome was defined as modified Rankin Score 0-2 at 3 months.
resultsAmong the 54 cases, only time to angiographic reperfusion and age independently predicted good clinical outcome after angiographic reperfusion. The probability of good clinical outcome decreased as time to angiographic reperfusion increased (unadjusted p = 0.02, adjusted p = 0.01) and approached that of cases without angiographic reperfusion within 7 hours.
conclusionsWe provide evidence that good clinical outcome following angiographically successful reperfusion is significantly time-dependent. At later times, angiographic reperfusion may be associated with a poor risk-benefit ratio in unselected patients.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.