Evidence map›Paper›PMID 21990808›Full record

SynthesisJournal of neurointerventional surgery2011

Meta-analysis of randomized intra-arterial thrombolytic trials for the treatment of acute stroke due to middle cerebral artery occlusion.

Jeremy D Fields, Pooja Khatri, Gary M Nesbit, Kenneth C Liu, Stanley L Barnwell, Helmi L Lutsep, Wayne M Clark, Maarten G Lansberg

Open access · greenAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of neurointerventional surgery, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 4 pooled it
4.2field-weighted citation impact, top 6% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 4 syntheses or guidelines pooled it, 44 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Guideline
  5. Observational
  6. Article
  7. Review
  8. Review
  9. Article
  10. Evaluation and management of acute ischemic stroke.Continuum (Minneapolis, Minn.) · 2014
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Jeremy D FieldsOregon Health and Science University, Portland, OR, USA. fieldsje@ohsu.edu
Pooja Khatri
Gary M Nesbit
Kenneth C Liu
Stanley L Barnwell
Helmi L Lutsep
Wayne M Clark
Maarten G Lansberg
Oregon Health & Science University · USStanford Medicine · USUniversity of Cincinnati Medical Center · USUniversity of Virginia Health System · US

Funding

The Significance of Intracranial Hemorrhage after Revascularization TherapyK23NS059843 · NINDS · UNIVERSITY OF CINCINNATI · PI KHATRI, POOJA · 2007 to 2011
$778k
NINDS NIH HHS K23 NS059843
6 · The paper itself

Abstract

backgroundRandomized clinical trials supporting the use of intra-arterial administration of thrombolytics (IAT) for the treatment of stroke due to middle cerebral artery (MCA) occlusion have been positive on some, but not all, endpoints. A meta-analysis was performed to estimate with more precision the effect of IAT on several key clinical endpoints.

methodsAll randomized trials of IAT in the treatment of MCA stroke were identified by PUBMED search and by hand search of potentially relevant references. Trial methodologies were assessed for compatibility in study protocols and statistical analysis. A meta-analysis was performed evaluating the effect of IAT on functional outcome at 90 days and symptomatic intracranial hemorrhage (SICH) within 24 h.

resultsThree trials met the criteria for the meta-analysis. IAT treated patients were significantly more likely to have a modified Rankin scale (mRS) ≤ 1 (31% vs 20%, OR 2.0, 95% CI 1.2 to 3.4, p=0.01); mRS ≤ 2 (43% vs 31%, OR 1.9, 95% CI 1.2 to 3.0, p=0.01); and NIH Stroke Scale score 0 or 1 (23% vs 12%, OR 2.4, 95% CI 1.3 to 4.4, p=0.007) at the 90 day follow-up. There was no effect on mortality at 90 days (20% vs 19%, OR 0.84, 95% CI 0.5 to 1.5). The risk of SICH was significantly increased in the active treatment arms (11% vs 2%, OR 4.6, 95% CI 1.3 to 16, p=0.02).

conclusionsOur meta-analysis demonstrates that all standard functional endpoints for stroke trials were substantially improved in the active treatment arms. Despite an increased risk of SICH, there was no effect on mortality. These results support endovascular treatment of acute ischemic stroke due to MCA occlusion with intra-arterial thrombolytics.

Indexed as

Thrombolytic TherapyFibrinolytic AgentsHumansInfarction, Middle Cerebral ArteryInfusions, Intra-ArterialRandomized Controlled Trials as TopicFibrinolytic Agents

Identifiers

PMID21990808
PMCPMC3420806
OpenAlexW2138406218

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.