Evidence map›Paper›PMID 26701648›Full record

Trial reportPloS one2015

Effect of X-Ray Attenuation of Arterial Obstructions on Intravenous Thrombolysis and Outcome after Ischemic Stroke.

Grant Mair, Rüdiger von Kummer, Richard I Lindley, Peter A G Sandercock, Joanna M Wardlaw, IST-3 Collaborative Group

Open access · goldAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.2field-weighted citation impact, top 37% 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

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. Observational
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

6 authors at 3 institutions in 2 countries.

Grant MairDivision of Neuroimaging Sciences, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom.
Rüdiger von KummerDepartment of Neuroradiology, Dresden University Stroke Centre, University Hospital, Dresden, Germany.
Richard I LindleyWestmead Hospital Clinical School and The George Institute for Global Health, University of Sydney, Sydney, Australia.
Peter A G SandercockDivision of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom.
Joanna M WardlawDivision of Neuroimaging Sciences, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom.
IST-3 Collaborative Group
Western General Hospital · GBThe George Institute for Global Health · AUUniversity of Edinburgh · GB

Funding

Chief Scientist OfficeMedical Research Council EME 09-800-15Medical Research Council G0400069
6 · The paper itself

Abstract

objectiveTo assess whether the x-ray attenuation of intra-arterial obstruction measured on non-contrast CT in ischemic stroke can predict response to thrombolysis and subsequent functional outcome.

methodsThe Third International Stroke Trial (IST-3) was a multicenter randomized-controlled trial of intravenous thrombolysis (rt-PA) given within six hours of ischemic stroke. Ethical approval and informed consent were obtained. In a subgroup of 109 IST-3 patients (38 men, median age 82 years), a single reader, masked to all clinical and other imaging data, manually measured x-ray attenuation (Hounsfield Units, HU) on non-contrast CT at the location of angiographically-proven intra-arterial obstructions, pre-randomization and at 24-48 hour follow-up. We calculated change in attenuation between scans. We assessed the impact of pre-randomization arterial obstruction attenuation on six-month functional outcome.

resultsMost arterial obstructions (64/109, 59%) were hyperattenuating (mean 51.0 HU). Compared with control, treatment with rt-PA was associated with a greater, but non-significant, reduction in obstruction attenuation at follow-up (-8.0 HU versus -1.4 HU in patients allocated control, p = 0.117). In multivariable ordinal regression analysis controlled for patient age, stroke severity, location and extent of obstruction, time from stroke onset to baseline scan and rt-PA treatment allocation, the attenuation of pre-randomization arterial obstruction was not independently associated with six-month outcome (odds ratio = 0.99, 95% confidence interval = 0.94-1.03, p = 0.516).

conclusionsIn ischemic stroke, the x-ray attenuation of the arterial obstruction may decline more rapidly from baseline to 24-48 hours following treatment with thrombolysis but we found no evidence that baseline arterial obstruction attenuation predicts six-month outcome.

Indexed as

Thrombolytic TherapyAdministration, IntravenousAgedArterial Occlusive DiseasesBrain IschemiaCase-Control StudiesFemaleHumansMaleProspective StudiesStrokeTreatment OutcomeX-Ray Therapy

Identifiers

PMID26701648
PMCPMC4689396
OpenAlexW2282946060

What OpenQuestion holds

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LicenceCC BY
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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.