Evidence map›Paper›PMID 28344654›Full record

ArticleTherapeutic advances in neurological disorders2017

Endovascular thrombectomy with or without systemic thrombolysis?

Georgios Tsivgoulis, Aristeidis H Katsanos, Dimitris Mavridis, Anne W Alexandrov, Georgios Magoufis, Adam Arthur, Valeria Caso, Peter D Schellinger, Andrei V Alexandrov

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In one paragraph

Article in Therapeutic advances in neurological disorders, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 4 pooled it
–field-weighted citation impact
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

18 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  17. Vascular medicine and thrombectomy in stroke.Therapeutic advances in neurological disorders · 2018
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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

9 authors.

Georgios TsivgoulisSecond Department of Neurology, Attikon University General Hospital, School of Medicine, University of Athens, Iras 39, Gerakas Attikis, Athens, 15344, Greece.
Aristeidis H KatsanosSecond Department of Neurology, Attikon University General Hospital, School of Medicine, University of Athens, Athens, Greece Department of Neurology, University of Ioannina School of Medicine, Ioannina, Greece.
Dimitris MavridisDepartment of Primary Education, University of Ioannina, Ioannina, Greece Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece.
Anne W AlexandrovDepartment of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA Australian Catholic University, Sydney, Australia.
Georgios MagoufisAcute Stroke Unit and Department of Interventional Neuroradiology, Metropolitan Hospital, Piraeus, Greece.
Adam ArthurDepartment of Neurosurgery, Semmes-Murphey Neurologic and Spine Institute, University of Tennessee Health Science Center, Memphis, TN, USA.
Valeria CasoStroke Unit, University of Perugia, Santa Maria della Misericordia Hospital, Perugia, Italy.
Peter D SchellingerDepartments of Neurology and Neurogeriatry, Johannes Wesling Medical Center, Minden, Germany.
Andrei V AlexandrovDepartment of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesCurrent recommendations advocate that pretreatment with intravenous thrombolysis (IVT) should first be offered to all eligible patients with emergent large vessel occlusion (ELVO) before an endovascular thrombectomy (ET) procedure. However, there are observational data that question the safety and efficacy of IVT pretreatment in patients with ELVO.

methodsWe performed a meta-analysis of the included subgroups from ET randomized controlled trials (RCTs) to evaluate the comparative efficacy between direct ET without IVT pretreatment and bridging therapy (IVT and ET) in patients with ELVO.

resultsWe included a total of seven RCTs, including 1764 patients with ELVO (52.8% men). Patients receiving bridging therapy (IVT followed by ET) had lower rates (

conclusionDespite the limitations and the risk of confounding bias, our findings contradict the recent notion regarding potential equality between ET and bridging therapy in ELVO patients and suggest that IVT and ET are complementary therapies that should be pursued in a parallel and noncompeting fashion.

Indexed as

acute ischemic strokeemergent large vessel occlusionintravenous thrombolysismechanical thrombectomymeta-analysis

Identifiers

PMID28344654
PMCPMC5349372

What OpenQuestion holds

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Registered trials

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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.