Evidence map›Paper›PMID 29674752›Full record

ReviewNature reviews. Neurology2018

Protecting the ischaemic penumbra as an adjunct to thrombectomy for acute stroke.

Jean-Claude Baron

Erratum issued Registry-linked trialAbstract readReview
PubMed Publisher
In one paragraph

Review in Nature reviews. Neurology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT07364344 (A Single-Center,Open-Label Clinical Study on the Safety and Preliminary Efficacy of Hibernation-Like Therapy), which is not on this map. Cited by 98 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
98citing papers in PubMed, 4 pooled it
11.8field-weighted citation impact, top 1% 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.

NCT07364344 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

A Single-Center,Open-Label Clinical Study on the Safety and Preliminary Efficacy of Hibernation-Like Therapy (Chlorpromazine and Promethazine) in Patients With Acute Ischemic Stroke (AIS) Eligible for Reperfusion Therapy.

TypeinterventionalSponsorJi Xunming,MD,PhDRan2026 to 2026Enrolled57ConditionsAcute Ischemic StrokeArmsHibernation-like Therapy (Chlorpromazine and Promethazine, C+P)
3 · Its place in the literature

Who cites it

98 citing papers in PubMed, 4 syntheses or guidelines pooled it, 186 citations in OpenAlex.

  1. Pooled it
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  4. The effect of angiopoietin-1 upregulation on the outcome of acute ischaemic stroke in rodent models: A meta-analysis.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2019
    Pooled it
  5. Trial
  6. Transcranial direct current stimulation is safe and feasible in hyperacute ischemic stroke (DICAST-SF trial).Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026
    Trial
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  10. Review
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  15. Observational
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38 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

1 author at 1 institution in 1 country.

Jean-Claude BaronDepartment of Neurology, Hôpital Sainte-Anne, Université Paris 5, INSERM U894, Paris, France. jean-claude.baron@inserm.fr.
Inserm · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

After ischaemic stroke, brain damage can be curtailed by rescuing the 'ischaemic penumbra' - that is, the severely hypoperfused, at-risk but not yet infarcted tissue. Current evidence-based treatments involve restoration of blood flow so as to salvage the penumbra before it evolves into irreversibly damaged tissue, termed the 'core'. Intravenous thrombolysis (IVT) can salvage the penumbra if given within 4.5 h after stroke onset; however, the early recanalization rate is only ~30%. Direct removal of the occluding clot by mechanical thrombectomy considerably improves outcomes over IVT alone, but despite early recanalization in > 80% of cases, ~50% of patients who receive this treatment do not enjoy functional independence, usually because the core is already too large at the time of recanalization. Novel therapies aiming to 'freeze' the penumbra - that is, prevent core growth until recanalization is complete - hold potential as adjuncts to mechanical thrombectomy. This Review focuses on nonpharmacological approaches that aim to restore the physiological balance between oxygen delivery to and oxygen demand of the penumbra. Particular emphasis is placed on normobaric oxygen therapy, hypothermia and sensory stimulation. Preclinical evidence and early pilot clinical trials are critically reviewed, and future directions, including clinical translation and trial design issues, are discussed.

Indexed as

Evoked PotentialsAnimalsBalloon OcclusionBrain IschemiaCombined Modality TherapyElectric Stimulation TherapyFluorocarbonsHumansHypothermia, InducedIschemic PreconditioningMechanical ThrombolysisOxygen Inhalation TherapyStrokeThrombolytic TherapyFluorocarbons

Identifiers

PMID29674752
OpenAlexW2799480200

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.