Evidence map›Paper›PMID 31008337›Full record

ArticleEuropean stroke journal2018

Endovascular therapy versus intravenous thrombolysis in cervical artery dissection ischemic stroke - Results from the SWISS registry.

Christopher Traenka, Simon Jung, Jan Gralla, Rebekka Kurmann, Christoph Stippich, Barbara Goeggel Simonetti, Henrik Gensicke, Hubertus Mueller, Karl Lovblad, Ashraf Eskandari and 15 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European stroke journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 3 pooled it
3.4field-weighted citation impact, top 7% 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

16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 38 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Review
  6. Article
  7. [Spontaneous craniocervical dissection].Radiologie (Heidelberg, Germany) · 2025
    Review
  8. Review
  9. Article
  10. Article
  11. Article
  12. Article
  13. Cervical and intracranial artery dissections.Therapeutic advances in neurological disorders · 2021
    Review
  14. Etiology of recurrent large vessel occlusions treated with repeated thrombectomy.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2020
    Article
  15. Article
  16. Article
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

25 authors at 10 institutions in 2 countries.

Christopher TraenkaDepartment of Neurology and Stroke Center, University Hospital, University of Basel, Basel, Switzerland.
Simon JungDepartment of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland.
Jan GrallaDepartment of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland.
Rebekka KurmannDepartment of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland.
Christoph StippichDepartment of Neuroradiology and Stroke Center, University Hospital, University of Basel, Basel, Switzerland.
Barbara Goeggel SimonettiDepartment of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland.
Henrik GensickeDepartment of Neurology and Stroke Center, University Hospital, University of Basel, Basel, Switzerland.
Hubertus MuellerDepartment of Neurology, Geneva University Hospitals, Geneva, Switzerland.
Karl LovbladDivision of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland.
Ashraf EskandariStroke Center, Neurology Service, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
Francesco PuccinelliDepartment of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
Jochen VehoffDepartment of Neurology, Kantonsspital St. Gallen, Gallen, Switzerland.
Johannes WeberDivision of Neuroradiology, Department of Radiology, Kantonsspital St. Gallen, Gallen, Switzerland.
Susanne WegenerDepartment of Neurology, University Hospital Zurich, Zurich, Switzerland.
Levke SteinerDepartment of Neurology, University Hospital Zurich, Zurich, Switzerland.
Georg KägiDepartment of Neurology, Kantonsspital St. Gallen, Gallen, Switzerland.
Andreas LuftDepartment of Neurology, University Hospital Zurich, Zurich, Switzerland.
Roman SztajzelDepartment of Neurology, Geneva University Hospitals, Geneva, Switzerland.
Urs FischerDepartment of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland.
Leo H BonatiDepartment of Neurology and Stroke Center, University Hospital, University of Basel, Basel, Switzerland.
Nils PetersDepartment of Neurology and Stroke Center, University Hospital, University of Basel, Basel, Switzerland.
Patrik MichelStroke Center, Neurology Service, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
Philippe A LyrerDepartment of Neurology and Stroke Center, University Hospital, University of Basel, Basel, Switzerland.
Marcel ArnoldDepartment of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland.
Stefan T EngelterDepartment of Neurology and Stroke Center, University Hospital, University of Basel, Basel, Switzerland.
University of Basel · CHKantonsspital St. Gallen · CHUniversity Hospital of Bern · CHUniversity Hospital of Geneva · CHUniversity Hospital of Zurich · CHUniversity of Bern · CHUniversity Hospital of Basel · CHUniversity of Lausanne · CHFelix Platter-Hospital · CHUniversity Hospital of Lausanne · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIn patients with stroke attributable to cervical artery dissection, we compared endovascular therapy to intravenous thrombolysis regarding three-month outcome, recanalisation and complications. MATERIALS AND

methodsIn a multicentre intravenous thrombolysis/endovascular therapy-register-based cohort study, all consecutive cervical artery dissection patients with intracranial artery occlusion treated within 6 h were eligible for analysis. Endovascular therapy patients (with or without prior intravenous thrombolysis) were compared to intravenous thrombolysis patients regarding (i) excellent three-month outcome (modified Rankin Scale score 0-1), (ii) symptomatic intracranial haemorrhage, (iii) recanalisation of the occluded intracranial artery and (iv) death. Upon a systematic literature review, we performed a meta-analysis comparing endovascular therapy to intravenous thrombolysis in cervical artery dissection patients regarding three-month outcome using a random-effects Mantel-Haenszel model.

resultsAmong 62 cervical artery dissection patients (median age 48.8 years), 24 received intravenous thrombolysis and 38 received endovascular therapy. Excellent three-month outcome occurred in 23.7% endovascular therapy and 20.8% with intravenous thrombolysis patients. Symptomatic intracranial haemorrhage occurred solely among endovascular therapy patients (5/38 patients, 13.2%) while four (80%) of these patients had bridging therapy; 6/38 endovascular therapy and 0/24 intravenous thrombolysis patients died. Four of these 6 endovascular therapy patients had bridging therapy. Recanalisation was achieved in 84.2% endovascular therapy patients and 66.7% intravenous thrombolysis patients (odds ratio 3.2, 95% confidence interval [0.9-11.38]). Sensitivity analyses in a subgroup treated within 4.5 h revealed a higher recanalisation rate among endovascular therapy patients (odds ratio 3.87, 95% confidence interval [1.00-14.95]), but no change in the key clinical findings. In a meta-analysis across eight studies (n = 212 patients), cervical artery dissection patients (110 intravenous thrombolysis and 102 endovascular therapy) showed identical odds for favourable outcome (odds ratio 0.97, 95% confidence interval [0.38-2.44]) among endovascular therapy patients and intravenous thrombolysis patients. DISCUSSION AND

conclusionIn this cohort study, there was no clear signal of superiority of endovascular therapy over intravenous thrombolysis in cervical artery dissection patients, which - given the limitation of our sample size - does not prove that endovascular therapy in these patients cannot be superior in future studies. The observation that symptomatic intracranial haemorrhage and deaths in the endovascular therapy group occurred predominantly in bridging patients requires further investigation.

Indexed as

dissectionendovascular therapyStrokethrombolysis

Identifiers

PMID31008337
PMCPMC6453244
OpenAlexW2781624971

What OpenQuestion holds

Textmetadata
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.