Evidence map›Paper›PMID 33053947›Full record

ReviewJournal of stroke2020

Mothership versus Drip-and-Ship Model for Mechanical Thrombectomy in Acute Stroke: A Systematic Review and Meta-Analysis for Clinical and Radiological Outcomes.

Michele Romoli, Maurizio Paciaroni, Georgios Tsivgoulis, Elio Clemente Agostoni, Simone Vidale

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of stroke, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 69 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
69citing papers in PubMed, 9 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

69 citing papers in PubMed, 9 syntheses or guidelines pooled it.

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  7. Fibrinogen depletion and intracerebral hemorrhage after thrombolysis for ischemic stroke: a meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022
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  9. Stroke network performance during the first COVID-19 pandemic stage: A meta-analysis based on stroke network models.International journal of stroke : official journal of the International Stroke Society · 2021
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  18. The burden and management of emergency room neurological consultation in hub and spoke Italian hospitals: the nationwide surveys of the Italian Association for Emergency Neurology (ANEU).Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
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9 more citing papers are in PubMed but not listed here.

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

5 authors.

Michele RomoliNeurology Unit, Rimini "Infermi" Hospital, AUSL Romagna, Rimini, Italy.
Maurizio PaciaroniStroke Unit and Division of Cardiovascular Medicine, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy.
Georgios TsivgoulisSecond Department of Neurology, "Attikon" Hospital School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Elio Clemente AgostoniDepartment of Neurology, Niguarda Ca' Granda Hospital, Milan, Italy.
Simone VidaleNeurology Unit, Rimini "Infermi" Hospital, AUSL Romagna, Rimini, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeSubstantial uncertainty exists on the benefit of organizational paradigms in stroke networks. Here we systematically reviewed and meta-analyzed data from studies comparing functional outcome between the mothership (MS) and the drip and ship (DS) models.

methodsThe meta-analysis protocol was registered international prospective register of systematic reviews (PROSPERO) and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, EMBASE, and Cochrane Central databases were searched for randomized-controlled clinical trials (RCTs), retrospective and prospective studies comparing MS versus DS. Primary endpoints were functional independence at 90 days (modified Rankin Scale <3) and successful recanalization (Thrombolysis in Cerebral Infarction Scale [TICI] >2a); secondary endpoints were 3-month mortality and symptomatic intracranial haemorrhage (sICH). Odds ratios for endpoints were pooled using the random effects model and were compared between the two organizational models.

resultsOverall, 18 studies (n=7,017) were included in quantitative synthesis. MS paradigm was superior to DS model for functional independence (odds ratio, 1.34; 95% confidence interval, 1.16 to 1.55; I2=30%). Meta-regression analysis revealed association between onset-to-needle time and good functional outcome, with longer onset-to-needle time being detrimental. Similar rates of recanalization, sICH and mortality at 90 days were documented between MS and DS.

conclusionsPatients with acute ischemic stroke eligible for reperfusion strategies might benefit more from MS paradigm as compared to DS. RCTs are needed to further refine best management taking into account logistics, facilities and resources.

Indexed as

Drip and shipEndovascular proceduresMothershipStrokeThrombectomy

Identifiers

PMID33053947
PMCPMC7568974

What OpenQuestion holds

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LicenceCC BY-NC
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.