Evidence map›Paper›PMID 33330955›Full record

ArticleNeuroradiology2021

Impact of bridging thrombolysis on clinical outcome in stroke patients undergoing endovascular thrombectomy: a retrospective analysis of a regional stroke registry.

Fatih Seker, Susanne Bonekamp, Susanne Rode, Sonja Hyrenbach, Martin Bendszus, Markus A Möhlenbruch

Abstract read
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Article in Neuroradiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Fatih SekerDepartment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
Susanne BonekampDepartment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
Susanne RodeQualitätssicherung im Gesundheitswesen Baden-Württemberg GmbH, Stuttgart, Germany.
Sonja HyrenbachQualitätssicherung im Gesundheitswesen Baden-Württemberg GmbH, Stuttgart, Germany.
Martin BendszusDepartment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
Markus A MöhlenbruchDepartment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany. markus.moehlenbruch@med.uni-heidelberg.de.ORCID http://orcid.org/0000-0002-5075-704X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIt is unclear whether stroke patients undergoing endovascular thrombectomy (EVT) should receive bridging intravenous thrombolysis (IVT), if eligible. This study aims at analyzing the impact of bridging IVT on short-term clinical outcome.

methodsIn a prospective regional stroke registry, all stroke patients with premorbid modified Rankin Scale (mRS) score of 0-2 who were admitted within 4.5 h after onset and treated with EVT were analyzed retrospectively. Patients receiving "IVT prior to EVT" (IVEVT) were compared to those undergoing "EVT only" regarding the ratio of good outcome, discharge mRS, mRS shift, hospital mortality, and occurrence of symptomatic intracranial hemorrhage.

resultsIn total, 2022 patients were included, 816 patients (40.4%) achieved good clinical outcome; 1293 patients (63.9%) received bridging IVT. There was no significant difference between both groups regarding the ratio of good outcome (IVEVT 41.4% vs. EVT 38.5%, P = 0.231), discharge mRS (median, IVEVT 3 vs. EVT 3, P = 0.178), mRS shift (median, IVEVT 3 vs. EVT 3, P = 0.960), and hospital mortality (IVEVT 19.3% vs. EVT 19.5%, P = 0.984). Bridging IVT was not a predictor of outcome (adjusted OR 1.00, 95% CI 0.79-1.26, P = 0.979). However, it was an independent predictor of symptomatic intracranial hemorrhage (adjusted OR 1.79, 95% CI 1.21-2.72, P = 0.005).

conclusionsThe results of the present study suggest that bridging IVT does not seem to improve short-term clinical outcome of patients undergoing EVT. Nonetheless, there might be a subgroup of patients that benefits from IVT. This needs to be addressed in randomized controlled trials.

Indexed as

Brain IschemiaEndovascular ProceduresStrokeFibrinolytic AgentsHumansProspective StudiesRegistriesRetrospective StudiesThrombectomyThrombolytic TherapyTreatment OutcomeFibrinolytic AgentsStrokeThrombectomyThrombolysis

Identifiers

PMID33330955
PMCPMC8128793

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