SynthesisJournal of neurointerventional surgery2021
Safety and efficacy of intra-arterial fibrinolytics as adjunct to mechanical thrombectomy: a systematic review and meta-analysis of observational data.
Synthesis in Journal of neurointerventional surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- The Added Benefit of Intra-Arterial Thrombolysis After Successful Recanalization by Endovascular Treatment: A Systematic Review and Meta-Analysis of Randomized-Controlled Clinical Trials.European journal of neurology · 2025Pooled it
- Efficacy and safety of intra-arterial thrombolysis after endovascular reperfusion for acute ischemic stroke: a systematic review and meta-analysis of randomized trials.International journal of surgery (London, England) · 2025Pooled it
- Natural Evolution of Incomplete Reperfusion in Patients Following Endovascular Therapy After Ischemic Stroke.Stroke · 2025Pooled it
- Intra-arterial thrombolytics during endovascular thrombectomy for acute ischaemic stroke in the MR CLEAN Registry.Stroke and vascular neurology · 2023Trial
- Beyond Recanalization: A Mechanistic and Procedural Framework for Adjunct Pharmacologic Therapy During Mechanical Thrombectomy.Journal of clinical medicine · 2026Review
- Intra-arterial thrombolysis as adjunct to endovascular treatment in acute basilar artery occlusion.Journal of neurology · 2026Article
- Health Economic Impact of Incomplete Reperfusion Patterns After Endovascular Thrombectomy in Acute Ischemic Stroke.Clinical neuroradiology · 2026Article
- Safety and efficacy of intra-arterial tenecteplase for non-complete reperfusion of intracranial occlusions: Methodology of a randomized, controlled, multicenter study.European stroke journal · 2026Article
- How Do Patient Outcomes in Mechanical Thrombectomy for Large-Core Stroke Vary Based on Neuroimaging Modalities Used for Patient Selection? A Multicenter Multinational Study.Translational stroke research · 2025Article
- Intra-Arterial Thrombolysis After Mechanical Thrombectomy in Patients with Acute Ischemic Stroke: A Systematic Review and Meta-Analysis With Trial Sequential Analysis.Stroke (Hoboken, N.J.) · 2025Article
- POST-UK (Adjunctive Intra-Arterial Urokinase After Successful Endovascular Thrombectomy in Patients With Large-Vessel Occlusion Stroke): Study Protocol of a Multicenter, Prospective, Randomized, Open-Label, Blinded-End Point Trial.Stroke (Hoboken, N.J.) · 2025Article
- Introducing the Futile Recanalization Prediction Score (FRPS): A Novel Approach to Predict and Mitigate Ineffective Recanalization after Endovascular Treatment of Acute Ischemic Stroke.Neurology international · 2024Article
- The Management of Persistent Distal Occlusions after Mechanical Thrombectomy and Thrombolysis: An Inter- and Intrarater Agreement Study.AJNR. American journal of neuroradiology · 2024Article
- Value of Immediate Flat Panel Perfusion Imaging after Endovascular Therapy (AFTERMATH): A Proof of Concept Study.AJNR. American journal of neuroradiology · 2024Article
- Intra-Arterial Thrombolysis is Associated with Delayed Reperfusion of Remaining Vessel Occlusions following Incomplete Thrombectomy.AJNR. American journal of neuroradiology · 2023Article
- Prediction of delayed reperfusion in patients with incomplete reperfusion following thrombectomy.European stroke journal · 2023Article
- World Federation for Interventional Stroke Treatment (WIST) multispecialty training guidelines for endovascular stroke intervention.Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2023Article
- Association of Intravenous Thrombolysis with Delayed Reperfusion After Incomplete Mechanical Thrombectomy.Clinical neuroradiology · 2023Article
- Intra-arterial tenecteplase is safe and may improve the first-pass recanalization for acute ischemic stroke with large-artery atherosclerosis: the BRETIS-TNK trial.Frontiers in neurology · 2023Article
- Article
Corrections and comments
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Authors and funding
27 authors at 13 institutions in 7 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAchieving the best possible reperfusion is a key determinant of clinical outcome after mechanical thrombectomy (MT). However, data on the safety and efficacy of intra-arterial (IA) fibrinolytics as an adjunct to MT with the intention to improve reperfusion are sparse.
methodsWe performed a PROSPERO-registered (CRD42020149124) systematic review and meta-analysis accessing MEDLINE, PubMed, and Embase from January 1, 2000 to January 1, 2020. A random-effect estimate (Mantel-Haenszel) was computed and summary OR with 95% CI were used as a measure of added IA fibrinolytics versus control on the risk of symptomatic intracranial hemorrhage (sICH) and secondary endpoints (modified Rankin Scale ≤2, mortality at 90 days).
resultsThe search identified six observational cohort studies and three observational datasets of MT randomized-controlled trial data reporting on IA fibrinolytics with MT as compared with MT alone, including 2797 patients (405 with additional IA fibrinolytics (100 urokinase (uPA), 305 tissue plasminogen activator (tPA)) and 2392 patients without IA fibrinolytics). Of 405 MT patients treated with additional IA fibrinolytics, 209 (51.6%) received prior intravenous tPA. We did not observe an increased risk of sICH after administration of IA fibrinolytics as adjunct to MT (OR 1.06, 95% CI 0.64 to 1.76), nor excess mortality (0.81, 95% CI 0.60 to 1.08). Although the mode of reporting was heterogeneous, some studies observed improved reperfusion after IA fibrinolytics.
conclusionThe quality of evidence regarding peri-interventional administration of IA fibrinolytics in MT is low and limited to observational data. In highly selected patients, no increase in sICH was observed, but there is large uncertainty.
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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.