ArticleJournal of stroke2021
Safety and Angiographic Efficacy of Intra-Arterial Fibrinolytics as Adjunct to Mechanical Thrombectomy: Results from the INFINITY Registry.
Article in Journal of stroke, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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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
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 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
- Trial
- 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
- Dose-Specific Intra-Arterial Thrombolysis After Endovascular Thrombectomy for Large-Vessel Occlusion Stroke: A Network Meta-Analysis of Randomized Trials.Stroke (Hoboken, N.J.) · 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
- 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
- Cost-effectiveness of intra-arterial thrombolysis after successful thrombectomy.BMJ surgery, interventions, & health technologies · 2025Article
- Thrombectomy Plus Intra-Arterial Thrombolysis Versus Thrombectomy for Acute Large Vessel Occlusions: a Matched-Control Study.Clinical neuroradiology · 2024Article
- Assessment of Thrombectomy versus Combined Thrombolysis and Thrombectomy in Patients with Acute Ischemic Stroke and Medium Vessel Occlusion.Radiology · 2024Article
- Correlation of Peripheral Blood Inflammatory Indicators to Prognosis After Intravenous Thrombolysis in Acute Ischemic Stroke: A Retrospective Study.International journal of general medicine · 2024Article
- Intra-Arterial Thrombolysis is Associated with Delayed Reperfusion of Remaining Vessel Occlusions following Incomplete Thrombectomy.AJNR. American journal of neuroradiology · 2023Article
- Intra-Arterial Thrombolysis to Improve Final Thrombolysis in Cerebral Infarction Score after Thrombectomy: A Case-Series Analysis.Neurointervention · 2023Article
- Association Between Intravenous Thrombolysis and Clinical Outcomes Among Patients With Ischemic Stroke and Unsuccessful Mechanical Reperfusion.JAMA network open · 2023Observational
- Endovascular versus Medical Management of Acute Basilar Artery Occlusion: A Systematic Review and Meta-Analysis of the Randomized Controlled Trials.Journal of stroke · 2023Review
- Article
Corrections and comments
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Authors and funding
33 authors at 12 institutions in 4 countries.
Funding
Abstract
background and purposeData on safety and efficacy of intra-arterial (IA) fibrinolytics as adjunct to mechanical thrombectomy (MT) are sparse.
methodsINtra-arterial FIbriNolytics In ThrombectomY (INFINITY) is a retrospective multi-center observational registry of consecutive patients with anterior circulation large-vessel occlusion ischemic stroke treated with MT and adjunctive administration of IA fibrinolytics (alteplase [tissue plasminogen activator, tPA] or urokinase [UK]) at 10 European centers. Primary outcome was the occurrence of symptomatic intracranial hemorrhage (sICH) according to the European Cooperative Acute Stroke Study II definition. Secondary outcomes were mortality and modified Rankin Scale (mRS) scores at 3 months.
resultsOf 5,612 patients screened, 311 (median age, 74 years; 44.1% female) received additional IA after or during MT (194 MT+IA tPA, 117 MT+IA UK). IA fibrinolytics were mostly administered for rescue of thrombolysis in cerebral infarction (TICI) 0-2b after MT (80.4%, 250/311). sICH occurred in 27 of 308 patients (8.8%), with an increased risk in patients with initial TICI0/1 (adjusted odds ratio [aOR], 2.3; 95% confidence interval [CI], 1.1 to 5.0 per TICI grade decrease) or in those with intracranial internal carotid artery occlusions (aOR, 3.7; 95% CI, 1.2 to 12.5). In patients with attempted rescue of TICI0-2b and available angiographic follow-up, 116 of 228 patients (50.9%) showed any angiographic reperfusion improvement after IA fibrinolytics, which was associated with mRS ≤2 (aOR, 3.1; 95% CI, 1.4 to 6.9).
conclusionsAdministration of IA fibrinolytics as adjunct to MT is performed rarely, but can improve reperfusion, which is associated with better outcomes. Despite a selection bias, an increased risk of sICH seems possible, which underlines the importance of careful patient selection.
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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.