Evidence map›Paper›PMID 33817340›Full record

ArticleEuropean stroke journal2021

European Stroke Organisation (ESO) guidelines on intravenous thrombolysis for acute ischaemic stroke.

Eivind Berge, William Whiteley, Heinrich Audebert, Gian Marco De Marchis, Ana Catarina Fonseca, Chiara Padiglioni, Natalia Pérez de la Ossa, Daniel Strbian, Georgios Tsivgoulis, Guillaume Turc

6 registry-linked trialsOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European stroke journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 6 registered trials, which are not on this map. Cited by 656 papers, 19 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
656citing papers in PubMed, 19 pooled it
122.3field-weighted citation impact, top 1% 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.

NCT05849805 nacompletednot on this mapstarted 2023, after this paper: background citation

The Feasibility, Safety and Efficacy of Y-3 Injection Through Skull Bone Marrow Bypassing Blood-brain Barrier in the Treatment of Acute Malignant Middle Cerebral Artery Infarction(SOLUTION)

TypeinterventionalSponsorBeijing Tiantan HospitalRan2023 to 2024Enrolled20ConditionsStroke, Acute IschemicArmsIntracalvaria bone marrow injection, Conventional treatment
NCT06121336 recruitingnot on this mapstarted 2023, after this paper: background citation

PRecisiOn Medicine In StrokE Study on the Evolution of Plasma Brain-Derived Tau in 100 Patients With Acute Ischemic Stroke

TypeobservationalSponsorLudwig-Maximilians - University of MunichRan2023 to 2027Enrolled100ConditionsStroke, Stroke, Acute, Stroke, Ischemic, Cerebrovascular DisordersArmsPlasma levels of BD-tau
NCT06672757 nanot yet recruitingnot on this mapstarted 2024, after this paper: background citation

Use of App for Stroke Assessment VS Standard Level of Care During Prehospital Stroke Assessment

TypeinterventionalSponsorNaestved HospitalRan2024 to 2026Enrolled1,200ConditionsStroke, AcuteArmsCV_AID
NCT06727006 recruitingnot on this mapstarted 2023, after this paper: background citation

Stroke, Thrombolysis and Rescue Stenting

TypeobservationalSponsorASST Santi Paolo e CarloRan2023 to 2027Enrolled400ConditionsLarge Vessel Occlusion, Stroke Acute, Thrombolysis, Rescue Stenting
NCT07290751 phase4recruitingnot on this mapstarted 2025, after this paper: background citation

Intravenous Thrombolysis Combined With Tirofiban in Acute Ischemic Stroke: A Multicenter, Prospective, Double-Blind, Placebo-Controlled, Randomized Controlled Trial

TypeinterventionalSponsorBeijing Anzhen HospitalRan2025 to 2026Enrolled976ConditionsAcute Ischemic StrokeArmsTirofiban, Placebo (0.9% normal saline)
NCT07514949 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

The Feasibility and Safety of RK-4 Injection Bypassing Blood-brain Barrier in the Treatment of Acute Large Hemispheric Infarction Using Intracalvariosseous Injection Device

TypeinterventionalSponsoryilong WangRan2026 to 2026Enrolled6ConditionsStroke, Acute Ischemic Stroke, Blood-Brain BarrierArmsRK-4 ICO injection, Conventional treatment
3 · Its place in the literature

Who cites it

656 citing papers in PubMed, 19 syntheses or guidelines pooled it, 1,196 citations in OpenAlex.

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  16. Clinical characteristics and outcomes of ischemic stroke despite appropriate oral anticoagulation for atrial fibrillation: A systematic review and meta-analysis of real-world studies.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
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596 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

10 authors at 10 institutions in 11 countries.

Eivind BergeDepartment of Internal Medicine and Cardiology, Oslo University Hospital, Oslo, Norway.
William WhiteleyCentre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Heinrich AudebertKlinik und Hochschulambulanz für Neurologie, Charité Universitätsmedizin Berlin & Center for Stroke Research Berlin, Berlin, Germany.
Gian Marco De MarchisUniversity Hospital of Basel & University of Basel, Department for Neurology & Stroke Center, Basel, Switzerland.
Ana Catarina FonsecaDepartment of Neurosciences and Mental Health (Neurology), Hospital Santa Maria-CHLN, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.ORCID https://orcid.org/0000-0001-6913-5526
Chiara PadiglioniNeurology Unit-Stroke Unit, Gubbio/Gualdo Tadino and Città di Castello Hospitals, USL Umbria 1, Perugia, Italy.
Natalia Pérez de la OssaStroke Unit, Department of Neurology, Germans Trias i Pujol Hospital, Badalona, Spain.
Daniel StrbianDepartment of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Georgios TsivgoulisSecond Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Guillaume TurcDepartment of Neurology, GHU Paris Psychiatrie et Neurosciences, Hopital Sainte-Anne, Université de Paris, Paris, France.ORCID https://orcid.org/0000-0001-5059-4095
Charité - Universitätsmedizin Berlin · DECittà di Castello Hospital · ITHospital Universitari Germans Trias i Pujol · ESInserm · FRMRC Centre for Regenerative Medicine · GBOslo University Hospital · NOUniversity of Basel · CHUniversity of Helsinki · FIUniversity of Lisbon · PTUniversity of Tennessee Health Science Center · US

Funding

Chief Scientist Office SCAF/17/01Medical Research Council G0902303
6 · The paper itself

Abstract

Intravenous thrombolysis is the only approved systemic reperfusion treatment for patients with acute ischaemic stroke. These European Stroke Organisation (ESO) guidelines provide evidence-based recommendations to assist physicians in their clinical decisions with regard to intravenous thrombolysis for acute ischaemic stroke. These guidelines were developed based on the ESO standard operating procedure and followed the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. The working group identified relevant clinical questions, performed systematic reviews and meta-analyses of the literature, assessed the quality of the available evidence, and wrote recommendations. Expert consensus statements were provided if not enough evidence was available to provide recommendations based on the GRADE approach. We found high quality evidence to recommend intravenous thrombolysis with alteplase to improve functional outcome in patients with acute ischemic stroke within 4.5 h after symptom onset. We also found high quality evidence to recommend intravenous thrombolysis with alteplase in patients with acute ischaemic stroke on awakening from sleep, who were last seen well more than 4.5 h earlier, who have MRI DWI-FLAIR mismatch, and for whom mechanical thrombectomy is not planned. These guidelines provide further recommendations regarding patient subgroups, late time windows, imaging selection strategies, relative and absolute contraindications to alteplase, and tenecteplase. Intravenous thrombolysis remains a cornerstone of acute stroke management. Appropriate patient selection and timely treatment are crucial. Further randomized controlled clinical trials are needed to inform clinical decision-making with regard to tenecteplase and the use of intravenous thrombolysis before mechanical thrombectomy in patients with large vessel occlusion.

Indexed as

fibrinolysisIschaemic strokerecommendationsthrombectomythrombolysis

Identifiers

PMID33817340
PMCPMC7995316
OpenAlexW3132060044

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.