Evidence map›Paper›PMID 34519851›Full record

SynthesisJournal of neurology2022

Thrombectomy with or without thrombolysis in patients with acute ischemic stroke: a systematic review and meta-analysis.

Xin Wu, Yi Ge, Shujun Chen, Zeya Yan, Zilan Wang, Wei Zhang, Zhouqing Chen, Tao Xue, Zhong Wang

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 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

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
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

9 authors.

Xin Wu *Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, China.
Yi Ge *Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu Province, China.
Shujun Chen *Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu Province, China.
Zeya YanDepartment of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, China.
Zilan WangDepartment of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, China.
Wei ZhangDepartment of Neurosurgery, Suzhou Ninth People's Hospital, Suzhou, 215200, China.
Zhouqing ChenDepartment of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, China.
Tao XueDepartment of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, China. 2992326676@qq.com.
Zhong WangDepartment of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, China. wangzhong761@163.com.ORCID http://orcid.org/0000-0002-7342-0845

Funding

Suzhou Health Talents Training Project GSWS2019002
6 · The paper itself

Abstract

backgroundRecently, several randomized controlled trials (RCTs) about direct mechanical thrombectomy (d-MT) vs. intravenous thrombolysis before MT (IVT + MT) for acute ischemic stroke (AIS) patients have been reported. This study aims to investigate the differences in efficacy and safety of MT with or without IVT for the treatment of patients with AIS.

methodsMEDLINE, EMBASE, Cochrane Library and Clinicaltrials.gov from March 2011 to February 2021 were systematically searched for studies comparing the two strategies directly. Review Manager 5.3 software was used to assess the risk of bias and pool the data with a random effect model.

resultsWe pooled 1633 patients from 4 RCTs. The primary outcome, proportion of patients achieving functional independence (mRS0-2) at 90 days, was not significantly different between the two groups (MT 46.02% vs. IVT + MT 45.47%, OR 1.02; 95% CI 0.84-1.25). However, the risk of developing any ICH was lower in the d-MT group (RR 0.75; 95% CI 0.63-0.89). In addition, the remaining secondary outcomes, such as successful reperfusion (eTICI scale, 2b-3) at final angiogram (OR 0.80; 95% CI, 0.62-1.03) and mortality at 90 days (RR 1.06; 95% CI 0.85-1.31), did not differ between the groups.

conclusionsOutcomes were similar for d-MT and IVT + MT, with d-MT having a lower risk of any ICH. We need to focus on precision medicine in the future. REGISTRATION: URL: http://inplasy.com ; Unique identifier: INPLASY202130094.

Indexed as

Brain IschemiaIschemic StrokeStrokeFibrinolytic AgentsHumansThrombectomyThrombolytic TherapyTreatment OutcomeFibrinolytic AgentsIschemiaMeta-analysisStrokeThrombectomyThrombolysis

Identifiers

PMID34519851

What OpenQuestion holds

Textmetadata
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.