Evidence map›Paper›PMID 35135066›Full record

ArticleJournal of stroke2022

Bridging Thrombolysis versus Direct Mechanical Thrombectomy in Stroke Due to Basilar Artery Occlusion.

Isabel Siow, Benjamin Y Q Tan, Keng Siang Lee, Natalie Ong, Emma Toh, Anil Gopinathan, Cunli Yang, Pervinder Bhogal, Erika Lam, Oliver Spooner and 18 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of stroke, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 9 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

24 citing papers in PubMed, 9 syntheses or guidelines pooled it.

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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

28 authors.

Isabel SiowYong Loo Lin School of Medicine, National University of Singapore, Singapore.
Benjamin Y Q TanYong Loo Lin School of Medicine, National University of Singapore, Singapore.
Keng Siang LeeBristol Medical School, University of Bristol, Bristol, UK.
Natalie OngYong Loo Lin School of Medicine, National University of Singapore, Singapore.
Emma TohYong Loo Lin School of Medicine, National University of Singapore, Singapore.
Anil GopinathanYong Loo Lin School of Medicine, National University of Singapore, Singapore.
Cunli YangYong Loo Lin School of Medicine, National University of Singapore, Singapore.
Pervinder BhogalDepartment of Interventional Neuroradiology, The Royal London Hospital, Barts NHS Trust, London, UK.
Erika LamStroke Department, The Royal London Hospital, Barts NHS Trust, London, UK.
Oliver SpoonerStroke Department, The Royal London Hospital, Barts NHS Trust, London, UK.
Lukas MeyerDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Jens FiehlerDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Panagiotis PapanagiotouDepartment of Diagnostic and Interventional Neuroradiology, Hospital Bremen-Mitte, Bremen, Germany.
Andreas KastrupDepartment of Neurology, Hospital Bremen-Mitte, Bremen, Germany.
Maria AlexandrouDepartment of Diagnostic and Interventional Neuroradiology, Hospital Bremen-Mitte, Bremen, Germany.
Seraphine ZubelDepartment of Neuroradiology, University Hospital Magdeburg, Magdeburg, Germany.
Qingyu WuDepartment of Neuroradiology, University Hospital Magdeburg, Magdeburg, Germany.
Anastasios MpotsarisDepartment of Neuroradiology, University Hospital Magdeburg, Magdeburg, Germany.
Volker MausInstitute of Diagnostic and Interventional Radiology, Neuroradiology and Nuclear Medicine, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.
Tommy AndersonDepartment of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden.
Vamsi GontuDepartment of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden.
Fabian ArnbergDepartment of Medical Imaging, AZ Groeninge, Kortrijk, Belgium.
Tsong Hai LeeDepartment of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Bernard P L ChanDivision of Neurology, Department of Medicine, National University Health System, Singapore.
Raymond C S SeetDivision of Neurology, Department of Medicine, National University Health System, Singapore.
Hock Luen TeohDivision of Neurology, Department of Medicine, National University Health System, Singapore.
Vijay K SharmaYong Loo Lin School of Medicine, National University of Singapore, Singapore.
Leonard L L YeoYong Loo Lin School of Medicine, National University of Singapore, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeMechanical thrombectomy (MT) is an effective treatment for patients with basilar artery occlusion (BAO) acute ischemic stroke. It remains unclear whether bridging intravenous thrombolysis (IVT) prior to MT confers any benefit. This study compared the outcomes of acute BAO patients who were treated with direct MT versus combined IVT plus MT.

methodsThis multicenter retrospective cohort study included patients who were treated for acute BAO from eight comprehensive stroke centers between January 2015 and December 2019. Patients received direct MT or combined bridging IVT plus MT. Primary outcome was favorable functional outcome defined as modified Rankin Scale 0-3 measured at 90 days. Secondary outcome measures included mortality and symptomatic intracranial hemorrhage (sICH).

resultsAmong 322 patients, 127 (39.4%) patients underwent bridging IVT followed by MT and 195 (60.6%) underwent direct MT. The mean±standard deviation age was 67.5±14.1 years, 64.0% were male and median National Institutes of Health Stroke Scale was 16 (interquartile range, 8 to 25). At 90-day, the rate of favorable functional outcome was similar between the bridging IVT and direct MT groups (39.4% vs. 34.4%, P=0.361). On multivariable analyses, bridging IVT was not as Comorbidisociated with favorable functional outcome, mortality or sICH. In subgroup analyses, patients with underlying atherosclerosis treated with bridging IVT compared to direct MT had a higher rate of favorable functional outcome at 90 days (37.2% vs. 15.5%, P=0.013).

conclusionsFunctional outcomes were similar in BAO patients treated with bridging IVT versus direct MT. In the subgroup of patients with underlying large-artery atherosclerosis stroke mechanism, bridging IVT may potentially confer benefit and this warrants further investigation.

Indexed as

Basilar arteryStrokeThrombectomyThrombolytic therapyVertebrobasilar insufficiency

Identifiers

PMID35135066
PMCPMC8829485

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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.