ArticleEuropean stroke journal2022
European Stroke Organisation - European Society for Minimally Invasive Neurological Therapy expedited recommendation on indication for intravenous thrombolysis before mechanical thrombectomy in patients with acute ischaemic stroke and anterior circulation large vessel occlusion.
Article in European stroke journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT06121336 (PRecisiOn Medicine In StrokE Study on the Evolution of Plasma Brain-Derived Tau in 100 Patients With Acute Ischemic Stroke), which is not on this map. Cited by 53 papers, 5 of them syntheses that pooled 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.
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.
PRecisiOn Medicine In StrokE Study on the Evolution of Plasma Brain-Derived Tau in 100 Patients With Acute Ischemic Stroke
Who cites it
53 citing papers in PubMed, 5 syntheses or guidelines pooled it, 102 citations in OpenAlex.
- Endovascular thrombectomy with or without intravenous thrombolysis in large-vessel ischemic stroke: an updated meta-analysis.Scientific reports · 2026Pooled it
- 2025 update to European Stroke Organisation (ESO) guideline on blood pressure management in acute ischaemic stroke and intracerebral haemorrhage.European stroke journal · 2026Guideline
- Intravenous thrombolysis in acute ischemic stroke patients with pre-stroke disability: A systematic review and meta-analysis.Brain and behavior · 2024Pooled it
- Time to treatment with bridging intravenous alteplase before endovascular treatment:subanalysis of the randomized controlled SWIFT-DIRECT trial.Journal of neurointerventional surgery · 2023Pooled it
- IV Thrombolysis Initiated Before Transfer for Endovascular Stroke Thrombectomy: A Systematic Review and Meta-analysis.Neurology · 2023Pooled it
- Safety and efficacy of tenecteplase versus alteplase in stroke patients with carotid tandem lesions: Results from the AcT trial.International journal of stroke : official journal of the International Stroke Society · 2024Trial
- Observational
- Acute Ischemic Stroke in 2026: From Time to Penumbra-An Updated Narrative Review of Reperfusion Strategies with a Latin American Implementation Perspective.Journal of clinical medicine · 2026Review
- Direct Thrombectomy vs. Combined Treatment With Intravenous Thrombolysis in the Extended Time Window: A Target Trial Emulation.European journal of neurology · 2026Article
- The Safety and Efficacy of Mechanical Thrombectomy with Acute Carotid Artery Stenting in an Extended Time Window: A Single-Center Study.Medical sciences (Basel, Switzerland) · 2026Article
- Comparison of Volatile Anesthesia and Intravenous Anesthesia for Endovascular Thrombectomy in Acute Ischemic Stroke Patients Under General Anesthesia: A Systematic Review and Meta-Analysis.Critical care research and practice · 2026Review
- Bridging Thrombolysis before Endovascular Therapy Improves Functional Outcomes in Medium-Large Core Stroke within 4.5 Hours: A Multicenter Propensity-Matched Study.Cerebrovascular diseases extra · 2026Article
- Tailored Treatment of Acute Ischemic Stroke: A Narrative Review of Evidence-Based Strategies by Imaging Type and Thrombectomy Availability.Medicina (Kaunas, Lithuania) · 2025Review
- Efficacy and safety of bridging intravenous thrombolysis before mechanical thrombectomy in acute ischemic stroke: A systematic review and meta-analysis.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- Feasibility of non-invasive neuromonitoring using BIS and NIRS during endovascular treatment of acute ischemic stroke.Neurological research and practice · 2025Article
- Dynamic cerebral autoregulation during and 3 months after endovascular treatment in large vessel occlusion stroke.Scientific reports · 2025Observational
- Efficacy and Safety of Intravenous Thrombolysis in the Extended Time Window for Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
- Age-Specific Differences in Inflammatory Biomarkers and Their Impact on Futile Recanalization After Mechanical Thrombectomy: An Inverse Probability Weighting Analysis.European journal of neurology · 2025Observational
- Effectiveness of intravenous thrombolysis in patients with large-vessel occlusion receiving endovascular treatment in Korea.Acute and critical care · 2025Article
- Drip and ship in patients with acute ischemic stroke: a narrative review.Therapeutic advances in neurological disorders · 2025Review
Corrections and comments
- Erratum issued
Authors and funding
18 authors at 17 institutions in 11 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Six randomized controlled clinical trials have assessed whether mechanical thrombectomy (MT) alone is non-inferior to intravenous thrombolysis (IVT) plus MT within 4.5 hours of symptom onset in patients with anterior circulation large vessel occlusion (LVO) ischaemic stroke and no contraindication to IVT. An expedited recommendation process was initiated by the European Stroke Organisation (ESO) and conducted with the European Society of Minimally Invasive Neurological Therapy (ESMINT) according to ESO standard operating procedure based on the GRADE system. We identified two relevant Population, Intervention, Comparator, Outcome (PICO) questions, performed systematic reviews and meta-analyses of the literature, assessed the quality of the available evidence and wrote evidence-based recommendations. Expert opinion was provided if insufficient evidence was available to provide recommendations based on the GRADE approach. For stroke patients with anterior circulation LVO directly admitted to a MT-capable centre ('mothership') within 4.5 hours of symptom onset and eligible for both treatments, we recommend IVT plus MT over MT alone (moderate evidence, strong recommendation). MT should not prevent the initiation of IVT, nor should IVT delay MT. In stroke patients with anterior circulation LVO admitted to a centre without MT facilities and eligible for IVT ≤4.5 hrs and MT, we recommend IVT followed by rapid transfer to a MT capable-centre ('drip-and-ship') in preference to omitting IVT (low evidence, strong recommendation). Expert consensus statements on ischaemic stroke on awakening from sleep are also provided. Patients with anterior circulation LVO stroke should receive IVT in addition to MT if they have no contraindications to either treatment.
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What OpenQuestion holds
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.