Evidence map›Paper›PMID 35833948›Full record

ArticleClinical neuroradiology2023

Association of Intravenous Thrombolysis with Delayed Reperfusion After Incomplete Mechanical Thrombectomy.

Adnan Mujanovic, Christoph Kammer, Christoph C Kurmann, Lorenz Grunder, Morin Beyeler, Matthias F Lang, Eike I Piechowiak, Thomas R Meinel, Simon Jung, William Almiri and 10 more

Open access · hybridFull text read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical neuroradiology, 2023. 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
1.2field-weighted citation impact, top 21% 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.

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, 8 citations in OpenAlex.

  1. 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

20 authors at 1 institution in 2 countries.

Adnan MujanovicUniversity Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Christoph KammerUniversity Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Christoph C KurmannUniversity Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Lorenz GrunderUniversity Institute of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Morin BeyelerDepartment of Neurology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Matthias F LangUniversity Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Eike I PiechowiakUniversity Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Thomas R MeinelDepartment of Neurology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Simon JungDepartment of Neurology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
William AlmiriUniversity Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Sara Pilgram-PastorUniversity Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Angelika HoffmannUniversity Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
David J SeiffgeDepartment of Neurology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Mirjam R HeldnerDepartment of Neurology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Tomas DobrockyUniversity Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Pasquale MordasiniUniversity Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Marcel ArnoldDepartment of Neurology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Jan GrallaUniversity Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Urs FischerDepartment of Neurology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Johannes KaesmacherUniversity Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland. johannes.kaesmacher@insel.ch.ORCID http://orcid.org/0000-0002-9177-2289
University of Bern · CH

Funding

Schweizerische Akademie der Medizinischen Wissenschaften JK
6 · The paper itself

Abstract

purposeTreatment of distal vessel occlusions causing incomplete reperfusion after mechanical thrombectomy (MT) is debated. We hypothesized that pretreatment with intravenous thrombolysis (IVT) may facilitate delayed reperfusion (DR) of residual vessel occlusions causing incomplete reperfusion after MT.

methodsRetrospective analysis of patients with incomplete reperfusion after MT, defined as extended thrombolysis in cerebral infarction (eTICI) 2a-2c, and available perfusion follow-up imaging at 24 ± 12 h after MT. DR was defined as absence of any perfusion deficit on time-sensitive perfusion maps, indicating the absence of any residual occlusion. The association of IVT with the occurrence of DR was evaluated using a logistic regression analysis adjusted for confounders. Sensitivity analyses based on IVT timing (time between IVT start and the occurrence incomplete reperfusion following MT) were performed.

resultsIn 368 included patients (median age 73.7 years, 51.1% female), DR occurred in 225 (61.1%). Atrial fibrillation, higher eTICI grade, better collateral status and longer intervention-to-follow-up time were all associated with DR. IVT did not show an association with the occurrence of DR (aOR 0.80, 95% CI 0.44-1.46, even in time-sensitive strata, aOR 2.28 [95% CI 0.65-9.23] and aOR 1.53 [95% CI 0.52-4.73] for IVT to incomplete reperfusion following MT timing <80 and <100 min, respectively).

conclusionA DR occurred in 60% of patients with incomplete MT at ~24 h and did not seem to occur more often in patients receiving pretreatment IVT. Further research on potential associations of IVT and DR after MT is required.

Indexed as

Brain IschemiaMechanical ThrombolysisStrokeAgedCerebral InfarctionFemaleFibrinolytic AgentsHumansMaleReperfusionRetrospective StudiesThrombectomyThrombolytic TherapyTreatment OutcomeFibrinolytic AgentsIncomplete ReperfusionIschemic strokeOutcomePerfusion imagingTissue-type plasminogen activatortPA

Identifiers

PMID35833948
PMCPMC10014807
OpenAlexW4285388508

What OpenQuestion holds

Textfull text, public
LicenceCC BY
measurements read79
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.