Evidence map›Paper›PMID 35871179›Full record

SynthesisNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2022

Intravenous thrombolysis before mechanical thrombectomy for acute ischemic stroke due to large vessel occlusion; should we cross that bridge? A systematic review and meta-analysis of 36,123 patients.

Hazem S Ghaith, Mohamed Elfil, Mohamed Diaa Gabra, Asmaa Ahmed Nawar, Mohamed Sameh Abd-Alkhaleq, Khaled M Hamam, Lara Ebrahim Aboelnasr, Esraa Ayman Elgezery, Mohamed Hosny Osman, Hanaa Elsayed and 3 more

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 6 pooled it
3.7field-weighted citation impact, top 6% 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

14 citing papers in PubMed, 6 syntheses or guidelines pooled it, 25 citations in OpenAlex.

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  4. Intravenous thrombolysis plus mechanical thrombectomy versus mechanical thrombectomy alone for acute ischemic stroke: A systematic review and updated meta-analysis of clinical trials.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2024
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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

13 authors at 6 institutions in 4 countries.

Hazem S GhaithFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohamed ElfilMedical Research Group of Egypt, Cairo, Egypt.
Mohamed Diaa GabraMedical Research Group of Egypt, Cairo, Egypt.
Asmaa Ahmed NawarMedical Research Group of Egypt, Cairo, Egypt.
Mohamed Sameh Abd-AlkhaleqMedical Research Group of Egypt, Cairo, Egypt.
Khaled M HamamMedical Research Group of Egypt, Cairo, Egypt.
Lara Ebrahim AboelnasrMedical Research Group of Egypt, Cairo, Egypt.
Esraa Ayman ElgezeryMedical Research Group of Egypt, Cairo, Egypt.
Mohamed Hosny OsmanMedical Research Group of Egypt, Cairo, Egypt.
Hanaa ElsayedMedical Research Group of Egypt, Cairo, Egypt.
Sarya SwedMedical Research Group of Egypt, Cairo, Egypt.
Ulrick Sidney KanmounyeMedical Research Group of Egypt, Cairo, Egypt.
Ahmed NegidaMedical Research Group of Egypt, Cairo, Egypt. ahmed_negida@hms.harvard.edu.ORCID http://orcid.org/0000-0001-5363-6369
Scientific Research Group in Egypt · EGZagazig University · EGAl-Azhar University · EGMisr University for Science and Technology · EGSouth Valley University · EGUniversity of Aleppo · SY

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe use of intravenous thrombolysis (IVT) before mechanical thrombectomy (MT) for acute ischemic stroke due to large vessel occlusion (AIS-LVO) is a debatable subject in the field of neuro-interventional surgery. We conducted this systematic review and meta-analysis to synthesize evidence from published studies on the outcomes of IVT + MT compared with MT alone in AIS-LVO patients.

methodsWe searched PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials from inception to January 2022 for relevant clinical trials and observational studies. Eligible studies were identified, and all relevant outcomes were pooled in the meta-analysis DerSimonian-Liard random-effects model.

resultsForty-nine studies, with a total of 36,123 patients, were included in this meta-analysis. IVT + MT was significantly superior to MT alone in terms of successful recanalization (RR 1.06, 95% CI 1.03 to 1.09), mortality (RR 0.75, 95% CI 0.68-0.82), favorable functional outcome (RR 1.21, 95% CI 1.13 to 1.29), and complete recanalization (RR 1.06, 95% CI 1.00 to 1.11). There were no significant differences between the two groups in terms of improvement of the National Institute of Health Stroke Scale (NIHSS) score at 24 h or at discharge (p > 0.05). Complications including symptomatic intracranial hemorrhage, symptomatic intracerebral hemorrhage (sICH), procedure-related complications, and parenchymal hematoma were comparable between the two groups (p > 0.05).

conclusionFor AIS-LVO, IVT + MT is associated with slightly better rates of survival, successful and complete recanalization, and favorable functional outcome as compared with MT alone. Further clinical trials are needed to corroborate such benefits of bridging IVT.

Indexed as

Brain IschemiaIschemic StrokeStrokeFibrinolytic AgentsHumansThrombectomyThrombolytic TherapyTreatment OutcomeFibrinolytic AgentsAcute ischemic strokeEndovascular thrombectomyIntravenous thrombolysisMechanical thrombectomyMeta-analysisSystematic review

Identifiers

PMID35871179
OpenAlexW4286771024

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.