Evidence map›Paper›PMID 35902234›Full record

SynthesisJournal of neurointerventional surgery2023

Time to treatment with bridging intravenous alteplase before endovascular treatment:subanalysis of the randomized controlled SWIFT-DIRECT trial.

Thomas R Meinel, Johannes Kaesmacher, Lukas Buetikofer, Daniel Strbian, Omer Faruk Eker, Christophe Cognard, Pasquale Mordasini, Sandro Deppeler, Vitor Mendes Pereira, Jean François Albucher and 54 more

Registry-linked trialOpen access · hybridAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of neurointerventional surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03192332 (Solitaire™ With the Intention For Thrombectomy Plus Intravenous t-PA Versus DIRECT Solitaire™ Stent-retriever Thrombectomy in Acute Anterior Circulation Stroke), which is not on this map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 16% 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.

NCT03192332 nacompletednot on this map

Solitaire™ With the Intention For Thrombectomy Plus Intravenous t-PA Versus DIRECT Solitaire™ Stent-retriever Thrombectomy in Acute Anterior Circulation Stroke

TypeinterventionalSponsorInsel Gruppe AG, University Hospital BernRan2017 to 2021Enrolled410ConditionsIschemic StrokeArmsStent-retriever thrombectomy with revascularization device of the Solitaire™ type, Intravenous thrombolysis with recombinant tissue-type plasminogen activator (IV t-PA)
3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
  10. Article
  11. Combined Therapeutics: Future Opportunities for Co-therapy with Thrombectomy.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2023
    Review
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

64 authors at 20 institutions in 8 countries.

Thomas R Meinel *Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.ORCID http://orcid.org/0000-0002-0647-9273
Johannes Kaesmacher *University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.ORCID http://orcid.org/0000-0002-9177-2289
Lukas BuetikoferCTU Bern, University of Bern, Bern, Switzerland.
Daniel StrbianDepartment of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Omer Faruk EkerDepartment of Neuroradiology, Hospices Civils de Lyon, Lyon, France.
Christophe CognardDepartment of Diagnostic and Therapeutic Neuroradiology, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.ORCID http://orcid.org/0000-0003-4287-2627
Pasquale MordasiniUniversity Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
Sandro DeppelerNeuro Clinical Trial Unit, Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
Vitor Mendes PereiraDivision of Neuroradiology and Division of Neurosurgery, Departments of Medical Imaging and Surgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0002-6804-3985
Jean François AlbucherDepartment of Neurology, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
Jean DarcourtDepartment of Neuroradiology, Hospices Civils de Lyon, Lyon, France.ORCID http://orcid.org/0000-0003-1620-4449
Romain BourcierDepartment of Diagnostic and Interventional Neuroradiology, Centre Hospitalier Universitaire de Nantes, Nantes Université, Nantes, France.
Benoit GuillonDepartment of Neurology, Centre Hospitalier Universitaire de Nantes, Nantes Université, Nantes, France.
Chrysanthi PapagiannakiDepartment of Radiology, CHU Rouen, Rouen, France.ORCID http://orcid.org/0000-0002-9473-9644
Guillaume CostentinDepartment of Neurology, CHU Rouen, Rouen, France.
Gerli SiboltDepartment of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Silja RätyDepartment of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Benjamin GoryDepartment of Diagnostic and Therapeutic Neuroradiology, CHRU-Nancy, Université de Lorraine, INSERM U1254, Nancy, France.
Sébastien RichardDepartment of Neurology, Stroke Unit, CHRU-Nancy, Université de Lorraine, INSERM U1116, Nancy, France.ORCID http://orcid.org/0000-0002-0945-5656
Jan LimanDepartment of Neurology, Klinikum Nürnberg, Nürnberg, Germany.
Marielle ErnstDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Göttingen, Gottingen, Germany.
Marion BoulangerDeparment of Neurology, CHU Caen Normandie, University Caen Normandie, INSERM U1237, Caen, France.
Charlotte BarbierDepartment of Neuroradiology, CHU Caen Normandie, University Caen Normandie, INSERM U1237, Caen, France.
Laura MechtouffDepartment of Vascular Neurology, Hospices Civils de Lyon, Lyon, France.ORCID http://orcid.org/0000-0001-9165-5763
Liqun ZhangDepartment of Neurology, St George's University Hospital NHS Foundation Trust, London, UK.
Gaultier MarnatDepartment of Interventional and Diagnostic Neuroradiology, CHU Bordeaux, University of Bordeaux, Bordeaux, France.ORCID http://orcid.org/0000-0002-7611-7753
Igor SibonStroke Unit, CHU Bordeaux, University of Bordeaux, Bordeaux, France.
Omid NikoubashmanDepartment of Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany.ORCID http://orcid.org/0000-0002-2055-4217
Arno ReichDepartment of Neurology, University Hospital RWTH Aachen, Aachen, Germany.
Arturo ConsoliDepartment of Stroke and Diagnostic and Interventional Neuroradiology, Foch Hospital, Suresnes, France.
David WeisenburgerDepartment of Stroke and Diagnostic and Interventional Neuroradiology, Foch Hospital, Suresnes, France.
Manuel RequenaStroke Unit, Department of Neurology, Hospital Vall d'Heborn, Barcelona, Spain.ORCID http://orcid.org/0000-0002-5671-6484
Alvaro Garcia-TornelStroke Unit, Department of Neurology, Hospital Vall d'Heborn, Barcelona, Spain.ORCID http://orcid.org/0000-0003-3633-3002
Suzana SalemeDepartment of Neuroradiology, CHU Limoges, Limoges, France.
Solène MoulinDepartment of Neurology, CHU Reims, Reims, France.
Paolo PaganoDepartment of Neuroradiology, CHU Reims, Reims, France.ORCID http://orcid.org/0000-0001-5821-2653
Guillaume SaliouService of Interventional and Diagnostic Radiology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.ORCID http://orcid.org/0000-0003-3832-7976
Emmanuel CarreraDepartment of Neurology, Hôpitaux Universitaires de Genève, Geneva, Switzerland.
Kevin JanotDepartment of Diagnostic and Interventional Neuroradiology, Tours University Hospital, Tours, France.ORCID http://orcid.org/0000-0002-7305-3125
Marti BoixStroke Unit, Department of Neurosciences, University Hospital Germans Trias i Pujol, Barcelona, Spain.
Raoul PopDepartment of Interventional Neuroradiology, Strasbourg University Hospitals, Strasbourg, France.ORCID http://orcid.org/0000-0003-4417-1496
Lucie Della SchiavaDepartment of Neurology, Lille University Hospital, Lille, France.
Andreas LuftDepartment of Neurology, University Hospital Zurich, Zurich, Switzerland.
Michel PiotinDepartment of interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France.
Jean Christophe GentricDepartment of Neuroradiology, Brest University Hospital, Brest, France.
Aleksandra PikulaDepartment of Neurology, University Health Network - Toronto Western Hospital - University of Toronto, Toronto, Ontario, Canada.
Waltraud PfeilschifterDepartment of Neurology, University Hospital Frankfurt, Frankfurt, Germany.
Marcel ArnoldDepartment of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
Adnan SiddiquiDepartment of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
Michael T FroehlerVanderbilt Cerebrovascular Program, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Anthony J FurlanSchool of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
René ChapotDepartment of Intracranial Endovascular Therapy, Alfried-Krupp Krankenhaus, Essen, Germany.
Martin WiesmannDepartment of Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany.ORCID http://orcid.org/0000-0002-8261-5513
Paolo MachiDepartment of Neuroradiology, Hôpitaux Universitaires de Genève, Geneva, Switzerland.
Hans-Christoph DienerDepartment of Neuroepidemiology, Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), Essen, Germany.
Zsolt KulcsarDepartment of Neuroradiology, University Hospital of Zurich, Zurich, Switzerland.
Leo BonatiDepartment of Neurology, University Hospital Basel, Basel, Switzerland.
Claudio BassettiDepartment of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
Simon EscalardDepartment of interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France.
David LiebeskindDepartment of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine, UCLA, University of California, Los Angeles, California, USA.ORCID http://orcid.org/0000-0002-5109-8736
Jeffrey L SaverDepartment of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine, UCLA, University of California, Los Angeles, California, USA.ORCID http://orcid.org/0000-0001-9141-2251
Urs FischerDepartment of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland urs.fischer@usb.ch.
Jan GrallaUniversity Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
SWIFT-DIRECT investigators
University of Bern · CHInserm · FRCentre Hospitalier Universitaire de Reims · FRHospices Civils de Lyon · FRRWTH Aachen University · DEUniversity of Helsinki · FICentre Hospitalier Universitaire de Nantes · FRCentre Hospitalier Universitaire de Rouen · FRCentre Hospitalier Universitaire de Toulouse · FRFondation de Rothschild · FRHôpital Beau-Séjour · CHHôpital Foch · FRUniversité de Bordeaux · FRUniversity Health Network · CAUniversity Hospital of Zurich · CHUniversity of California, Los Angeles · USAlfried Krupp Hospital · DECase Western Reserve University · USCentre Hospitalier Régional Universitaire de Brest · FRCentre Hospitalier Universitaire de Limoges · FR

Funding

High Speed Angiography at 1000 frames per secondR01EB030092 · NIBIB · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI RUDIN, STEPHEN · 2020 to 2023
$2.6M
NIBIB NIH HHS R01 EB030092
6 · The paper itself

Abstract

backgroundWe hypothesized that treatment delays might be an effect modifier regarding risks and benefits of intravenous thrombolysis (IVT) before mechanical thrombectomy (MT).

methodsWe used the dataset of the SWIFT-DIRECT trial, which randomized 408 patients to IVT+MT or MT alone. Potential interactions between assignment to IVT+MT and expected time from onset-to-needle (OTN) as well as expected time from door-to-needle (DTN) were included in regression models. The primary outcome was functional independence (modified Rankin Scale (mRS) 0-2) at 3 months. Secondary outcomes included mRS shift, mortality, recanalization rates, and (symptomatic) intracranial hemorrhage at 24 hours.

resultsWe included 408 patients (IVT+MT 207, MT 201, median age 72 years (IQR 64-81), 209 (51.2%) female). The expected median OTN and DTN were 142 min and 54 min in the IVT+MT group and 129 min and 51 min in the MT alone group. Overall, there was no significant interaction between OTN and bridging IVT assignment regarding either the functional (adjusted OR (aOR) 0.76, 95% CI 0.45 to 1.30) and safety outcomes or the recanalization rates. Analysis of in-hospital delays showed no significant interaction between DTN and bridging IVT assignment regarding the dichotomized functional outcome (aOR 0.48, 95% CI 0.14 to 1.62), but the shift and mortality analyses suggested a greater benefit of IVT when in-hospital delays were short.

conclusionsWe found no evidence that the effect of bridging IVT on functional independence is modified by overall or in-hospital treatment delays. Considering its low power, this subgroup analysis could have missed a clinically important effect, and exploratory analysis of secondary clinical outcomes indicated a potentially favorable effect of IVT with shorter in-hospital delays. Heterogeneity of the IVT effect size before MT should be further analyzed in individual patient meta-analysis of comparable trials. TRIAL REGISTRATION NUMBER: URL: https://www. CLINICALTRIALS: gov ; Unique identifier: NCT03192332.

Indexed as

Brain IschemiaStrokeAgedFemaleFibrinolytic AgentsHumansMaleThrombectomyThrombolytic TherapyTime-to-TreatmentTissue Plasminogen ActivatorTreatment OutcomeFibrinolytic AgentsTissue Plasminogen ActivatorThrombectomyThrombolysis

Identifiers

PMID35902234
PMCPMC10715486
OpenAlexW4288445152

What OpenQuestion holds

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LicenceCC BY
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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.