Evidence map›Paper›PMID 36963842›Full record

ArticleNeurology2023

Bridging Thrombolysis Before Endovascular Therapy in Stroke Patients With Faster Core Growth.

Longting Lin, Hao Zhang, Feifeng Liu, Chen Chen, Chushuang Chen, Andrew Bivard, Mark W Parsons, Gang Li, for INSPIRE

Abstract read
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In one paragraph

Article in Neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 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

11 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Longting LinFrom the South Western Clinical School (L.L., M.W.P.), Faculty of Medicine, University of New South Wales, Sydney; Faculty of Health (L.L., Chushuang Chen, M.W.P.), University of Newcastle, Australia; Shanghai East Hospital (H.Z., F.L., Chen Chen, G.L.), Tongji University, China; and Melbourne Brain Centre (A.B., M.W.P.), Royal Melbourne Hospital, University of Melbourne, Australia.ORCID 0000-0001-7104-9846
Hao ZhangFrom the South Western Clinical School (L.L., M.W.P.), Faculty of Medicine, University of New South Wales, Sydney; Faculty of Health (L.L., Chushuang Chen, M.W.P.), University of Newcastle, Australia; Shanghai East Hospital (H.Z., F.L., Chen Chen, G.L.), Tongji University, China; and Melbourne Brain Centre (A.B., M.W.P.), Royal Melbourne Hospital, University of Melbourne, Australia.
Feifeng LiuFrom the South Western Clinical School (L.L., M.W.P.), Faculty of Medicine, University of New South Wales, Sydney; Faculty of Health (L.L., Chushuang Chen, M.W.P.), University of Newcastle, Australia; Shanghai East Hospital (H.Z., F.L., Chen Chen, G.L.), Tongji University, China; and Melbourne Brain Centre (A.B., M.W.P.), Royal Melbourne Hospital, University of Melbourne, Australia.
Chen ChenFrom the South Western Clinical School (L.L., M.W.P.), Faculty of Medicine, University of New South Wales, Sydney; Faculty of Health (L.L., Chushuang Chen, M.W.P.), University of Newcastle, Australia; Shanghai East Hospital (H.Z., F.L., Chen Chen, G.L.), Tongji University, China; and Melbourne Brain Centre (A.B., M.W.P.), Royal Melbourne Hospital, University of Melbourne, Australia.
Chushuang ChenFrom the South Western Clinical School (L.L., M.W.P.), Faculty of Medicine, University of New South Wales, Sydney; Faculty of Health (L.L., Chushuang Chen, M.W.P.), University of Newcastle, Australia; Shanghai East Hospital (H.Z., F.L., Chen Chen, G.L.), Tongji University, China; and Melbourne Brain Centre (A.B., M.W.P.), Royal Melbourne Hospital, University of Melbourne, Australia.ORCID 0000-0001-6014-846X
Andrew BivardFrom the South Western Clinical School (L.L., M.W.P.), Faculty of Medicine, University of New South Wales, Sydney; Faculty of Health (L.L., Chushuang Chen, M.W.P.), University of Newcastle, Australia; Shanghai East Hospital (H.Z., F.L., Chen Chen, G.L.), Tongji University, China; and Melbourne Brain Centre (A.B., M.W.P.), Royal Melbourne Hospital, University of Melbourne, Australia.ORCID 0000-0001-7762-5832
Mark W ParsonsFrom the South Western Clinical School (L.L., M.W.P.), Faculty of Medicine, University of New South Wales, Sydney; Faculty of Health (L.L., Chushuang Chen, M.W.P.), University of Newcastle, Australia; Shanghai East Hospital (H.Z., F.L., Chen Chen, G.L.), Tongji University, China; and Melbourne Brain Centre (A.B., M.W.P.), Royal Melbourne Hospital, University of Melbourne, Australia. mark.parsons@unsw.edu.au ligang@tongji.edu.cn.
Gang LiFrom the South Western Clinical School (L.L., M.W.P.), Faculty of Medicine, University of New South Wales, Sydney; Faculty of Health (L.L., Chushuang Chen, M.W.P.), University of Newcastle, Australia; Shanghai East Hospital (H.Z., F.L., Chen Chen, G.L.), Tongji University, China; and Melbourne Brain Centre (A.B., M.W.P.), Royal Melbourne Hospital, University of Melbourne, Australia. mark.parsons@unsw.edu.au ligang@tongji.edu.cn.ORCID 0000-0003-1009-2124
for INSPIRE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesIt is still uncertain that going direct to endovascular thrombectomy (EVT) leads to equivalent outcomes as bridging IV thrombolysis (IVT) in acute ischemic patients. This study aimed to explore whether the rate of ischemic core growth influenced the patient outcomes after bridging IVT vs direct EVT.

methodsThis was a retrospective cohort study based on the International Stroke Perfusion Imaging Registry (INSPIRE). It selected acute ischemic stroke patients receiving perfusion CT within 4.5 hours of stroke onset. Patients who went direct to EVT were compared with those who received bridging treatment of IVT before EVT. Ischemic core growth rate was estimated by the acute ischemic core volume on perfusion CT divided by the time from stroke onset to perfusion CT, based on the assumption of a linear growth pattern of ischemic core. Core growth rate was stratified into fast (>15 mL/h) and slow (≤15 mL/h), based on its interaction with bridging IVT in predicting the primary outcome. The primary outcome was modified Rankin scale of 0-2 at 3 months. The secondary outcomes included successful thrombectomy reperfusion defined by modified Thrombolysis in Cerebral Infarction score of 2b-3 and time from groin puncture to reperfusion.

resultsOf the 1,221 EVT patients in the INSPIRE, 323 patients were selected, of which 82 patients received direct EVT and 241 patients received bridging IVT. Bridging IVT was associated with a higher rate of good clinical outcome among patients with fast core growth (39% vs 7% for direct EVT, odds ratio [OR] 8.75 [1.96-39.1], DISCUSSION: Patients with fast core growth were more likely to benefit from bridging IVT. This is likely because prior IVT facilitates clot removal and thus reduces time to reperfusion.

Indexed as

Brain IschemiaEndovascular ProceduresIschemic StrokeStrokeFibrinolytic AgentsHumansRetrospective StudiesThrombectomyThrombolytic TherapyTreatment OutcomeFibrinolytic Agents

Identifiers

PMID36963842
PMCPMC10186238

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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.