Evidence map›Paper›PMID 38166040›Full record

SynthesisPloS one2024

Perfusion vs non-perfusion computed tomography imaging in the late window of emergent large vessel ischemic stroke: A systematic review and meta-analysis.

Jose Danilo B Diestro, Abdelsimar T Omar, Yu-Qing Zhang, Teruko Kishibe, Alexander Mastrolonardo, Melissa Mary Lannon, Katrina Ignacio, Eduardo Pimenta Ribeiro Pontes Almeida, Anahita Malvea, Ange Diouf and 11 more

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

  1. Article
  2. Observational
  3. Article
  4. Endovascular Treatment for Basilar Artery Occlusion.Journal of clinical medicine · 2024
    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

21 authors.

Jose Danilo B DiestroDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0001-8450-2021
Abdelsimar T OmarDivision of Neurosurgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
Yu-Qing ZhangDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Teruko KishibeHealth Sciences Library, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
Alexander MastrolonardoMichael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
Melissa Mary LannonDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Katrina IgnacioDepartment of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Alberta, Canada.ORCID 0000-0001-7263-8474
Eduardo Pimenta Ribeiro Pontes AlmeidaUniversity Health Network-Toronto General Hospital, Toronto, Ontario, Canada.ORCID 0000-0001-8196-866X
Anahita MalveaDivision of Neurosurgery, Department of Surgery, Unity Health- St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Ange DioufDivision of Diagnostic and Therapeutic Neuroradiology, Department of Medical Imaging, Unity Health- St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Arjun Vishnu SharmaDepartment of Neurology and Critical Care, McMaster University, Hamilton, ON, Canada.
Qingwu YangDepartment of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Shapingba District, Chongqing, China.
Zhongming QiuDepartment of Neurology, The 903rd Hospital of The People's Liberation Army, Xihu District, Hangzhou, China.
Mohammed A AlmekhlafiDepartment of Clinical Neurosciences, Radiology, and Community Health Sciences, Cumming School of Medicine at the University of Calgary, Calgary, Alberta, Canada.
Thanh N NguyenDepartment of Neurology, Boston University School of Medicine, Boston, Massachusetts, United States of America.
Atif ZafarDepartment of Medicine, Division of Neurology, Unity Health- St. Michael's Hospital, University of Toronto, Toronto, Ontario.
Vitor Mendes PereiraDivision of Diagnostic and Therapeutic Neuroradiology, Department of Medical Imaging, Unity Health- St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Julian SpearsDivision of Diagnostic and Therapeutic Neuroradiology, Department of Medical Imaging, Unity Health- St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Thomas R MarottaDivision of Diagnostic and Therapeutic Neuroradiology, Department of Medical Imaging, Unity Health- St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Forough FarrokhyarDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Sunjay SharmaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGuidelines recommend the treatment of emergent large vessel ischemic stroke (ELVIS) patients presenting beyond 6 hours of last known well time with endovascular thrombectomy (EVT) based on perfusion computed tomography (CT) neuroimaging. We compared the outcomes (long-term good clinical outcomes, symptomatic intracranial hemorrhage (sICH), and mortality) of ELVIS patients according to the type of CT neuroimaging they underwent.

methodsWe searched the following databases: Medline, Embase, CENTRAL, and Scopus from January 1, 2015, to June 14, 2023. We included studies of late-presenting ELVIS patients undergoing EVT that had with data for non-perfusion and perfusion CT neuroimaging. We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Data were pooled using a random effects model.

resultsWe found 7 observational cohorts. Non-perfusion versus perfusion CT was not statistically significantly different for both long-term clinical (n = 3,224; RR: 0.96; 95% CI 0.86 to 1.06; I2 = 18%) and sICH (n = 3,724; RR: 1.08 95% CI 0.60 to 1.94; I2 = 76%). Perfusion CT had less mortality (n = 3874; RR: 1.22; 95% CI 1.07 to 1.40; I2 = 0%). The certainty of these findings is very low because of limitations in the risk of bias, indirectness, and imprecision domains of the Grading of Recommendations, Assessment, Development and Evaluations.

conclusionThe use of either non-perfusion or perfusion CT neuroimaging may have little to no effect on long-term clinical outcomes and sICH for late-presenting EVT patients. Perfusion CT neuroimaging may be associated with a reduced the risk of mortality. Evidence uncertainty warrants randomized trial data.

Indexed as

Brain IschemiaEndovascular ProceduresIschemic StrokeHumansIntracranial HemorrhagesPerfusionThrombectomyTomography, X-Ray ComputedTreatment Outcome

Identifiers

PMID38166040
PMCPMC10760723

What OpenQuestion holds

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Registered trials

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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.