ArticleStroke2024
Intravenous Thrombolysis Before Endovascular Treatment in Posterior Circulation Occlusions: A MR CLEAN Registry Study.
Article in Stroke, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 3 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
9 citing papers in PubMed, 3 syntheses or guidelines pooled it, 9 citations in OpenAlex.
- Comparing Efficacy and Safety of Bridging Therapy Versus Endovascular Thrombectomy in Acute Basilar Artery Occlusion: A Systematic Review and Meta-Analysis.Brain and behavior · 2026Pooled it
- Association of anesthesia strategies with outcomes in endovascular treatment for distal and medium vessel occlusions: A propensity score-matched analysis of the MR CLEAN registry and meta-analysis.European stroke journal · 2026Pooled it
- Revascularization treatment for posterior circulation ischemic stroke: a systematic review and network meta-analysis.BMC neurology · 2025Pooled it
- Imaging suspected posterior circulation stroke in the emergency department: a practical modality-based review.Emergency radiology · 2026Review
- Tenecteplase Versus Alteplase for First-Pass Reperfusion in Basilar Artery Occlusion Stroke Thrombectomy.Annals of neurology · 2026Article
- Intravenous thrombolysis before endovascular treatment in acute vertebrobasilar occlusions: Pooled analysis of the French and German Stroke Registries.European stroke journal · 2025Article
- Intravenous Thrombolysis Prior to Endovascular Treatment in Basilar Artery Occlusions: A Patient Pooled Analysis of Four Randomized Controlled Trials.Cardiovascular and interventional radiology · 2025Article
- Association of anesthesia strategies with outcomes in endovascular treatment for distal and medium vessel occlusions: A propensity score-matched analysis of the MR CLEAN registry and meta-analysis.European stroke journal · 2025Article
- Intravenous thrombolysis before endovascular treatment in acute posterior circulation occlusions, what's next?Frontiers in neurology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 8 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe effectiveness of intravenous thrombolysis (IVT) before endovascular treatment (EVT) has been investigated in randomized trials and meta-analyses. These studies mainly concerned anterior circulation occlusions. We aimed to investigate clinical, technical, and safety outcomes of IVT before EVT in posterior circulation occlusions in a nationwide registry.
methodsPatients were included from the MR CLEAN Registry (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands), a nationwide, prospective, multicenter registry of patients with acute ischemic stroke due to a large intracranial vessel occlusion receiving EVT between 2014 and 2019. All patients with a posterior circulation occlusion were included. Primary outcome was a shift toward better functional outcome on the modified Rankin Scale at 90 days. Secondary outcomes were favorable functional outcome (modified Rankin Scale scores, 0-3), occurrence of symptomatic intracranial hemorrhages, successful reperfusion (extended Thrombolysis in Cerebral Ischemia ≥2B), first-attempt successful reperfusion, and mortality at 90 days. Regression analyses with adjustments based on univariable analyses and literature were applied.
resultsA total of 248 patients were included, who received either IVT (n=125) or no IVT (n=123) before EVT. Results show no differences in a shift on the modified Rankin Scale (adjusted common odds ratio, 1.04 [95% CI, 0.61-1.76]). Although symptomatic intracranial hemorrhages occurred more often in the IVT group (4.8% versus 2.4%), regression analysis did not show a significant difference (adjusted odds ratio, 1.65 [95% CI, 0.33-8.35]). Successful reperfusion, favorable functional outcome, first-attempt successful reperfusion, and mortality did not differ between patients treated with and without IVT.
conclusionsWe found no significant differences in clinical, technical, and safety outcomes between patients with a large vessel occlusion in the posterior circulation treated with or without IVT before EVT. Our results are in line with the literature on the anterior circulation.
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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.