Evidence map›Paper›PMID 38388688›Full record

Trial reportAJNR. American journal of neuroradiology2024

Effect of Clot Burden Score on Safety and Efficacy of Intravenous Alteplase Prior to Mechanical Thrombectomy in Acute Ischemic Stroke: A Subgroup Analysis of a Randomized Phase 3 Trial.

Zifu Li, Yu Zhou, Xiaoxi Zhang, Lei Zhang, Yongwei Zhang, Pengfei Xing, Yongxin Zhang, Qinghai Huang, Qiang Li, Qiao Zuo and 4 more

Open access · hybridAbstract readRandomized Controlled TrialClinical Trial, Phase III
PubMed Full text at PMC Publisher
In one paragraph

Trial report in AJNR. American journal of neuroradiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 41% 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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
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

14 authors at 1 institution in 1 country.

Zifu LiFrom the Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.ORCID 0000-0002-9332-3786
Yu ZhouFrom the Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.ORCID 0000-0002-8095-1257
Xiaoxi ZhangFrom the Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.ORCID 0000-0003-3937-407X
Lei ZhangFrom the Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.ORCID 0000-0001-9958-3098
Yongwei ZhangFrom the Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.ORCID 0000-0003-1525-5893
Pengfei XingFrom the Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.ORCID 0000-0002-2663-1092
Yongxin ZhangFrom the Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.ORCID 0000-0003-1525-5893
Qinghai HuangFrom the Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.ORCID 0000-0002-5612-5190
Qiang LiFrom the Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.ORCID 0000-0002-8204-8862
Qiao ZuoFrom the Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.ORCID 0000-0003-4512-6363
Xiaofei YeFrom the Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Jianmin LiuFrom the Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.ORCID 0000-0002-3599-8267
Pengfei YangFrom the Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China p.yang@vip.163.com.ORCID 0000-0002-6154-3602
DIRECT-MT Investigators
Second Military Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeWhether thrombus burden in acute ischemic stroke modify the effect of intravenous thrombolysis (IVT) before mechanical thrombectomy (MT) remains uncertain. We aim to investigate the treatment effect of stratified clot burden score (CBS) on the efficacy and safety of direct versus bridging MT. MATERIALS AND

methodsThis is an exploratory subgroup analysis of a randomized trial evaluating the effect of CBS on clinical outcome in the DIRECT-MT trial. CBS was divided into 3 groups (0-3, 4-6, and 7-10) based on preoperative CTA, where higher scores indicated a lower clot burden. We report the adjusted common odds ratio for a shift toward better outcomes on the mRS after thrombectomy alone compared with combination treatment by stratified CBS groups.

resultsNo modification effect of mRS distribution was observed by CBS subgroups (CBS 0-3: adjusted common ratio odds 1.519 [95% CI, 0.928-2.486]; 4-6: 0.924 [0.635-1.345]; 7-10: 1.040 [0.481-2.247]). Patients with CBS 4-6 had a higher rate of early reperfusion (adjusted OR (aOR), 0.3 [95% CI, 0.1-0.9]), final reperfusion (aOR 0.5 [95% CI, 0.3-0.9]), and fewer thrombectomy attempts (aOR 0.4 [95% CI, 0.1-0.7]). Patients with CBS 7-10 had a higher rate of asymptomatic intracranial hemorrhage (14.9% versus 36.8%,

conclusionsThe subgroup analysis of DIRECT-MT suggested that thrombus burden did not alter the treatment effect of IVT before MT on functional outcomes in CBS subgroups.

Indexed as

Brain IschemiaIschemic StrokeStrokeThrombosisFibrinolytic AgentsHumansThrombectomyThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeFibrinolytic AgentsTissue Plasminogen Activator

Identifiers

PMID38388688
PMCPMC11286111
OpenAlexW4392024306

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.