Evidence map›Paper›PMID 38481942›Full record

ArticleFrontiers in neurology2024

Effect of concomitant usage of alteplase and mechanical thrombectomy for M1 middle cerebral artery occlusion on clinical outcome: a retrospective analysis of 457 patients from two centers.

Slaven Pikija, Monika Killer-Oberpfalzer, Johannes A R Pfaff, Christoph J Griessenauer, Michael Sonnberger, Milan Vosko, Johannes S Mutzenbach, Daniel Schwarzenhofer, Constantin Hecker

Open access · goldAbstract read
In one paragraph

Article in Frontiers in neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.4field-weighted citation impact, top 40% 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

0 citing papers in PubMed, 1 citations in OpenAlex.

No citing paper in PubMed yet.

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

9 authors at 3 institutions in 1 country.

Slaven PikijaDepartment of Neurology, University Hospital Salzburg, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.
Monika Killer-OberpfalzerDepartment of Neurology, University Hospital Salzburg, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.
Johannes A R PfaffDepartment of Neuroradiology, University Hospital Salzburg, Christian Doppler Klinik, Paracelsus Medical University Salzburg, Salzburg, Austria.
Christoph J GriessenauerDepartment of Neurosurgery, University Hospital Salzburg, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.
Michael SonnbergerDepartment of Neuroradiology, Neuromed Campus, Johannes Kepler University, Linz, Austria.
Milan VoskoDepartment of Neurology 1, Neuromed Campus, Kepler University Hospital, Johannes Kepler University, Linz, Austria.
Johannes S MutzenbachDepartment of Neurology, University Hospital Salzburg, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.
Daniel SchwarzenhoferDepartment of Neurology 2, Med Campus III, Kepler University Hospital, Johannes Kepler University, Linz, Austria.
Constantin HeckerInstitute of Neurointervention, Paracelsus Medical University, Salzburg, Austria.
Christian Doppler Klinik · ATParacelsus Medical University · ATJohannes Kepler University of Linz · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Endovascular thrombectomy (EVT) and concomitant usage of intravenous alteplase (alteplase) in large vessel occlusion stroke may produce unwanted excess intracerebral hemorrhage (ICH). Whether this applies specifically to isolated occlusion of the M1 segment of the middle cerebral artery (MCA) is unknown. Methods: A retrospective study from two tertiary thrombectomy centers. ICH was determined according to Heidelberg Bleeding Classification (HBC). Factors associated with the occurrence of ICH in EVT alone vs. EVT with alteplase were evaluated using logistic regression analysis. Factors related to the clinical outcome as determined with a modified Rankin scale (mRS) were investigated with univariate and adjusted multivariate logistic regression analysis. The interaction between clinical variables and the usage of alteplase on the occurrence of ICH was evaluated. Results: Any ICH occurred in 156/457 (34.1%) patients Class 1a bleeding in 37 (8.1%), type 2 in 45 (9.8%) Class 1c in 22 (4.8%), Class 2 in 25 (5.5%), and Class 3 (extraparenchymal) in 27 (5.9%). ICH occurred in similar frequency between alteplase-treated patients vs. EVT alone (85/262 [32%] vs. 71/195 [36%]; OR 1.19 (95% CI 0.81-1.76). After adjustment, odds for clinical outcome were lower in ICH patients (OR 0.44 [95% CI 0.25-0.74]), Conclusion: Utilization of alteplase alongside EVT for MCA M1 occlusion did not result in excessive ICH occurrences or clinical deterioration.

Indexed as

alteplase (rt-PA)intracerebral hemorrhagemechanical thrombectomy (MT)modified Rankin scale (mRS)stroke

Identifiers

PMID38481942
PMCPMC10933087
OpenAlexW4392236470

What OpenQuestion holds

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LicenceCC BY
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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.