SynthesisSystematic reviews2024
Safety and efficacy of intravenous thrombolysis before mechanical thrombectomy in patients with atrial fibrillation.
Synthesis in Systematic reviews, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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.
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Who cites it
6 citing papers in PubMed, 6 citations in OpenAlex.
- A quantitative CT perfusion-derived online dynamic nomogram for predicting hemorrhagic transformation after intravenous thrombolysis in acute ischemic stroke.European journal of radiology open · 2025Article
- Heart Failure and Stroke: A Narrative Review.Journal of clinical medicine · 2025Review
- Impact of thrombolytic therapy on basilar artery occlusion patients with atrial fibrillation: results from a multi-center prospective cohort study.Frontiers in neurology · 2025Article
- Prognostic impact of collateral circulation in direct thrombectomy versus bridging thrombectomy for acute ischemic stroke patients with anterior circulation large vessel occlusion: a retrospective comparative study.Frontiers in neuroscience · 2025Article
- Atrial fibrillation is associated with increased in-hospital mortality and complications after IV t-PA in acute ischemic stroke: evidence from the China Stroke Center Alliance (CSCA).Frontiers in neurology · 2025Article
- Outcomes after direct thrombectomy versus combined thrombolysis and thrombectomy in acute large artery occlusion stroke with atrial fibrillation.Frontiers in neurologyArticle
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundIntravenous thrombolysis (IVT) before endovascular thrombectomy (EVT) is the standard treatment for patients with acute ischemic stroke caused by large vessel occlusion (AIS-LVO). However, the efficacy and safety of IVT before EVT in AIS-LVO patients with atrial fibrillation (AF) remains controversial. Thus, this study aims to assess the benefit of IVT plus EVT and direct EVT alone in AIS-LVO patients with AF.
methodRelevant studies that evaluated the outcomes of IVT plus EVT versus direct EVT alone in AIS-LVO patients with AF were systematically searched in PubMed, Embase, and Cochrane Library from inception to August 10, 2023. The outcomes included successful reperfusion (score of 2b to 3 for thrombolysis in cerebral infarction), symptomatic intracerebral hemorrhage (sICH), good clinical outcome (modified Rankin scale score ≤ 2) at 3 months, and 3-month mortality.
resultEight eligible observational studies involving 6998 (3827 in the IVT plus EVT group and 3171 in the direct EVT group) patients with AIS-LVO complicated by AF were included. Compared with direct EVT, IVT plus EVT resulted in better 3-month clinical outcomes (odds ratio [OR] 1.27, 95% confidence interval [CI] 1.05-1.54) and lower 3-month mortality (OR 0.78, 95% CI 0.68-0.88). However, the incidence of sICH (OR 1.26, 95% CI 0.91-1.75) and the rate of successful reperfusion (OR 0.98, 95% CI 0.83-1.17) were not significantly different between treatment modalities.
conclusionIVT plus EVT leads to better functional outcomes and lower mortality in AIS-LVO patients with AF. Withholding IVT plus EVT from patients with AF alone may not be justified.
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