Evidence map›Paper›PMID 38836276›Full record

ArticleJournal of stroke2024

Endovascular Thrombectomy Versus Intravenous Thrombolysis of Posterior Cerebral Artery Occlusion Stroke.

Silja Räty, Thanh N Nguyen, Simon Nagel, Davide Strambo, Patrik Michel, Christian Herweh, Muhammad M Qureshi, Mohamad Abdalkader, Pekka Virtanen, Marta Olive-Gadea and 67 more

Abstract read
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In one paragraph

Article in Journal of stroke, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
–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

13 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Observational
  6. Article
  7. Article
  8. Article
  9. Article
  10. Review
  11. Review
  12. Observational
  13. 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

77 authors.

Silja RätyDepartment of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Thanh N NguyenDepartment of Radiology, Boston Medical Center, Boston, MA, USA.
Simon NagelDepartment of Neurology, Klinikum Ludwigshafen, Ludwigshafen, Germany.
Davide StramboDepartment of Neurology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Patrik MichelDepartment of Neurology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Christian HerwehDepartment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
Muhammad M QureshiDepartment of Radiology, Boston Medical Center, Boston, MA, USA.
Mohamad AbdalkaderDepartment of Radiology, Boston Medical Center, Boston, MA, USA.
Pekka VirtanenDepartment of Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Marta Olive-GadeaDepartment of Neurology, University Hospital Vall d'Hebron, Barcelona, Spain.
Marc RiboDepartment of Neurology, University Hospital Vall d'Hebron, Barcelona, Spain.
Marios PsychogiosDepartment of Neuroradiology, University Hospital Basel, University of Basel, Basel, Switzerland.
Anh NguyenDepartment of Neuroradiology, University Hospital Basel, University of Basel, Basel, Switzerland.
Joji B KuramatsuDepartment of Neurology, University of Erlangen, Erlangen, Germany.
David HaupenthalDepartment of Neurology, University of Erlangen, Erlangen, Germany.
Martin KöhrmannDepartment of Neurology, Universitätsklinikum Essen, Essen, Germany.
Cornelius DeuschlDepartment of Radiology, Universitätsklinikum Essen, Essen, Germany.
Jordi Kühne EscolàDepartment of Neurology, Universitätsklinikum Essen, Essen, Germany.
Jelle DemeestereDepartment of Neurology, UZ Leuven, Leuven, Belgium.
Robin LemmensDepartment of Neurology, UZ Leuven, Leuven, Belgium.
Lieselotte VandewalleDepartment of Neurology, UZ Leuven, Leuven, Belgium.
Shadi YaghiDepartment of Neurology, Rhode Island Hospital, Providence, RI, USA.
Liqi ShuDepartment of Neurology, Rhode Island Hospital, Providence, RI, USA.
Volker PuetzDepartment of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Daniel P O KaiserDresden Neurovascular Center, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Johannes KaesmacherInstitute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, University of Bern, Bern, Switzerland.
Adnan MujanovicInstitute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, University of Bern, Bern, Switzerland.
Dominique Cornelius MarterstocDepartment of Neuroradiology, University of Erlangen, Erlangen, Germany.
Tobias EngelhornDepartment of Neuroradiology, University of Erlangen, Erlangen, Germany.
Anne BerberichDepartment of Neurology, Klinikum Ludwigshafen, Ludwigshafen, Germany.
Piers KleinDepartment of Radiology, Boston Medical Center, Boston, MA, USA.
Diogo C HaussenDepartment of Neurology, Grady Memorial Hospital, Atlanta, GA, USA.
Mahmoud H MohammadenDepartment of Neurology, Grady Memorial Hospital, Atlanta, GA, USA.
Hend AbdelhamidDepartment of Neurology, Grady Memorial Hospital, Atlanta, GA, USA.
Isabel FragataDepartment of Neuroradiology, Centro Hospitalar Universitario de Lisboa Central, Lisbon, Portugal.
Bruno CunhaDepartment of Neuroradiology, Centro Hospitalar Universitario de Lisboa Central, Lisbon, Portugal.
Michele RomoliNeurology and Stroke Unit, Department of Neuroscience, Bufalini Hospital, Cesena, Italy.
Wei HuDepartment of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Jianlon SongDepartment of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Johanna T FifiDepartment of Neurosurgery, Mount Sinai Hospital, New York, NY, USA.
Stavros MatsoukasDepartment of Neurosurgery, Mount Sinai Hospital, New York, NY, USA.
Sunil A ShethDepartment of Neurology, UT Health McGovern Medical School, Houston, TX, USA.
Sergio A Salazar-MarioniDepartment of Neurology, UT Health McGovern Medical School, Houston, TX, USA.
João Pedro MartoDepartment of Neurology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.
João Nuno RamosDepartment of Neuroradiology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.
Milena MiszczukDepartment of Neuroradiology, Charité - Universitätsmedizin Berlin, and Berlin Institute of Health (BIH), Freie Universität Berlin and Humboldt-Universität, Berlin, Germany.
Christoph RieglerDepartment of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, and Berlin Institute of Health (BIH), Freie Universität Berlin and Humboldt-Universität, Berlin, Germany.
Sven PoliHertie-Institute for Clinical Brain Research, Tübingen University, Tübingen, Germany.
Khouloud PoliHertie-Institute for Clinical Brain Research, Tübingen University, Tübingen, Germany.
Ashutosh P JadhavDepartment of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA.
Shashvat DesaiDepartment of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA.
Volker MausDepartment of Radiology, Neuroradiology and Nuclear Medicine, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.
Maximilian KaederDepartment of Radiology, Neuroradiology and Nuclear Medicine, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.
Adnan H SiddiquiDepartment of Neurosurgery, University of Buffalo, Buffalo, NY, USA.
Andre MonteiroDepartment of Neurosurgery, University of Buffalo, Buffalo, NY, USA.
Tatu KokkonenDepartment of Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Francesco DianaDepartment of Interventional Neuroradiology, University Hospital Vall d'Hebron, Barcelona, Spain.
Hesham E MasoudDepartment of Neurology, New York Upstate Medical University, Syracuse, NY, USA.
Neil SuryadarevaDepartment of Neurology, New York Upstate Medical University, Syracuse, NY, USA.
Maxim MokinDepartment of Neurosurgery, University of South Florida, Tampa, FL, USA.
Shail ThankiDepartment of Neurosurgery, University of South Florida, Tampa, FL, USA.
Pauli YlikotilaDepartment of Neurology, Turku University Hospital and University of Turku, Turku, Finland.
Kemal AlpayDepartment of Radiology, Turku University Hospital and University of Turku, Turku, Finland.
James E SieglerDepartment of Neurology, University of Chicago, Chicago, IL, USA.
Italo LinfanteMiami Neuroscience Institute, Miami, FL, USA.
Guilherme DabusMiami Neuroscience Institute, Miami, FL, USA.
Dileep YavaghalDepartment of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.
Vasu SainiDepartment of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.
Christian H NolteDepartment of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, and Berlin Institute of Health (BIH), Freie Universität Berlin and Humboldt-Universität, Berlin, Germany.
Eberhart SiebertDepartment of Neuroradiology, Charité - Universitätsmedizin Berlin, and Berlin Institute of Health (BIH), Freie Universität Berlin and Humboldt-Universität, Berlin, Germany.
Markus A MöhlenbruchDepartment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
Peter A RinglebDepartment of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
Raul G NogueiraDepartment of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Uta HanningDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Lukas MeyerDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Urs FischerDepartment of Neurology, University Hospital Basel, University of Basel, Basel, Switzerland.
Daniel StrbianDepartment of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposePosterior cerebral artery occlusion (PCAo) can cause long-term disability, yet randomized controlled trials to guide optimal reperfusion strategy are lacking. We compared the outcomes of PCAo patients treated with endovascular thrombectomy (EVT) with or without intravenous thrombolysis (IVT) to patients treated with IVT alone.

methodsFrom the multicenter retrospective Posterior cerebraL ArTery Occlusion (PLATO) registry, we included patients with isolated PCAo treated with reperfusion therapy within 24 hours of onset between January 2015 and August 2022. The primary outcome was the distribution of the modified Rankin Scale (mRS) at 3 months. Other outcomes comprised 3-month excellent (mRS 0-1) and independent outcome (mRS 0-2), early neurological improvement (ENI), mortality, and symptomatic intracranial hemorrhage (sICH). The treatments were compared using inverse probability weighted regression adjustment.

resultsAmong 724 patients, 400 received EVT+/-IVT and 324 IVT alone (median age 74 years, 57.7% men). The median National Institutes of Health Stroke Scale score on admission was 7, and the occluded segment was P1 (43.9%), P2 (48.3%), P3-P4 (6.1%), bilateral (1.0%), or fetal posterior cerebral artery (0.7%). Compared to IVT alone, EVT+/-IVT was not associated with improved functional outcome (adjusted common odds ratio [OR] 1.07, 95% confidence interval [CI] 0.79-1.43). EVT increased the odds for ENI (adjusted OR [aOR] 1.49, 95% CI 1.05-2.12), sICH (aOR 2.87, 95% CI 1.23-6.72), and mortality (aOR 1.77, 95% CI 1.07-2.95).

conclusionDespite higher odds for early improvement, EVT+/-IVT did not affect functional outcome compared to IVT alone after PCAo. This may be driven by the increased risk of sICH and mortality after EVT.

Indexed as

Endovascular thrombectomyIntravenous thrombolysisPosterior cerebral arteryPosterior circulation stroke

Identifiers

PMID38836276
PMCPMC11164587

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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.