Evidence map›Paper›PMID 38863660›Full record

ArticleNeurology. Clinical practice2024

Worldwide Survey on Approach to Thrombolysis in Acute Ischemic Stroke With Large Vessel Occlusion.

Nishita Singh, Nima Kashani, Alonso G Zea Vera, Aleksander Tkach, Aravind Ganesh

Abstract read
In one paragraph

Article in Neurology. Clinical practice, 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
–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

1 citing paper in PubMed.

  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

5 authors.

Nishita SinghDepartment of Internal Medicine (NS), Neurology Division, University of Manitoba, Winnipeg, Canada; Department of Clinical Neurosciences (NS, NK, AG), University of Calgary, Alberta, Canada; Department of Diagnostic and Interventional Neuroradiology (NK), Royal University Hospital, University of Saskatchewan, Saskatoon, Canada; Division of Neurology (AGZV), Children's National Hospital, Washington, DC; and Kelowna General Hospital (AT), University of British Columbia, Canada.ORCID https://orcid.org/0000-0003-3647-0904
Nima KashaniDepartment of Internal Medicine (NS), Neurology Division, University of Manitoba, Winnipeg, Canada; Department of Clinical Neurosciences (NS, NK, AG), University of Calgary, Alberta, Canada; Department of Diagnostic and Interventional Neuroradiology (NK), Royal University Hospital, University of Saskatchewan, Saskatoon, Canada; Division of Neurology (AGZV), Children's National Hospital, Washington, DC; and Kelowna General Hospital (AT), University of British Columbia, Canada.ORCID https://orcid.org/0000-0002-9752-784X
Alonso G Zea VeraDepartment of Internal Medicine (NS), Neurology Division, University of Manitoba, Winnipeg, Canada; Department of Clinical Neurosciences (NS, NK, AG), University of Calgary, Alberta, Canada; Department of Diagnostic and Interventional Neuroradiology (NK), Royal University Hospital, University of Saskatchewan, Saskatoon, Canada; Division of Neurology (AGZV), Children's National Hospital, Washington, DC; and Kelowna General Hospital (AT), University of British Columbia, Canada.ORCID https://orcid.org/0000-0002-8172-3117
Aleksander TkachDepartment of Internal Medicine (NS), Neurology Division, University of Manitoba, Winnipeg, Canada; Department of Clinical Neurosciences (NS, NK, AG), University of Calgary, Alberta, Canada; Department of Diagnostic and Interventional Neuroradiology (NK), Royal University Hospital, University of Saskatchewan, Saskatoon, Canada; Division of Neurology (AGZV), Children's National Hospital, Washington, DC; and Kelowna General Hospital (AT), University of British Columbia, Canada.ORCID https://orcid.org/0009-0009-4063-4431
Aravind GaneshDepartment of Internal Medicine (NS), Neurology Division, University of Manitoba, Winnipeg, Canada; Department of Clinical Neurosciences (NS, NK, AG), University of Calgary, Alberta, Canada; Department of Diagnostic and Interventional Neuroradiology (NK), Royal University Hospital, University of Saskatchewan, Saskatoon, Canada; Division of Neurology (AGZV), Children's National Hospital, Washington, DC; and Kelowna General Hospital (AT), University of British Columbia, Canada.ORCID https://orcid.org/0000-0001-5520-2070

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and Objectives: With recent trials suggesting that endovascular thrombectomy (EVT) alone may be noninferior to combined intravenous thrombolysis (IVT) with alteplase and EVT and that tenecteplase is non-inferior to alteplase in treating acute ischemic stroke, we sought to understand current practices around the world for treating acute ischemic stroke with large vessel occlusion (LVO) depending on the center of practice (IVT-capable vs IVT and EVT-capable stroke center). Methods: The electronic survey launched by the Practice Current section of Neurology: Clinical Practice included 6 clinical and 8 demographic questions. A single-case scenario was presented of a 65-year-old man presenting with right hemiplegia with aphasia with a duration of 1 hour. Imaging showed left M1-MCA occlusion with no early ischemic changes. The respondents were asked about their treatment approach in 2 settings: the patient presented to (1) the IVT-only capable center and (2) the IVT and EVT-capable center. They were also asked about the thrombolytic agent of choice in current and ideal circumstances for these settings. Results: A total of 203 physicians (42.9% vascular neurologists) from 44 countries completed the survey. Most participants (55.2%) spent ≥50% of their time delivering stroke care. The survey results showed that in current practice, more than 90% of respondents would offer IVT + EVT to patients with LVO stroke presenting to either an EVT-capable (91.1%) or IVT-only-capable center (93.6%). Although nearly 80% currently use alteplase for thrombolysis, around 60% would ideally like to switch to tenecteplase independent of the practice setting. These results were similar between stroke and non-stroke neurologists. Discussion: Most physicians prefer IVT before EVT in patients with acute ischemic stroke attributable to large vessel occlusion independent of the practice setting.

Identifiers

PMID38863660
PMCPMC11164043

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.