Evidence map›Paper›PMID 39266014›Full record

ArticleJournal of stroke2024

Mechanical Thrombectomy Versus Intravenous Thrombolysis in Distal Medium Vessel Acute Ischemic Stroke: A Multinational Multicenter Propensity Score-Matched Study.

Hamza Adel Salim, Vivek Yedavalli, Basel Musmar, Nimer Adeeb, Muhammed Amir Essibayi, Kareem El Naamani, Nils Henninger, Sri Hari Sundararajan, Anna Luisa Kühn, Jane Khalife and 51 more

Abstract read
PubMed Full text at PMC Publisher
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 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 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

21 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Observational
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Observational
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. 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

61 authors.

Hamza Adel SalimDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA.
Vivek YedavalliDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA.
Basel MusmarDepartment of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Baton Rouge, LA, USA.
Nimer AdeebDepartment of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Baton Rouge, LA, USA.
Muhammed Amir EssibayiDepartment of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Kareem El NaamaniDepartment of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.
Nils HenningerDepartment of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Sri Hari SundararajanDepartment of Endovascular Neurosurgery and Neuroradiology NJMS, Newark, NJ, USA.
Anna Luisa KühnDivision of Neurointerventional Radiology, Department of Radiology, University of Massachusetts Medical Center, Worcester, MA, USA.
Jane KhalifeCooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA.
Sherief GhozyDepartments of Neurological Surgery & Radiology, Mayo Clinic, Rochester, MN, USA.
Luca ScarciaDepartment of Neuroradiology, Henri Mondor Hospital, Creteil, France.
Benjamin Y Q TanDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Benjamin PulliDepartment of Interventional Neuroradiology, Stanford Medical Center, Palo Alto, CA, USA.
Jeremy J HeitDepartment of Interventional Neuroradiology, Stanford Medical Center, Palo Alto, CA, USA.
Robert W RegenhardtNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
Nicole M CancelliereNeurovascular Centre, Divisions of Therapeutic Neuroradiology and Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada.
Joshua D BernstockDepartment of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Aymeric RouchaudUniversity Hospital of Limoges, Neuroradiology Department, Dupuytren, Université de Limoges, Limoges, France.
Jens FiehlerCooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA.
Sunil ShethDepartment of Neurology, UTHealth McGovern Medical School, Houston, TX, USA.
Ajit S PuriDivision of Neurointerventional Radiology, Department of Radiology, University of Massachusetts Medical Center, Worcester, MA, USA.
Christian DyzmannNeuroradiology Department, Sana Kliniken, Lübeck GmbH, Lübeck, Germany.
Marco ColasurdoDepartment of Interventional Radiology, Oregon Health and Science University, Portland, OR, USA.
Xavier BarreauInterventional Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France.
Leonardo RenieriInterventistica Neurovascolare, Ospedale Careggi di Firenze, Florence, Italy.
João Pedro FilipeDepartment of Diagnostic and Interventional Neuroradiology, Centro Hospitalar Universitário do Porto, Porto, Portugal.
Pablo HarkerDepartment of Neurology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Razvan Alexandru RaduDepartment of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France.
Thomas R MarottaNeurovascular Centre, Divisions of Therapeutic Neuroradiology and Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada.
Julian SpearsNeurovascular Centre, Divisions of Therapeutic Neuroradiology and Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada.
Takahiro OtaDepartment of Neurosurgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.
Ashkan MowlaDivision of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA.
Pascal JabbourDepartment of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.
Arundhati BiswasDepartment of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, USA.
Frédéric ClarençonDepartment of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France; GRC BioFast, Sorbonne University, Paris VI, Paris, France.
James E SieglerCooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA.
Thanh N NguyenDepartments of Radiology & Neurology, Boston Medical Center, Boston, MA, USA.
Ricardo VarelaDepartment of Neurology, Centro Hospitalar Universitário do Porto, Porto, Portugal.
Amanda BakerDepartment of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
David AltschulDepartment of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Nestor R GonzalezDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Markus A MöhlenbruchSektion Vaskuläre und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany.
Vincent CostalatDepartment of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France.
Benjamin GoryDepartment of Interventional Neuroradiology, Nancy University Hospital, Nancy, France.
Christian Paul StrackeDepartment of Radiology, Interventional Neuroradiology Section, University Medical Center Münster, Münster, Germany.
Mohammad Ali Aziz-SultanDepartment of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Constantin HeckerDepartments of Neurology & Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University, Salzburg, Austria.
Hamza ShaikhCooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA.
David S LiebeskindUCLA Stroke Center and Department of Neurology Department, University of California, Los Angeles, Los Angeles, CA, USA.
Alessandro PedicelliUOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Roma, Italy.
Andrea M AlexandreUOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Roma, Italy.
Illario TancrediDepartment of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium.
Tobias D FaizyDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Erwah KalsoumDepartment of Neuroradiology, Henri Mondor Hospital, Creteil, France.
Boris LubiczDepartment of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, Brussels, Belgium.
Aman B PatelNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
Vitor Mendes PereiraNeurovascular Centre, Divisions of Therapeutic Neuroradiology and Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada.
Adrien GuenegoDepartment of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, Brussels, Belgium.
Adam A DmytriwNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
MAD MT InvestigatorsDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA.

Funding

Role of Sarm1 in TBI-accentuated C9orf72 Frontotemporal DementiaR21NS131756 · NINDS · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI HENNINGER, NILS · 2023 to 2024
$461k
NINDS NIH HHS R21 NS131756
6 · The paper itself

Abstract

background and purposeThe management of acute ischemic stroke (AIS) due to distal medium vessel occlusion (DMVO) remains uncertain, particularly in comparing the effectiveness of intravenous thrombolysis (IVT) plus mechanical thrombectomy (MT) versus IVT alone. This study aimed to evaluate the safety and efficacy in DMVO patients treated with either MT-IVT or IVT alone.

methodsThis multinational study analyzed data from 37 centers across North America, Asia, and Europe. Patients with AIS due to DMVO were included, with data collected from September 2017 to July 2023. The primary outcome was functional independence, with secondary outcomes including mortality and safety measures such as types of intracerebral hemorrhage.

resultsThe study involved 1,057 patients before matching, and 640 patients post-matching. Functional outcomes at 90 days showed no significant difference between groups in achieving good functional recovery (modified Rankin Scale 0-1 and 0-2), with adjusted odds ratios (OR) of 1.21 (95% confidence interval [CI] 0.81 to 1.79; P=0.35) and 1.00 (95% CI 0.66 to 1.51; P>0.99), respectively. Mortality rates at 90 days were similar between the two groups (OR 0.75, 95% CI 0.44 to 1.29; P=0.30). The incidence of symptomatic intracerebral hemorrhage was comparable, but any type of intracranial hemorrhage was significantly higher in the MT-IVT group (OR 0.43, 95% CI 0.29 to 0.63; P<0.001).

conclusionThe results of this study indicate that while MT-IVT and IVT alone show similar functional and mortality outcomes in DMVO patients, MT-IVT presents a higher risk of hemorrhagic complications, thus MT-IVT may not routinely offer additional benefits over IVT alone for all DMVO stroke patients. Further prospective randomized trials are needed to identify patient subgroups most likely to benefit from MT-IVT treatment in DMVO.

Indexed as

Distal medium vessel occlusionsMechanical thrombectomyStroke

Identifiers

PMID39266014
PMCPMC11471362

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.