Evidence map›Paper›PMID 39567366›Full record

SynthesisStroke2025

Natural Evolution of Incomplete Reperfusion in Patients Following Endovascular Therapy After Ischemic Stroke.

Adnan Mujanovic, Daniel Windecker, Petra Cimflova, Thomas R Meinel, David J Seiffge, Elias Auer, Grégoire Boulouis, Marcel Arnold, Bettina L Serrallach, Roman Rohner and 8 more

Registry-linked trialAbstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Stroke, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05499832 (Safety and Efficacy of Intra-arterial Tenecteplase for Noncomplete Reperfusion of Intracranial Occlusions), which is not on this map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing 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.

NCT05499832 phase3completednot on this map

Safety and Efficacy of Intra-arterial Tenecteplase for Noncomplete Reperfusion of Intracranial Occlusions

TypeinterventionalSponsorInsel Gruppe AG, University Hospital BernRan2023 to 2025Enrolled156ConditionsIschemic StrokeArmsTenecteplase
3 · Its place in the literature

Who cites it

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

  1. Pooled it
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  5. Review
  6. Brain-Derived Cystathionine β-Synthase-Generated HCurrent issues in molecular biology · 2026
    Article
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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

18 authors.

Adnan MujanovicDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital (A.M., D.W., P.C., B.L.S., R.R., T.D., E.I.P., J.G., J.K.).ORCID 0000-0002-6839-7134
Daniel WindeckerDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital (A.M., D.W., P.C., B.L.S., R.R., T.D., E.I.P., J.G., J.K.).ORCID 0009-0000-7632-0084
Petra CimflovaDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital (A.M., D.W., P.C., B.L.S., R.R., T.D., E.I.P., J.G., J.K.).ORCID 0000-0001-8058-383X
Thomas R MeinelDepartment of Neurology, University Hospital Bern, Inselspital (T.R.M., D.J.S., E.A., M.A., U.F.), University of Bern, Switzerland.ORCID 0000-0002-0647-9273
David J SeiffgeDepartment of Neurology, University Hospital Bern, Inselspital (T.R.M., D.J.S., E.A., M.A., U.F.), University of Bern, Switzerland.ORCID 0000-0003-3890-3849
Elias AuerDepartment of Neurology, University Hospital Bern, Inselspital (T.R.M., D.J.S., E.A., M.A., U.F.), University of Bern, Switzerland.
Grégoire BoulouisDiagnostic and Interventional Neuroradiology, CIC-IT 1415, CHRU de Tours, France (G.B., K.J., J.K.).ORCID 0000-0001-8422-9205
Marcel ArnoldDepartment of Neurology, University Hospital Bern, Inselspital (T.R.M., D.J.S., E.A., M.A., U.F.), University of Bern, Switzerland.ORCID 0000-0002-4274-4644
Bettina L SerrallachDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital (A.M., D.W., P.C., B.L.S., R.R., T.D., E.I.P., J.G., J.K.).ORCID 0000-0002-1301-7798
Roman RohnerDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital (A.M., D.W., P.C., B.L.S., R.R., T.D., E.I.P., J.G., J.K.).ORCID 0009-0006-1331-705X
Kevin JanotDiagnostic and Interventional Neuroradiology, CIC-IT 1415, CHRU de Tours, France (G.B., K.J., J.K.).ORCID 0000-0002-7305-3125
Tomas DobrockyDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital (A.M., D.W., P.C., B.L.S., R.R., T.D., E.I.P., J.G., J.K.).ORCID 0000-0002-6167-3343
Michael D HillDepartment of Clinical Neurosciences, Department of Community Health Sciences, Department of Medicine, Department of Radiology (M.D.H.), Hotchkiss Brain Institute, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada.ORCID 0000-0002-6269-1543
Mayank GoyalDepartment of Radiology, Department of Clinical Neurosciences (M.G.), Hotchkiss Brain Institute, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada.ORCID 0000-0001-9060-2109
Eike I PiechowiakDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital (A.M., D.W., P.C., B.L.S., R.R., T.D., E.I.P., J.G., J.K.).ORCID 0000-0001-5609-0998
Jan GrallaDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital (A.M., D.W., P.C., B.L.S., R.R., T.D., E.I.P., J.G., J.K.).ORCID 0000-0003-1953-9033
Urs FischerDepartment of Neurology, University Hospital Bern, Inselspital (T.R.M., D.J.S., E.A., M.A., U.F.), University of Bern, Switzerland.ORCID 0000-0003-0521-4051
Johannes KaesmacherDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital (A.M., D.W., P.C., B.L.S., R.R., T.D., E.I.P., J.G., J.K.).ORCID 0000-0002-9177-2289

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA third of endovascularly treated patients with stroke experience incomplete reperfusion (expanded Thrombolysis in Cerebral Infarction [eTICI] <3), and the natural evolution of this incomplete reperfusion remains unknown. We systematically reviewed the literature and performed a meta-analysis on the natural evolution of incomplete reperfusion after endovascular therapy.

methodsA systematic review of MEDLINE, Embase, and PubMed up until March 1, 2024, using a predefined strategy. Only full-text English-written articles reporting rates of either favorable (ie, delayed reperfusion (DR) or no new infarct) or unfavorable progression (ie, persistent perfusion deficit or new infarct) of incompletely reperfused tissue were included. The primary outcome was the rate of DR and its association with functional independence (modified Rankin Scale score, 0-2) at 90 days postintervention. Pooled odds ratios with 95% CIs were calculated using a random-effects model.

resultsSix studies involving 950 patients (50.7% female; median age, 71 years; interquartile range, 60-79) were included. Four studies assessed the evolution of incomplete reperfusion on magnetic resonance imaging perfusion imaging, while 2 studies used diffusion-weighted imaging and noncontrast computed tomography imaging, where new infarct was used to denote unfavorable progression. Five studies defined incomplete reperfusion as eTICI 2b50 or 2c. DR occurred in 41% (interquartile range, 33%-51%) of cases 24 hours postintervention. Achieving DR was associated with a higher likelihood of functional independence at 90 days (odds ratio, 2.5 [95% CI, 1.9-3.4]).

conclusionsNearly half of eTICI <3 patients achieve DR, leading to favorable clinical outcomes. This subgroup may derive limited or potentially harmful effects from pursuing additional reperfusion strategies (eg, intra-arterial lytics or secondary thrombectomy). Accurately predicting the evolution of incomplete reperfusion could optimize patient selection for adjunctive reperfusion strategies at the end of an intervention. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifiers: NCT05499832.

Indexed as

Endovascular ProceduresIschemic StrokeReperfusionThrombolytic TherapyAgedFemaleHumansMaleMiddle AgedTreatment Outcomeendovascular proceduresfunctional statusperfusion imagingreperfusionstroke

Identifiers

PMID39567366
PMCPMC11771359

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Registered trials

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.