Evidence map›Paper›PMID 39976740›Full record

Trial reportClinical neuroradiology2025

Susceptibility Vessel Sign and Intravenous Alteplase in Stroke Patients Treated with Thrombectomy : A Secondary Analysis of the SWIFT DIRECT Trial.

Morin Beyeler, Roman Rohner, Petra Ijäs, Omer F Eker, Christophe Cognard, Romain Bourcier, Igor Sibon, Margaux Lefebvre, Sébastien Richard, Arturo Consoli and 13 more

Abstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical neuroradiology, 2025. 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

23 authors.

Morin BeyelerDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 25, 3010, Bern, Switzerland. morin.beyeler@insel.ch.ORCID http://orcid.org/0000-0001-5911-7957
Roman RohnerGraduate School for Health Sciences, University of Bern, Bern, Switzerland.ORCID http://orcid.org/0009-0006-1331-705X
Petra IjäsDepartment of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Omer F EkerDepartment of Vascular Neurology, Hospices Civils de Lyon, Lyon, France.
Christophe CognardDepartment of Diagnostic and Therapeutic Neuroradiology, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
Romain BourcierDepartment of Diagnostic and Therapeutic Neuroradiology, University Hospital of Nantes, L'institut du thorax, Nantes, Pays de la Loire, France.
Igor SibonDepartment of Diagnostic and Therapeutic Neuroradiology, CHU de Bordeaux, Bordeaux, France.
Margaux LefebvreDepartment of Radiology, CHU Rouen, Rouen, France.
Sébastien RichardDepartment of Neuroradiology, CHRU-Nancy, Université de Lorraine, Nancy, France.
Arturo ConsoliDepartment of Stroke and Diagnostic and Interventional Neuroradiology, Foch Hospital, Suresnes, France.
Solène MoulinDepartment of Neurology, CHU Reims, Reims, France.
Marielle ErnstDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Goettingen, Goettingen, Germany.
Marc RiboDepartment of Interventional Neuroradiology, Hospital Vall d'Hebron, Barcelona, Spain.
Charlotte BarbierNeuroradiology Department, CHU Caen Normandie, INSERM U1237, University Caen Normandie, Caen, France.
Omid NikoubashmanDepartment of Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany.
David S LiebeskindDepartment of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine, University of California, Los Angeles, USA.
Martina B GoeldlinDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 25, 3010, Bern, Switzerland.
Eike I PiechowiakInstitute for Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 25, 3010, Bern, Switzerland.
Lukas BütikoferDepartment of Clinical Research, University of Bern, Bern, Switzerland.
Jan GrallaInstitute for Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 25, 3010, Bern, Switzerland.
Urs FischerDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 25, 3010, Bern, Switzerland.ORCID http://orcid.org/0000-0003-0521-4051
Johannes KaesmacherInstitute for Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 25, 3010, Bern, Switzerland. johannes.kaesmacher@insel.ch.ORCID http://orcid.org/0000-0002-9177-2289
SWIFT DIRECT investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe susceptibility vessel sign (SVS) on baseline MRI in acute ischemic stroke patients has been associated with better outcomes post-thrombectomy. This study aimed to investigate whether the presence of the SVS modifies the treatment effect of intravenous thrombolysis plus endovascular thrombectomy (IVT + EVT) versus thrombectomy alone (EVT alone).

methodsIn this secondary analysis of the SWIFT DIRECT trial, comparing IVT + EVT versus EVT alone, treatment effect and its heterogeneity were assessed with rates of pre-interventional reperfusion (eTICI 2a-3) and successful post-interventional reperfusion (eTICI of 2b-3) according to the SVS status using adjusted multivariable logistic regression. Secondary objectives were to analyze whether the presence of SVS or its individual characteristics (location, length, width, overestimation ratio, two-layered sign) were associated with outcomes.

results197 of the initial 408 trial participants were included in this secondary analysis, of which 52% received IVT + EVT. SVS was present in 92% of the participants (n = 181). There was no evidence for treatment effect heterogeneity regarding the post-interventional radiological and clinical effects of IVT + EVT versus EVT alone with strata of SVS. In SVS+ participants, IVT favored pre-interventional reperfusion (aOR 7.95, 95% CI 1.42-44.46), whereas in SVS-patients, it did not (P for interaction = 0.02). The individual SVS characteristics showed no significant associations with outcomes.

conclusionPresence of SVS does not seem to modify the effect of IVT + EVT versus EVT alone. In SVS+ patients, IVT might improve pre-interventional reperfusion. There is insufficient evidence to recommend using SVS to inform IVT decisions prior to EVT.

Indexed as

Fibrinolytic AgentsIschemic StrokeStrokeThrombectomyTissue Plasminogen ActivatorAdministration, IntravenousAgedEndovascular ProceduresFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedTreatment OutcomeFibrinolytic AgentsTissue Plasminogen ActivatorIntravenous alteplaseIschemic strokeSusceptibility vessel signSWIFT-DIRECTThrombectomy

Identifiers

PMID39976740
PMCPMC12454450

What OpenQuestion holds

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Registered trials

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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.