Evidence map›Paper›PMID 40082388›Full record

SynthesisJournal of thrombosis and thrombolysis2025

Intravenous thrombolysis with tenecteplase versus alteplase in acute ischemic stroke tandem occlusions: a systematic review and meta-analysis of current available literature.

Ocílio Ribeiro Gonçalves, Márcio Yuri Ferreira, Gabriel de Almeida Monteiro, Victor Gonçalves Soares, Luiza G Schmitt, Sávio Batista, Luís O S Nogueira, Christian Ken Fukunaga, João Victor Araújo de Oliveira, João de Deus Costa Alves and 1 more

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Journal of thrombosis and thrombolysis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
  2. 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

11 authors.

Ocílio Ribeiro GonçalvesDepartment of Medicine, Federal University of Piauí, R. Dr. Anísio Maia, 1264, Ininga, Teresina, PI, Brazil. ocilio41@gmail.com.ORCID http://orcid.org/0009-0008-6103-8420
Márcio Yuri FerreiraDepartment of Neurosurgery, Lenox Hill Hospital/Northwell Health, New York, NY, USA.
Gabriel de Almeida MonteiroDepartment of Neurosurgery, Federal University Ceará, Sobral, Brazil.
Victor Gonçalves SoaresFederal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Brazil.
Luiza G SchmittDepartment of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Sávio BatistaFederal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Luís O S NogueiraMedicine Department, Amazonas State University, Manaus, Brazil.
Christian Ken FukunagaDepartment of Medicine, FMABC University Center, São Paulo, Brazil.
João Victor Araújo de OliveiraDepartment of Medicine, Federal University of Piauí, R. Dr. Anísio Maia, 1264, Ininga, Teresina, PI, Brazil.
João de Deus Costa AlvesDepartment of Imaging Diagnosis, UNIFESP, São Paulo, Brazil.
Kelson James AlmeidaDepartment of Medicine, Federal University of Piauí, R. Dr. Anísio Maia, 1264, Ininga, Teresina, PI, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Tandem occlusions, characterized by the simultaneous occurrence of both extracranial and ipsilateral intracranial arterial occlusions, represents a challenging subset of large vessel occlusion (LVO) strokes. Currently, the treatment choice for tandem infarcts involves intravenous thrombolysis (IVT) followed by endovascular thrombectomy (EVT). In current literature, direct head-to-head comparisons between Alteplase and Tenecteplase for IVT in patients with tandem occlusions remain limited. The goal of this systematic review and meta-analysis is to synthesize the currently available data comparing the efficacy and safety profiles of alteplase and tenecteplase specifically in patients with tandem occlusions. We systematically searched PubMed, Embase and Cochrane from inception to June 2024 for studies enrolling patients with tandem lesions in acute ischemic stroke (AIS) treated with IVT involving Tenecteplase or Alteplase. The primary outcomes of interest were (1) modified Rankin Scale (mRS) 0-1, (2) modified Rankin Scale (mRS) 0-2, (3) successful recanalization (TICI 2b-3), (4) symptomatic intracranial hemorrhage (sICH) and (5) overall mortality. We compared the results using Risk Ratio (RR) with 95% Confidence Intervals (CI). A random effects model was applied for all outcomes. The Mantel-Haenszel method was used to pool results from individual studies. We also used I

Indexed as

Fibrinolytic AgentsIschemic StrokeTenecteplaseThrombolytic TherapyTissue Plasminogen ActivatorAdministration, IntravenousHumansTreatment OutcomeFibrinolytic AgentsTenecteplaseTissue Plasminogen ActivatorAlteplaseIschemic strokeMeta-analysisTandem lesionTenecteplase

Identifiers

PMID40082388

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.