SynthesisNeurosurgical review2025
Intravenous thrombolysis before endovascular therapy for acute ischemic stroke due to tandem lesions: a systematic review and meta-analysis.
Synthesis in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Optimal pharmacological therapy for minor acute ischemic stroke: a network meta-analysis.Frontiers in neurologyPooled it
- Revisiting Antiplatelet Therapy in Acute Carotid Tandem Lesions.Journal of clinical medicine · 2026Review
- Earlier endovascular therapy within 24 h of ischemic stroke is associated with attenuated systemic inflammation and better neurological recovery.Frontiers in neurologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The role of intravenous thrombolysis (IVT) in patients with tandem lesions (TL) undergoing endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) remains a subject of ongoing debate. The substantial clot burden and the potential need for periprocedural antiplatelet therapy during emergent carotid stenting (CAS) add to the complexity of treatment decisions. This study aims to systematically review and meta-analyze the literature to evaluate the comparative safety and efficacy of IVT plus EVT versus EVT alone in AIS patients with TL. A systematic search was conducted across four databases to identify studies comparing outcomes for patients with TL receiving IVT prior to EVT with those receiving EVT alone. Outcomes of interest included symptomatic intracranial hemorrhage (sICH), functional independence (90-day modified Rankin Scale 0-2), successful reperfusion (modified Thrombolysis in Cerebral Infarction 2b-3), and 90-day mortality. We performed a random-effects meta-analysis to calculate pooled odds ratios (OR) for each outcome and conducted a sensitivity analysis for patients who underwent emergent CAS. The analysis included 24 studies with a total of 3,294 patients: 1,860 (56.5%) received IVT plus EVT, and 1,434 (43.5%) received EVT alone. There was no significant increase in the risk of sICH between the IVT + EVT and EVT alone groups (IVT + EVT: 8.4% vs. EVT alone: 8.8%; OR = 0.90; 95%CI 0.67-1.21; I
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Registered trials
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