Evidence map›Paper›PMID 41586281›Full record

ArticleStroke (Hoboken, N.J.)2024

Endovascular Thrombectomy With and Without Preceding Thrombolysis in Posterior Circulation Stroke-Insights From STAR.

Ev-Christin Heide, Sami Al Kasab, Ali Alawieh, Adam Arthur, Waleed Brinjikji, Shakeel Chowdhry, Roberto Crosa, Hugo Cuellar, Reade De Leacy, Travis Dumont and 27 more

Abstract read
In one paragraph

Article in Stroke (Hoboken, N.J.), 2024. 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. Article
  2. 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

37 authors.

Ev-Christin HeideDepartment of Neurology University Medical Center Goettingen Germany.ORCID https://orcid.org/0000-0003-4511-1022
Sami Al KasabDepartment of Neurosurgery and Department of Neurology Medical University of South Carolina Charleston SC.
Ali AlawiehDepartment of Neurosurgery Emory University School of Medicine Atlanta GA.
Adam ArthurDepartment of Neurosurgery Semmes-Murphey Neurologic and Spine Clinic University of Tennessee Health Science Center Memphis TN.
Waleed BrinjikjiDepartment of Radiology Mayo Clinic Rochester MN.
Shakeel ChowdhryNorth Shore University Health System Evanston IL.
Roberto CrosaDepartment of Neurosurgery Endovascular Neurological Center Montevideo Uruguay.
Hugo CuellarDepartment of Neurosurgery Louisiana State University Health Shreveport LA.
Reade De LeacyDepartment of Neurosurgery Mount Sinai Health System New York NY.
Travis DumontDepartment of Neurosurgery University of Arizona Tuscon AZ.
Marielle ErnstDepartment of Neuroradiology University Medical Center Goettingen Germany.
Mohamad EzzeldinDepartment of Clinical Sciences College of Medicine University of Houston Houston TX.
Isabel FragataNeuroradiology Department Centro Hospitalar Universitário de Lisboa Central Lisboa Portugal.
Brian HowardDepartment of Neurosurgery Emory University School of Medicine Atlanta GA.
Pascal JabbourDepartment of Neurosurgery Thomas Jefferson University Hospitals Philadelphia PA.
Peter KanDepartment of Neurosurgery University of Texas Medical Branch Galveston TX.
Joon-Tae KimDepartment of Neurology Chonnam National University Medical School Chonnam National University Hospital Gwangju South Korea.
Michael R LevittDepartment of Neurosurgery University of Washington Seattle WA.
Justin MascitelliDepartment of Neurosurgery University of Texas Health Science Center San Antonio TX.
Charles MatoukDepartment of Neurosurgery Yale School of Medicine New Haven CT.
Mark MossDepartment of Interventional Neuroradiology Washington Regional Medical Center Fayetteville AR.
Pedro NaviaInterventional and Diagnostic Neuroradiology Hospital Universitario La Paz Madrid Spain.
Joshua OsbunDepartment of Neurosurgery Washington University of School of Medicine St. Louis MO.
Min S ParkDepartment of Neurosurgery University of Virginia Charlottesville VA.
Adam PolifkaDepartment of Neurosurgery University of Florida Gainesville FL.
Marios-Nikos PsychogiosDepartment of interventional and diagnostical Neuroradiology University of Basel Basel Switzerland.
Ansaar RaiDepartment of Radiology West Virginia School of Medicine Morgantown WV.
Daniele G RomanoUniversity Hospital of Siena Siena Italy.
Amir ShabanDepartment of Neurology University of Iowa Hospitals and Clinics Iowa City IA.
Robert M StarkeDepartment of Neurosurgery University of Miami Health System Miami FL.
Omar TanweerDepartment of Neurosurgery Baylor College of Medicine Houston TX.
Richard WilliamsonDepartment of Neurosurgery Allegheny Health Network Pittsburgh PA.
Stacey Q WolfeDepartment of Neurosurgery Wake Forest School of Medicine Winston-Salem NC.
Shinichi YoshimuraDepartment of Neurosurgery Hyogo College of Medicine Nishinomiya Hyogo Japan.
Alejandro M SpiottaDepartment of Neurological Surgery Medical University of South Carolina Charleston SC.
Ilko L MaierDepartment of Neurology University Medical Center Goettingen Germany.
STAR Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Multiple randomized trials could not establish the noninferiority of endovascular thrombectomy (EVT) alone without preceding intravenous thrombolysis (IVT) or superiority of IVT followed by EVT in anterior circulation large-vessel occlusion stroke. The role of prior IVT in posterior circulation large-vessel occlusion remains controversial. Methods: In this multicenter, retrospective study, patients with stroke with large-vessel occlusion in the posterior circulation who received EVT alone or with IVT were selected from the stroke thrombectomy and aneurysm registry between 2013 and 2022. Effects of IVT followed by thrombectomy on favorable functional outcome (defined as modified Rankin scale≤3 at 90 days) and safety were investigated using multivariable logistic and linear regression models. Results: Of the 588 included patients, 67% (n = 394) were treated with EVT alone and 29% (n = 170) with EVT after IVT, and 4% (n = 24) have missing values on this variable. Controlling for multiple confounding factors, IVT was not associated with a higher likelihood of favorable functional outcome at 90 days (odds ratio, 1.04 [95% CI, 0.52-2.09; Conclusion: Similar functional outcomes and complication rates were seen in patients with posterior circulation large-vessel occlusion treated with EVT alone versus EVT after IVT. Further prospective studies are required to determine the utility of IVT in posterior circulation stroke, especially in patients being directly admitted to thrombectomy centers.

Indexed as

endovascular thrombectomyintravenous thrombolysismulticenterposterior circulation stroke

Identifiers

PMID41586281
PMCPMC12778559

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.