Evidence map›Paper›PMID 37282371›Full record

ReviewJournal of stroke2023

Endovascular Thrombectomy for Large Ischemic Strokes: A Living Systematic Review and Meta-Analysis of Randomized Trials.

Rami Z Morsi, Mohamed Elfil, Hazem S Ghaith, Mohammad Aladawi, Ahmad Elmashad, Sachin Kothari, Harsh Desai, Shyam Prabhakaran, Fawaz Al-Mufti, Tareq Kass-Hout

Open access · diamondAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of stroke, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 5 pooled it
6.2field-weighted citation impact, top 3% of its field
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

19 citing papers in PubMed, 5 syntheses or guidelines pooled it, 29 citations in OpenAlex.

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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

10 authors at 5 institutions in 2 countries.

Rami Z MorsiDepartment of Neurology, University of Chicago, Chicago, IL, USA.
Mohamed ElfilDepartment of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA.
Hazem S GhaithFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohammad AladawiDepartment of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA.
Ahmad ElmashadDepartment of Neurology, University of Connecticut, Farmington, CT, USA.
Sachin KothariDepartment of Neurology, University of Chicago, Chicago, IL, USA.
Harsh DesaiDepartment of Neurology, University of Chicago, Chicago, IL, USA.
Shyam PrabhakaranDepartment of Neurology, University of Chicago, Chicago, IL, USA.
Fawaz Al-MuftiDepartment of Neurosurgery, Westchester Medical Center, Valhalla, NY, USA.
Tareq Kass-HoutDepartment of Neurology, University of Chicago, Chicago, IL, USA.
University of Chicago · USUniversity of Nebraska Medical Center · USAl-Azhar University · EGUniversity of Connecticut · USWestchester Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeNew studies have shown that endovascular thrombectomy (EVT) is safe and effective for acute ischemic stroke (AIS) patients with large ischemic areas. The aim of our study is to conduct a living systematic review and meta-analysis of randomized trials comparing EVT versus medical management only.

methodsWe searched MEDLINE, Embase, and the Cochrane Library to identify randomized controlled trials (RCTs) comparing EVT versus medical management alone in AIS patients with large ischemic regions. We conducted our meta-analysis using fixed-effect models to compare functional independence, mortality, and symptomatic intracranial hemorrhage (sICH) between EVT and standard medical management only. We assessed the risk of bias using the Cochrane risk-of-bias tool and the certainty of evidence for each outcome using the Grading of Recommendations, Assessment, Development, and Evaluations approach.

resultsOf 14,513 citations, we included 3 RCTs with a total of 1,010 participants. We found low-certainty evidence of possibly a large increase in the proportion of patients with functional independence (risk difference [RD] 30.3%, 95% CI 15.0% to 52.3%), low-certainty evidence of possibly a small non-significant decrease in mortality (RD -0.7%, 95% CI -3.8% to 3.5%), and low-certainty evidence of possibly a small non-significant increase in sICH (RD 3.1%, 95% CI -0.3% to 9.8%) for AIS patients with large infarcts who underwent EVT compared to medical management only.

conclusionLow-certainty evidence shows that there is possibly a large increase in functional independence, a small non-significant decrease in mortality, and a small non-significant increase in sICH amongst AIS patients with large infarcts undergoing EVT compared to medical management only.

Indexed as

GRADELarge infarctLow ASPECTSSystematic reviewThrombectomy

Identifiers

PMID37282371
PMCPMC10250873
OpenAlexW4378905994

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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 Socratic graph.