Evidence map›Paper›PMID 38820696›Full record

SynthesisClinics (Sao Paulo, Brazil)2024

Real-world setting comparison of bridging therapy versus direct mechanical thrombectomy for acute ischemic stroke: A meta-analysis.

Bin Qin, Tao Wei, Wen Gao, Hui-Xun Qin, Yu-Ming Liang, Cheng Qin, Hong Chen, Ming-Xiu Yang

Abstract readMeta-AnalysisComparative StudySystematic Review
In one paragraph

Synthesis in Clinics (Sao Paulo, Brazil), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Observational
  3. Article
  4. Observational
  5. 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

8 authors.

Bin QinDepartment of Neurology, Liuzhou People's Hospital, Liuzhou, Guangxi, China; Liuzhou Key Laboratory of Epilepsy Prevention and Research, Liuzhou, Guangxi, China; Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Tao WeiDepartment of Neurology, Liuzhou People's Hospital, Liuzhou, Guangxi, China; Liuzhou Key Laboratory of Epilepsy Prevention and Research, Liuzhou, Guangxi, China.
Wen GaoDepartment of Neurology, Liuzhou People's Hospital, Liuzhou, Guangxi, China; Liuzhou Key Laboratory of Epilepsy Prevention and Research, Liuzhou, Guangxi, China.
Hui-Xun QinDepartment of Neurology, Liuzhou People's Hospital, Liuzhou, Guangxi, China; Liuzhou Key Laboratory of Epilepsy Prevention and Research, Liuzhou, Guangxi, China.
Yu-Ming LiangDepartment of Neurology, Liuzhou People's Hospital, Liuzhou, Guangxi, China; Liuzhou Key Laboratory of Epilepsy Prevention and Research, Liuzhou, Guangxi, China.
Cheng QinDepartment of Neurology, Liuzhou People's Hospital, Liuzhou, Guangxi, China; Liuzhou Key Laboratory of Epilepsy Prevention and Research, Liuzhou, Guangxi, China.
Hong ChenDepartment of Neurology, Liuzhou People's Hospital, Liuzhou, Guangxi, China; Liuzhou Key Laboratory of Epilepsy Prevention and Research, Liuzhou, Guangxi, China.
Ming-Xiu YangDepartment of Neurology, Liuzhou People's Hospital, Liuzhou, Guangxi, China; Liuzhou Key Laboratory of Epilepsy Prevention and Research, Liuzhou, Guangxi, China. Electronic address: lzrmyyymx@126.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeIntravenous Thrombolysis (IVT) prior to Mechanical Thrombectomy (MT) for Acute Ischaemic Stroke (AIS) due to Large-Vessel Occlusion (LVO) remains controversial. Therefore, the authors performed a meta-analysis of the available real-world evidence focusing on the efficacy and safety of Bridging Therapy (BT) compared with direct MT in patients with AIS due to LVO.

methodsFour databases were searched until 01 February 2023. Retrospective and prospective studies from nationwide or health organization registry databases that compared the clinical outcomes of BT and direct MT were included. Odds Ratios (ORs) and 95 % Confidence Intervals (CIs) for efficacy and safety outcomes were pooled using a random-effects model.

resultsOf the 12 studies, 86,695 patients were included. In patients with AIS due to LVO, BT group was associated with higher odds of achieving excellent functional outcome (modified Rankin Scale score 0-1) at 90 days (OR = 1.48, 95 % CI 1.25-1.75), favorable discharge disposition (to the home with or without services) (OR = 1.33, 95 % CI 1.29-1.38), and decreased mortality at 90 days (OR = 0.62, 95 % CI 0.56-0.70), as compared with the direct MT group. In addition, the risk of symptomatic intracranial hemorrhage did not increase significantly in the BT group.

conclusionThe present meta-analysis indicates that BT was associated with favorable outcomes in patients with AIS due to LVO. These findings support the current practice in a real-world setting and strengthen their validity. For patients eligible for both IVT and MT, BT remains the standard treatment until more data are available.

Indexed as

Ischemic StrokeThrombectomyThrombolytic TherapyFibrinolytic AgentsHumansMechanical ThrombolysisTreatment OutcomeFibrinolytic AgentsAcute ischaemic strokeBridging therapyIntravenous thrombolysisLarge-vessel occlusionMeta-analysisReal-world evidence

Identifiers

PMID38820696
PMCPMC11177057

What Socratic holds

Textmetadata
LicenceCC BY
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.