Evidence map›Paper›PMID 40246769›Full record

SynthesisJournal of neurology2025

Adjunctive intra-arterial thrombolysis following successful endovascular reperfusion in acute ischemic stroke: a systematic review and meta-analysis of seven randomized controlled trials.

Zekun Wang, Kangxiang Ji, Qi Fang

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

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

  1. Pooled it
  2. Article
  3. Article
  4. Intra-arterial thrombolysis after successful endovascular reperfusion for large vessel occlusion stroke: A meta-analysis of randomized seven controlled trials.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025
    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

3 authors.

Zekun WangDepartment of Neurology, The First Affiliated Hospital of Soochow University, No.899 Pinghai Road, Gusu District, Suzhou, 215031, Jiangsu Province, China. superzekun@126.com.ORCID http://orcid.org/0000-0003-0533-4184
Kangxiang JiDepartment of Neurology, The First Affiliated Hospital of Soochow University, No.899 Pinghai Road, Gusu District, Suzhou, 215031, Jiangsu Province, China.
Qi FangDepartment of Neurology, The First Affiliated Hospital of Soochow University, No.899 Pinghai Road, Gusu District, Suzhou, 215031, Jiangsu Province, China. fangqi_008@126.com.ORCID http://orcid.org/0000-0001-5663-8984

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe benefits and risks of adjunctive intra-arterial thrombolysis (IAT) after successful endovascular thrombectomy (EVT) in acute ischemic stroke due to large vessel occlusion (AIS-LVO) remain uncertain. This study aimed to evaluate the efficacy and safety of IAT in this setting.

methodsWe systematically searched PubMed, Embase, Web of Science, CENTRAL, and ClinicalTrials.gov from inception to February 2025, and reviewed abstracts from the 2025 International Stroke Conference, to identify randomized controlled trials (RCTs) comparing IAT versus placebo or best medical management in AIS-LVO patients who achieved successful reperfusion after EVT. Outcome measures included 90-day excellent (modified Rankin Scale [mRS] 0-1) and good (mRS 0-2) functional outcomes, 90-day reduced disability (≥ 1-point mRS improvement), symptomatic intracranial hemorrhage (sICH), any ICH, and 90-day mortality. A random-effects model was employed for the meta-analysis.

resultsSeven RCTs with 2131 patients (1083 assigned to IAT, and 1048 to control) were included. Compared to controls, IAT was associated with significantly higher likelihood of 90-day excellent functional outcomes (risk ratio 1.23, 95% confidence interval [CI] 1.11-1.36; I

conclusionAdjunctive IAT following successful EVT in AIS-LVO patients led to improved 90-day excellent functional outcomes and reduced disability without increasing sICH or mortality risks.

Indexed as

Endovascular ProceduresFibrinolytic AgentsIschemic StrokeThrombolytic TherapyCombined Modality TherapyHumansRandomized Controlled Trials as TopicReperfusionThrombectomyFibrinolytic AgentsAcute ischemic strokeEndovascular thrombectomyIntra-arterial thrombolysisLarge vessel occlusionMeta-analysisRandomized controlled trials

Identifiers

What Socratic holds

Textmetadata
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.