SynthesisNeurology2025
Intra-Arterial Thrombolysis Following Endovascular Recanalization for Large Vessel Occlusion Stroke: A Systematic Review and Meta-Analysis.
Synthesis in Neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 3 of them syntheses 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
6 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Intra-arterial thrombolysis agents following endovascular thrombectomy for acute ischemic stroke: a network meta-analysis.Frontiers in pharmacology · 2026Pooled it
- Intra-arterial tenecteplase in acute ischemic stroke after successful endovascular thrombectomy: a meta-analysis of randomized controlled trials.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Pooled it
- Safety and efficacy of intravenous tenecteplase in patients with acute ischemic stroke in extended time window: systematic review and meta-analysis.European journal of medical research · 2025Pooled it
- Dose-Specific Intra-Arterial Thrombolysis After Endovascular Thrombectomy for Large-Vessel Occlusion Stroke: A Network Meta-Analysis of Randomized Trials.Stroke (Hoboken, N.J.) · 2026Article
- Revisiting Incomplete Tissue-Level Reperfusion Following Successful Thrombectomy for Acute Ischemic Stroke.Annals of neurology · 2026Review
- Administering a Second Dose of Intravenous Tenecteplase in Acute Ischemic Stroke: Rationale and Design of a Pilot Clinical Trial.Stroke (Hoboken, N.J.) · 2025Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesThis systematic review and meta-analysis aims to evaluate the treatment effects of intra-arterial thrombolysis (IAT) after endovascular recanalization in patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO). Endovascular recanalization is the standard treatment for large vessel occlusion (LVO) stroke. Despite successful reperfusion after thrombectomy, fewer than half of the patients regain functional independence at 90 days, highlighting the potential role of impaired microcirculation in poor neurologic outcomes. The efficacy and safety of intra-arterial thrombolysis (IAT) after endovascular recanalization remains controversial. This systematic review and meta-analysis aims to evaluate the treatment effects of IAT after endovascular recanalization in patients with acute ischemic stroke (AIS) due to LVO.
methodsWe conducted a study-level systematic review and meta-analysis based on PubMed, Embase, CENTRAL, and ClinicalTrials.gov from database inception to February 8, 2025. Only randomized controlled trials (RCTs) reporting the efficacy and safety of IAT after endovascular recanalization in large vessel occlusion stroke were included. The risk of bias of the included studies was assessed using the Risk of Bias 2 tool. The pooled data were analyzed using a random-effects meta-analysis. Our primary outcome was the proportion of patients with modified Rankin Scale (mRS) scores 0-1 at 90 days. Other outcomes included the proportion of patients with mRS scores 0-2 at 90 days, all-cause mortality at 90 days, and symptomatic intracranial hemorrhage and any intracranial hemorrhage within 48 hours. The study protocol was registered on PROSPERO (CRD42025639519).
resultsA total of 6 RCTs with 1,985 initially enrolled patients were included in the analysis. A higher proportion of mRS scores 0-1 at 90 days was observed in the IAT group (risk ratio [RR] 1.25, 95% CI 1.11-1.41). No significant differences were found in the proportion of mRS scores 0-2 at 90 days (RR 1.04, 95% CI 0.96-1.13) between the groups. Regarding safety outcomes, 90-day all-cause mortality (RR 1.00, 95% CI 0.83-1.21), symptomatic intracranial hemorrhage (RR 1.14, 95% CI 0.76-1.70), and any intracranial hemorrhage (RR 1.16, 95% CI 0.98-1.37) were similar in the IAT group and control group. DISCUSSION: Among patients with AIS due to LVO, IAT after endovascular recanalization adds additional benefits to functional outcomes, with no increased risk of death or intracranial hemorrhage.
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Registered trials
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.