Safety and efficacy of intra-arterial fibrinolytics as adjunct to mechanical thrombectomy : a systematic review and meta-analysis of observational data
- Kaesmacher, Johannes
- Meinel, Thomas Raphael
- Kurmann, Christoph
- Zaidat, Osama O.
- Castonguay, Alicia C.
- Zaidi, Syed F.
- Mueller-Kronast, Nils
- Kappelhof, Manon
- Dippel, Diederik W. J.
- Soudant, Marc
- Bracard, Serge
- Hill, Michael D.
- Goyal, Mayank
- Strbian, Daniel
- Heiferman, Daniel M.
- Ashley, William
- Anadani, Mohammad
- Spiotta, Alejandro M.
- Dobrocky, Tomas
- Piechowiak, Eike
- Arnold, Marcel
- Goeldlin, Martina
- Seiffge, David
- Mosimann, Pascal J.
- Mordasini, Pasquale
- Gralla, Jan
- Fischer, Urs
Publication date
December 2021
DOI Publisher
BMJ Publishing Group Ltd Language
EnglishAbstract
Background Achieving the best possible reperfusion is a key determinant of clinical outcome after mechanical thrombectomy (MT). However, data on the safety and efficacy of intra-arterial (IA) fibrinolytics as an adjunct to MT with the intention to improve reperfusion are sparse. Methods We performed a PROSPERO-registered (CRD42020149124) systematic review and meta-analysis accessing MEDLINE, PubMed, and Embase from January 1, 2000 to January 1, 2020. A random-effect estimate (Mantel-Haenszel) was computed and summary OR with 95% CI were used as a measure of added IA fibrinolytics versus control on the risk of symptomatic intracranial hemorrhage (sICH) and secondary endpoints (modified Rankin ScalePeer reviewe
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