{
  "abstract": "Introduction Although thrombectomy is the standard of care for acute ischemic stroke (AIS) due to large-vessel occlusion (LVO), many patients fail to achieve disability-free recovery, highlighting the need for adjunctive therapy to improve outcomes.Aim of Study This systematic review and meta-analysis aimed to compare intra-arterial thrombolysis (IAT) and placebo following the successful recanalization of AIS-LVO.Method A systematic review of four databases was performed. Categorical and continuous outcomes were calculated using Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs), respectively. Any potential heterogeneity was resolved through leave-one-out influence analysis.Results Findings showed that patients received IAT significantly had higher in 90-day functional excellence (RR=1.15, 95%CI= 1.01 – 1.3, P=0.032) than control group. There was no significant difference between two groups regarding functional independence, mortality, symptomatic or any ICH, and total adverse events. There was a significantly higher functional excellence rate in IAT group compared with control group in studies that included patients with eTICI score of 2b-3 versus 2c-3 (RR= 1.5, P=0.016) and female patients derived more benefit from IAT than placebo (RR= 1.42, P=0.001). Notably, there was no significant heterogeneity across any primary and secondary outcomes.Conclusion In patients with AIS-LVO presenting within 24 hours of time last seen well who achieved successful endovascular recanalization, IAT significantly improved likelihood of functional excellence at three months without hemorrhagic risk. Further research is warranted to validate these findings.Conflict of Interest No",
  "authors": [
    {
      "affiliations": [
        "Gonabad University of Medical Sciences, Gonabad, Iran"
      ],
      "name": "Ali Mortezaei"
    },
    {
      "affiliations": [
        "Central Michigan University, Michigan, USA"
      ],
      "name": "Nadir Al-Saidi"
    },
    {
      "affiliations": [
        "Houston Methodist, Houston, USA"
      ],
      "name": "Khaled M Taghlabi"
    },
    {
      "affiliations": [
        "Harvard Medical School, Massachusetts, USA"
      ],
      "name": "Forough Yazdanian"
    },
    {
      "affiliations": [
        "Oxford University, UK, UK"
      ],
      "name": "Yan Lin Li"
    },
    {
      "affiliations": [
        "Johns Hopkins, Baltimore, USA"
      ],
      "name": "Vivek S Yedavalli"
    },
    {
      "affiliations": [
        "Harvard Medical School, Massachusetts, USA"
      ],
      "name": "Adam Dmytriw"
    },
    {
      "affiliations": [
        "Harvard Medical School, Massachusetts, USA"
      ],
      "name": "Robert Regenhardt"
    }
  ],
  "title": "A227 Intra-arterial thrombolysis after successful endovascular reperfusion for large vessel occlusion stroke: a meta-analysis of randomized controlled trials",
  "uid": "e70e0f00-309c-55f3-b28e-74c87cf28aa4"
}