Intra-arterial thrombolytics after endovascular thrombectomy for acute ischemic stroke: A network meta-analysis of RCTs.
J Neurol SciJul 19, 2026 (epub)
Mohamed Elfil, Abdallah Abbas, Haneen Sabet et al.
✦ AI-curated · Sources linked
In 30 seconds
This network meta-analysis evaluated the efficacy and safety of intra-arterial thrombolysis (IAT) after endovascular thrombectomy (EVT) for acute ischemic stroke in 2564 patients across eight randomized controlled trials. The study found that EVT combined with TNK 0.125 mg/kg and ALT 0.225 mg/kg significantly improved excellent outcomes (mRS 0-1) compared to EVT alone, with relative risks of 1.54 and 1.51, respectively.
Key findings
- EVT + TNK 0.125 mg/kg improved mRS 0-1 outcomes with RR 1.54.
- EVT + ALT 0.225 mg/kg also improved mRS 0-1 outcomes with RR 1.51.
- No regimen improved mRS 0-2 or mortality outcomes.
- EVT + TNK 0.0625 mg/kg increased the risk of any ICH with RR 1.34.
Why it matters
The findings suggest that adjunctive IAT may enhance recovery in patients undergoing EVT for acute ischemic stroke, potentially addressing the issue of futile recanalization without increasing the risk of symptomatic intracranial hemorrhage.