Intra-Arterial Thrombolysis Following Endovascular Recanalization for Large Vessel Occlusion Stroke

作者：Xin Jiang, Zixu Zhao, Ying Zhang, Wei Luo, Keyang Zheng, Minghui Zhang, Enze Li, Hui Lang, Jian Wang, Can Zhou, Li He · 发表于：Neurology · 年份：2025 · DOI：10.1212/wnl.0000000000213842 · 被引用次数：13 · 研究领域：Acute Ischemic Stroke Management、Stroke Rehabilitation and Recovery、Cerebrovascular and Carotid Artery Diseases

BACKGROUND AND OBJECTIVES: This 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. METHODS: We 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 proport...