GRADE summary of findings for EVT alone versus EVT with alteplase in patients who had an acute ischaemic stroke secondary to large vessel occlusion
Outcomes (timeframe) | Relative effects (95% CI); number of patients and trials. | Absolute effect estimates | Certainty of evidence | Plain language summary | |
Baseline risk of control group (EVT with alteplase)* | Difference (95% CI) | ||||
Minimal disability measured by modified Rankin Score 0–2 (90 days) | RR 0.97 (0.89 to 1.05) 2331 patients in six trials.13–18 | 49.1% | −1.5% (−5.4% to 2.5%) | Low (very serious imprecision) | There is possibly a small decrease in the proportion of patients that achieve functional independence with EVT alone |
Mortality (90 days) | RR 1.07 (0.88 to 1.29) 2333 patients in six trials.13–18 | 16.8% | 1.2% (−2.0% to 4.9%) | Low (very serious imprecision) | There is possibly a small increase in mortality with EVT alone |
Symptomatic intracranial haemorrhage (90 days) | RR 0.75 (0.52 to 1.07) 2328 patients in six trials.13–18 | 3.8% | −1.0% (−1.8% to 0.27%) | Moderate (serious imprecision) | There is probably a small decrease in symptomatic intracranial haemorrhage with EVT alone |
*The baseline risk for modified Rankin Score 0–2, mortality and symptomatic intracranial haemorrhage at 90 days was obtained from patients with anterior circulation large artery occlusion stroke receiving EVT with alteplase.22
EVT, endovascular thrombectomy; GRADE, Grading of Recommendations Assessment, Development and Evaluation; RR, risk ratio.