{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T10:23:19Z","timestamp":1774520599139,"version":"3.50.1"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stroke is the world\u2019s second-leading cause of death, with ischemic events accounting for nearly 9 of 10 cases. Rapid endovascular treatment (EVT) is now standard, yet the benefit of giving intravenous tPA beforehand (\u201cbridging therapy\u201d) remains uncertain. One reason: tPA often shifts the clot distally\u2014thrombus migration (TM)\u2014a phenomenon seen in roughly one-fifth of large-vessel strokes that can complicate the procedure but has also been linked to better outcomes. This study evaluates how TM influences clinical outcomes, aiming to clarify whether tPA adds value in patients who receive EVT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive literature search was conducted across various databases until April 2025 to identify relevant articles. The quality was assessed using the NOS tool and the analysis was performed using RevMan 5 software. Primary outcomes of interest were favorable functional outcomes (modified Rankin Scale score 0\u20132) and mortality 90\u00a0days after stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirteen studies (n\u2009=\u20096,198 patients) were identified fulfilling our research question. Thrombus migration was significantly associated with favourable neurological outcomes (mRS 0\u20132) at 90\u00a0days (OR\u2009=\u20091.43; P\u2009=\u20090.025). TM showed no significant impact on other outcomes, including 90-day mortality (OR\u2009=\u20090.86; P\u2009=\u20090.15), symptomatic intracranial hemorrhage (sICH) (OR\u2009=\u20091.12; P\u2009=\u20090.54), any ICH (OR\u2009=\u20091.25; P\u2009=\u20090.4), NIHSS change at discharge (MD\u2009=\u20090.36; P\u2009=\u20090.18) and successful reperfusion rates (TICI 2b\u20133) (OR\u2009=\u20090.69; P\u2009=\u20090.0686).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Thrombus migration during mechanical thrombectomy was associated with better 90-day functional outcomes. Although thrombus migration might affect complete revasculrization, it may offer clinical benefits by restoring blood flow to larger brain territories.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00415-025-13609-9","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:37:09Z","timestamp":1773031029000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of thrombus migration on endovascular treatment outcomes in patients with ischemic stroke: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"273","author":[{"given":"Hesham","family":"Kelani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed A.","family":"Elzayat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelrahman M.","family":"Elettreby","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hend","family":"Heikal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Farag","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily Wen Jing","family":"Shuai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bethany Jordyn","family":"Thach","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamza","family":"Khelifa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Carrieri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela Martin","family":"Gonzalez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vaughn","family":"Sherman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed Abd","family":"Elazim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Greene-Chandos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1945-7940","authenticated-orcid":false,"given":"Volodymyr","family":"Vulkanov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moshe","family":"Mizrahi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa R.","family":"Merlin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Rosenbaum-Halevi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priyank","family":"Khandelwal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"13609_CR1","unstructured":"Feigin VL (2024) Global, regional, and national burden of stroke and its risk factors, 1990\u20132021: a systematic analysis for the Global"},{"key":"13609_CR2","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1177\/17474930241308142","volume":"20","author":"VL Feigin","year":"2025","unstructured":"Feigin VL, Brainin M, Norrving B et al (2025) World stroke organization: global stroke fact sheet 2025. 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As the study focused on synthesising and analysing data from already published studies, no new data were directly acquired from human participants. Consequently, there was no need for ethical approval or patient consent. The review was conducted in accordance with recognised principles, including the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework, to ensure the study's transparency, integrity, and ethical conduct.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}],"article-number":"189"}}