{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T01:59:28Z","timestamp":1785549568942,"version":"3.56.0"},"reference-count":42,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["World Neurosurgery"],"published-print":{"date-parts":[[2023,7]]},"DOI":"10.1016\/j.wneu.2023.04.018","type":"journal-article","created":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T00:51:28Z","timestamp":1681087888000},"page":"113-121.e3","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":12,"special_numbering":"C","title":["Safety and Efficacy of Direct Thrombectomy Versus Bridging Therapy in Patients with Acute Ischemic Stroke Eligible for Intravenous Thrombolysis: A Meta-Analysis of Randomized Controlled Trials"],"prefix":"10.1016","volume":"175","author":[{"given":"Wenbo","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingge","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianxiao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tengfei","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyan","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liangfu","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonghong","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferdinand K.","family":"Hui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4168-8158","authenticated-orcid":false,"given":"Yingkun","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.wneu.2023.04.018_bib1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1056\/NEJMoa1411587","article-title":"A\u00a0randomized trial of intraarterial treatment for acute ischemic stroke","volume":"372","author":"Berkhemer","year":"2015","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.wneu.2023.04.018_bib2","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1056\/NEJMoa1414905","article-title":"Randomized assessment of rapid endovascular treatment of ischemic stroke","volume":"372","author":"Goyal","year":"2015","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.wneu.2023.04.018_bib3","doi-asserted-by":"crossref","first-page":"2285","DOI":"10.1056\/NEJMoa1415061","article-title":"Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke","volume":"372","author":"Saver","year":"2015","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.wneu.2023.04.018_bib4","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1056\/NEJMoa1414792","article-title":"Endovascular therapy for ischemic stroke with perfusion-imaging selection","volume":"372","author":"Campbell","year":"2015","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.wneu.2023.04.018_bib5","doi-asserted-by":"crossref","first-page":"2296","DOI":"10.1056\/NEJMoa1503780","article-title":"Thrombectomy within 8 hours after symptom onset in ischemic stroke","volume":"372","author":"Jovin","year":"2015","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.wneu.2023.04.018_bib6","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1001\/jama.2020.22388","article-title":"Intravenous thrombolysis before endovascular Thrombectomy__for acute ischemic Stroke.pdf","volume":"325","author":"Saver","year":"2021","journal-title":"JAMA"},{"key":"10.1016\/j.wneu.2023.04.018_bib7","doi-asserted-by":"crossref","first-page":"e344","DOI":"10.1161\/STROKEAHA.118.022606","volume":"50","author":"Powers","year":"2019","journal-title":"Stroke"},{"key":"10.1016\/j.wneu.2023.04.018_bib8","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1016\/S0140-6736(16)00163-X","article-title":"Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials","volume":"387","author":"Goyal","year":"2016","journal-title":"Lancet"},{"key":"10.1016\/j.wneu.2023.04.018_bib9","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1001\/jama.2020.23523","article-title":"Effect of endovascular treatment alone vs intravenous alteplase plus endovascular treatment on functional independence in patients with acute ischemic stroke: the DEVT randomized clinical trial","volume":"325","author":"Zi","year":"2021","journal-title":"JAMA"},{"key":"10.1016\/j.wneu.2023.04.018_bib10","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1056\/NEJMoa2001123","article-title":"Endovascular thrombectomy with or without intravenous alteplase in acute stroke","volume":"382","author":"Yang","year":"2020","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.wneu.2023.04.018_bib11","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1001\/jama.2020.23522","article-title":"Effect of mechanical thrombectomy without vs with intravenous thrombolysis on functional outcome among patients with acute ischemic stroke: the SKIP randomized clinical trial","volume":"325","author":"Suzuki","year":"2021","journal-title":"JAMA"},{"key":"10.1016\/j.wneu.2023.04.018_bib12","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.1056\/NEJMoa2107727","article-title":"A\u00a0randomized trial of intravenous alteplase before endovascular treatment for stroke","volume":"385","author":"LeCouffe","year":"2021","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.wneu.2023.04.018_bib13","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/S0140-6736(22)00537-2","article-title":"Thrombectomy alone versus intravenous alteplase plus thrombectomy in patients with stroke: an open-label, blinded-outcome, randomised non-inferiority trial","volume":"400","author":"Fischer","year":"2022","journal-title":"Lancet"},{"key":"10.1016\/j.wneu.2023.04.018_bib14","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/S0140-6736(22)00564-5","article-title":"Endovascular thrombectomy versus standard bridging thrombolytic with endovascular thrombectomy within 4\u00b75 h of stroke onset: an open-label, blinded-endpoint, randomised non-inferiority trial","volume":"400","author":"Mitchell","year":"2022","journal-title":"Lancet"},{"key":"10.1016\/j.wneu.2023.04.018_bib15","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1136\/neurintsurg-2021-017928","article-title":"Direct endovascular treatment versus bridging therapy in patients with acute ischemic stroke eligible for intravenous thrombolysis: systematic review and meta-analysis","volume":"14","author":"Zhang","year":"2022","journal-title":"J\u00a0Neurointerv Surg"},{"key":"10.1016\/j.wneu.2023.04.018_bib16","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1159\/000507844","article-title":"Bridging versus direct mechanical thrombectomy in acute ischemic stroke: a subgroup pooled meta-analysis for time of intervention, eligibility, and study design","volume":"49","author":"Vidale","year":"2020","journal-title":"Cerebrovasc Dis"},{"key":"10.1016\/j.wneu.2023.04.018_bib17","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1161\/STROKEAHA.120.031477","article-title":"Bridging thrombolysis achieved better outcomes than direct thrombectomy after large vessel occlusion: an updated meta-analysis","volume":"52","author":"Wang","year":"2021","journal-title":"Stroke"},{"key":"10.1016\/j.wneu.2023.04.018_bib18","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1111\/ane.13390","article-title":"Mechanical thrombectomy with or without thrombolysis: a meta-analysis of RCTs","volume":"143","author":"Vidale","year":"2021","journal-title":"Acta Neurol Scand"},{"key":"10.1016\/j.wneu.2023.04.018_bib19","author":"Higgins"},{"key":"10.1016\/j.wneu.2023.04.018_bib20","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"10.1016\/j.wneu.2023.04.018_bib21","author":"Higgins"},{"key":"10.1016\/j.wneu.2023.04.018_bib22","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"10.1016\/j.wneu.2023.04.018_bib23","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1177\/17474930211021353","article-title":"Direct mechanical thrombectomy without intravenous thrombolysis versus bridging therapy for acute ischemic stroke: a meta-analysis of randomized controlled trials","volume":"16","author":"Podlasek","year":"2021","journal-title":"Int J Stroke"},{"key":"10.1016\/j.wneu.2023.04.018_bib24","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1136\/neurintsurg-2021-017667","article-title":"Endovascular thrombectomy without versus with intravenous thrombolysis in acute ischemic stroke: a non-inferiority meta-analysis of randomized clinical trials","volume":"14","author":"Lin","year":"2022","journal-title":"J\u00a0Neurointerv Surg"},{"key":"10.1016\/j.wneu.2023.04.018_bib25","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1136\/neurintsurg-2021-018589","volume":"14","author":"Turc","year":"2022","journal-title":"J\u00a0Neurointerv Surg"},{"key":"10.1016\/j.wneu.2023.04.018_bib26","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/S1474-4422(18)30314-4","article-title":"Penumbral imaging and functional outcome in patients with anterior circulation ischaemic stroke treated with endovascular thrombectomy versus medical therapy: a meta-analysis of individual patient-level data","volume":"18","author":"Campbell","year":"2019","journal-title":"Lancet Neurol"},{"key":"10.1016\/j.wneu.2023.04.018_bib27","doi-asserted-by":"crossref","first-page":"2450","DOI":"10.1161\/STROKEAHA.117.017320","article-title":"Mechanical thrombectomy outcomes with and without intravenous thrombolysis in stroke patients: a meta-analysis","volume":"48","author":"Mistry","year":"2017","journal-title":"Stroke"},{"key":"10.1016\/j.wneu.2023.04.018_bib28","first-page":"2420","article-title":"Outcomes of mechanical thrombectomy with pre-intravenous thrombolysis: a systematic review and meta-analysis","volume":"268","author":"Fan","year":"2021","journal-title":"J\u00a0Neurol"},{"key":"10.1016\/j.wneu.2023.04.018_bib29","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000014956","article-title":"Comparative efficacy and safety of bridging strategies with direct mechanical thrombectomy in large vessel occlusion: a systematic review and meta-analysis","volume":"98","author":"Pan","year":"2019","journal-title":"Medicine (Baltimore)"},{"key":"10.1016\/j.wneu.2023.04.018_bib30","first-page":"1334","article-title":"Therapeutic strategies to attenuate hemorrhagic transformation after tissue plasminogen activator treatment for acute ischemic stroke","volume":"23","author":"Kanazawa","year":"2016","journal-title":"J\u00a0Atheroscler Thromb"},{"key":"10.1016\/j.wneu.2023.04.018_bib31","doi-asserted-by":"crossref","DOI":"10.1016\/j.jns.2020.117217","article-title":"Strategies to prevent hemorrhagic transformation after reperfusion therapies for acute ischemic stroke: a literature review","volume":"419","author":"Otsu","year":"2020","journal-title":"J\u00a0Neurol Sci"},{"key":"10.1016\/j.wneu.2023.04.018_bib32","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1136\/neurintsurg-2018-014141","article-title":"Hemorrhagic transformation is associated with poor functional outcome in patients with acute ischemic stroke due to a large vessel occlusion","volume":"11","author":"van Kranendonk","year":"2019","journal-title":"J\u00a0Neurointerv Surg"},{"key":"10.1016\/j.wneu.2023.04.018_bib33","article-title":"Risk factors and functional outcome were associated with hemorrhagic transformation after mechanical thrombectomy for acute large vessel occlusion stroke","author":"Li","year":"2020","journal-title":"J Neurosurg Sci"},{"key":"10.1016\/j.wneu.2023.04.018_bib34","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1111\/ene.14539","article-title":"Prognosis and risk factors associated with asymptomatic intracranial hemorrhage after endovascular treatment of large vessel occlusion stroke: a prospective multicenter cohort study","volume":"28","author":"Constant Dit Beaufils","year":"2021","journal-title":"Eur J Neurol"},{"key":"10.1016\/j.wneu.2023.04.018_bib35","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1136\/neurintsurg-2018-013848","article-title":"Prognosis of asymptomatic intracranial hemorrhage after endovascular treatment","volume":"11","author":"Hao","year":"2019","journal-title":"J\u00a0Neurointerv Surg"},{"key":"10.1016\/j.wneu.2023.04.018_bib36","doi-asserted-by":"crossref","first-page":"1752","DOI":"10.1016\/j.jstrokecerebrovasdis.2019.02.006","article-title":"Asymptomatic intracerebral hemorrhage may worsen clinical outcomes in acute ischemic stroke patients undergoing thrombectomy","volume":"28","author":"Jiang","year":"2019","journal-title":"J\u00a0Stroke Cerebrovasc Dis"},{"key":"10.1016\/j.wneu.2023.04.018_bib37","first-page":"8","article-title":"Ischemic stroke subtype classification: an asian viewpoint","volume":"16","author":"Kim","year":"2014","journal-title":"J\u00a0Stroke"},{"key":"10.1016\/j.wneu.2023.04.018_bib38","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1016\/S0140-6736(13)61088-0","article-title":"Intracranial atherosclerosis","volume":"383","author":"Qureshi","year":"2014","journal-title":"Lancet"},{"key":"10.1016\/j.wneu.2023.04.018_bib39","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1159\/000323610","article-title":"Clinical and radiological outcomes after intracranial atherosclerotic stroke: a comprehensive approach comparing stroke subtypes","volume":"31","author":"Kim","year":"2011","journal-title":"Cerebrovasc Dis"},{"key":"10.1016\/j.wneu.2023.04.018_bib40","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1111\/ene.13330","article-title":"Impact of intravenous thrombolysis on recanalization rates in patients with stroke treated with bridging therapy","volume":"24","author":"Mueller","year":"2017","journal-title":"Eur J Neurol"},{"key":"10.1016\/j.wneu.2023.04.018_bib41","doi-asserted-by":"crossref","first-page":"2409","DOI":"10.1161\/STROKEAHA.116.014181","article-title":"Incidence and predictors of early recanalization after intravenous thrombolysis: a systematic review and meta-analysis","volume":"47","author":"Seners","year":"2016","journal-title":"Stroke"},{"key":"10.1016\/j.wneu.2023.04.018_bib42","doi-asserted-by":"crossref","first-page":"e1361","DOI":"10.1212\/WNL.0000000000200029","article-title":"Mechanical thrombectomy vs bridging therapy for anterior circulation large vessel occlusion stroke: systematic review and meta-analysis","volume":"98","author":"Trifan","year":"2022","journal-title":"Neurology"}],"container-title":["World Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1878875023004928?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1878875023004928?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T09:22:16Z","timestamp":1761816136000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1878875023004928"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7]]},"references-count":42,"alternative-id":["S1878875023004928"],"URL":"https:\/\/doi.org\/10.1016\/j.wneu.2023.04.018","relation":{},"ISSN":["1878-8750"],"issn-type":[{"value":"1878-8750","type":"print"}],"subject":[],"published":{"date-parts":[[2023,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Safety and Efficacy of Direct Thrombectomy Versus Bridging Therapy in Patients with Acute Ischemic Stroke Eligible for Intravenous Thrombolysis: A Meta-Analysis of Randomized Controlled Trials","name":"articletitle","label":"Article Title"},{"value":"World Neurosurgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.wneu.2023.04.018","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}