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Meta-analysisNeurology · 2026

Neurology® Journal Club: Meta-Analysis of Randomized Controlled Trials on IV Thrombolysis in Patients With Minor Acute Ischemic Stroke.

Kevin Soon Hwee Teo, Jie Min Ong, Joshua Y P Yeo … Leonard L L Yeo

NeurologyMeta-analysis

IV thrombolysis not significantly associated with excellent recovery in minor stroke.

Neurology® Journal Club: Meta-Analysis of Randomized Controlled Trials on IV Thrombolysis in Patients With Minor Acute Ischemic Stroke.

Kevin Soon Hwee Teo et al. · Neurology · 2026

Methods

Drawing exclusively from randomized controlled trials (RCTs), the meta-analysis by Doheim et al. evaluates the comparative effectiveness of intravenous thrombolysis (IVT) vs nonthrombolytic standard of care (NT-SC) in patients with minor acute ischemic stroke (AIS).

Results

Odds of excellent functional recovery were not significantly lower with IV thrombolysis.

OR 0.85 (95% CI 0.70 to 1.03)

CI crosses the null - not significant

More results

The authors identified 9 reports encompassing 13 RCTs.

IVT was associated with lower odds of achieving functional independence and higher odds of symptomatic intracranial hemorrhage and mortality at 90 days.

A major strength is the study's exclusive inclusion of RCTs, which minimizes methodological heterogeneity and enhances internal validity.

More results

In conclusion, this meta-analysis suggests that IVT does not confer additional benefit over NT-SC for minor nondisabling stroke.

“

Conclusion

Future studies would benefit from incorporating broader, patient-centered functional outcomes to better capture the subtleties of disability in this patient population.

Post

Neurology® Journal Club: Meta-Analysis of Randomized Controlled Trials on IV Thrombolysis in Patients With Minor Acute Ischemic Stroke.

IV thrombolysis not significantly associated with excellent recovery in minor stroke.

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