Intravenous versus Intra-Arterial Thrombolysis in Ischemic Stroke: A Systematic Review and Meta-Analysis

Interesting stuff that only our doctors should be concerned about. I dislike that the outcome measures were not objective, like looking at CT/MRI scans to measure volume of dead/dying areas.
I have no clue what I had. You could ask your doctor why they chose what they did for you. They should have a research-backed answer.
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0116120

• Qing-feng Ma,
• Chang-biao Chu,
• Hai-qing Song mail
  
  

• Published: January 08, 2015
• DOI: 10.1371/journal.pone.0116120

Abstract

Background

Reperfusion following ischemic stroke can be attained by either intravenous thrombolysis (IVT) or intra-arterial thrombolysis (IAT). Only a limited number of randomized prospective studies have compared the efficacy and safety of IVT and IAT. This meta-analysis investigated possible clinical benefits of IAT relative to IVT in patients with acute ischemic stroke.

Methods

We searched the PubMed, Cochrane, and Google Scholar databases through October 2013 for manuscripts that describe the findings of randomized controlled or prospective studies that evaluated the outcomes of patients with ischemic stroke who were treated with IVT or IAT. The clinical outcome measures were score on the modified Rankin scale (mRS) and mortality at 90 days. A favorable outcome was defined as an mRS score of 0 to 2.

Results

For the mRS, the combined odds ratio (OR) of 3.28 (95% confidence interval (CI), 1.91 to 5.65, P < 0.001) indicated that patients who received IAT had a significantly higher chance for a favorable outcome than did those who received IVT. For mortality, the OR indicated that IAT therapy significantly reduced the proportion of patients who died within 90 days of the procedure (combined OR, 0.40; 95%CI, 0.17 to 0.92; P = 0.032).

Conclusion

This meta-analysis determined that IAT conferred a significantly greater probability of achieving a favorable outcome compared with IVT. There was also a significant difference in mortality rates between IAT and IVT. The studies included in this analysis were small and heterogeneous; therefore, larger randomized prospective clinical studies are necessary to further investigate this issue.