Highlight
– Individual participant data (IPD) meta-analysis of 6 randomized trials (n=2313) comparing IV alteplase plus endovascular treatment (EVT) versus EVT alone for anterior circulation large-vessel occlusion stroke.
– IV alteplase was associated with a modestly higher risk of any intracranial hemorrhage (ICH) and of parenchymal hematoma (PH1/PH2) (adjusted ORs 1.23 and 1.54, respectively).
– Both asymptomatic and symptomatic ICH were linked to worse functional outcomes; however, IVT may still confer net benefit through improved rates of early/final reperfusion.
