Fifteen studies were included (559 patients); sample sizes ranged between 11 to 59 patients.
The pooled recanalisation rate (partial or complete) was 69.6% (95% CI 63.9 to 75.0; 15 studies; Ι²=51.3%) favouring the intravenous/intra-arterial group compared to intravenous-treated group. When only complete recanalisation was evaluated the rate was lower (35.1%, 95% CI 23 to 48.2; 13 studies; Ι²=87.6%).
Rates favoured the intravenous/intra-arterial group compared to intravenous thrombolysis-treated group for favourable outcome (48.9%, 95% CI 42.9 to 54.9; 15 studies; Ι²=50.2%); mortality (17.9%, 95% CI 12.7 to 23.7; 15 studies; Ι²=66.6%); and symptomatic intracranial haemorrhage (8.6%, 95% CI 12.7 to 23.7; 15 studies; Ι²=66.6%).
The odds of favourable outcome were significantly higher in the intravenous/intra-arterial-treated group compared to intravenous thrombolysis-treated group (OR 2.26, 95% CI 1.16 to 4.40; Ι²=74%). No difference in mortality or symptomatic intracranial haemorrhage was found between these groups.
In meta-regression the lower the mean time to intravenous thrombolysis treatment, the greater the recanalisation rate, and lower the mortality rate. A positive association was also observed between: recanalisation and rate of patients treated for isolated middle cerebral-artery (MCA) occlusion; mortality and mean study age and NIHSS score; further details were reported in the paper.