6 or 9 mg/kg, (3) availability of mean or median National Instit

6 or .9 mg/kg, (3) availability of mean or median National Institutes of Health Stroke Scale (NIHSS) score at presentation, patient demographics (age, gender), and functional outcome assessed at discharge or later, (4) time interval AZD6244 between symptom onset and IV and endovascular treatment reported, (5) final recanalization following endovascular treatment reported, and (6) rate of symptomatic intracerebral hemorrhage (sICH) reported. Studies

were included regardless of the modality of endovascular treatment administered (pharmacological and/or mechanical). In the event of overlap of study populations, the smaller study was excluded. Using a predesigned data abstraction form, 2 reviewers (MZM and QAS) independently reviewed all manuscripts and abstracted the following information: (1) study characteristics (year of publication, design, recruitment period); (2) patient characteristics (number of patients, demographic characteristics, NIHSS score at presentation); (3) dose of IV rt-PA given and time from symptom onset to IV rt-PA administration; (4) time from symptom onset to angiography and/or IA treatment; (5) type of IA thrombolytic and mechanical devices used; (6) angiographic recanalization

MG-132 in vivo rates following endovascular treatment; (7) NIHSS score at 24-48 hours, when available; (8) rates of sICH; and (9) functional outcomes at discharge or later. The primary endpoints assessed in the analysis were partial or complete recanalization, favorable functional outcome, and sICH. Studies sometimes used different definitions of those endpoints (see Table 1). We used a modified Rankin scale score of 0-1 at 1-3 medchemexpress months after treatment to define favorable outcome. In 2 of the 11 studies, we determined the favorable outcome rates by reviewing individual patient data presented in tables or by acquiring it directly from the authors. In 3 of the 11 studies, favorable outcome was defined by other measures acquired

at discharge or last available follow-up. We repeated the analysis after excluding these 3 studies. Since we did not detect a difference in our results, we decided to include the studies and favorable outcome definitions used. When possible, we used a thrombolysis in myocardial infarction (TIMI) grade of 2-3 flow post-procedure to define partial or complete recanalization. For sICH, we used the definition provided by individual studies. Any disagreements between the 2 data abstractors were reconciled with the mediation of a third investigator (ALG). In order to compare the .6 mg/kg with the .9 mg/kg group, we pooled the demographic and clinical data from single studies: means of means or medians weighted by the sample size, and range of minimum and maximum individual patient data. When study range was not available it was approximated by the 95% confidence interval (CI).

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