Table 5.

—[Section 2.2.1] Summary of Findings: IA Thrombolysis in Patients With Acute Ischemic Stroke^h,39-40

Outcomes	No. of Participants (Studies) Follow-up	Quality of the Evidence (GRADE)	Relative Effect (95% CI)	Anticipated Absolute Effects, Time Frame 90 d
				Risk With No IA tPA	Risk Difference With IA tPA (95% CI)
Overall mortality	334 (3 studiesa) 90 d	Lowb-d due to indirectness, imprecision	RR, 0.86 (0.56-1.33)	210 deaths per 1,000e	29 fewer deaths per 1,000 (from 92 fewer to 69 more)
Good functional outcome,f mRS 0-2	334 (3 studiesa) 90 d	Moderateb,c due to indirectness	RR, 1.44 (1.06-1.95)	290 good outcomes per 1,000g	128 more good outcomes per 1,000 (from 17 more to 275 more)

IMS=Interventional Management of Stroke. See Table 1-3 legends for expansion of abbreviations.

^aPROACT I (1998), PROACT II (1999), MELT (2007).

^bI²=0%.

^cStudies conducted in patients without contraindication for IV tPA; studies used thrombolytics other than rtPA; control patients received heparin in PROACT I (1998) and PROACT II (1999).

^dCI includes both clinically significant harms and benefits.

^eBaseline mortality rate derived from mortality in control and treatment arms of PROACT I (1998), PROACT II (1999), MELT (2007), and the control arm of NINDS (1995) as reported in the IMS (2004) study (153 of 727=21%). Intervention and control rates were averaged to determine the baseline rate, because the interventions did not have a notable effect on mortality.

^fsICH not listed as a separate outcome because it is captured within the good functional outcome and mortality outcomes. sICH occurred in 20 of 191 (10%) patients treated with IA and 3 of 126 (2%) control patients.

^gBaseline good functional outcome rate derived from control arms of PROACT I (1998) and PROACT II (1999), MELT (2007), and the control arm of NINDS as reported in the IMS study (99 of 341=29%).

^hIA thrombolysis administered median time of 5.5 h PROACT (1998), 5.3 h PROACT II (1999), and 3.8 h MELT (2007) from symptom onset.