Cochrane · systematic review · CD000985
Infusion techniques for peripheral arterial thrombolysis
Broderick, C, Patel, JV · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
VascularAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
28
current version
GRADE rated
25
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 3 · 10.7%Very low 20 · 71.4%Low 5 · 17.9%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Intra‐arterial delivery compared to intravenous delivery for peripheral arterial thrombolysis
Population: patients with < 30 days' limb ischaemiaa
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
30‐Day amputation‐free survival Intra‐arterial delivery vs intravenous delivery | OR 1.71 [0.4, 7.34] | 1 study · 40 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Amputation (up to 6 months) Intra‐arterial delivery vs intravenous delivery | no estimate extracted | 2 studies · 78 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
30‐Day mortality Intra‐arterial delivery vs intravenous delivery | no estimate extracted | 2 studies · 78 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Vessel patency ‐ radiological success ‐ complete (to end of treatment) Intra‐arterial delivery vs intravenous delivery | OR 13.22 [2.79, 62.67] | 1 study · 40 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Duration of thrombolysis (to end of treatment) Intra‐arterial delivery vs intravenous delivery | no estimate extracted | 2 studies · 78 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
CVA (up to 6 months) Intra‐arterial delivery vs intravenous delivery | no estimate extracted | 2 studies · 78 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Major bleeding (up to 6 months) Intra‐arterial delivery vs intravenous delivery | OR 0.12 [0.01, 2.53] | 1 study · 40 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
High‐dose compared to low‐dose regimens of thrombolytic agents
Population: patients with < 42 days' limb ischaemiaa
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
30‐Day amputation‐free survival High‐dose vs low‐dose regimens of thrombolytic agents | no estimate extracted | 4 studies · 302 participants | Very low Downgraded: risk of bias, inconsistency, indirectness |
Amputation ( High‐dose vs low‐dose regimens of thrombolytic agents | no estimate extracted | 4 studies · 302 participants | Very low Downgraded: risk of bias, inconsistency, indirectness |
30‐Day mortality High‐dose vs low‐dose regimens of thrombolytic agents | no estimate extracted | 4 studies · 302 participants | Very low Downgraded: risk of bias, inconsistency, indirectness |
Vessel patency (at end of treatment) High‐dose vs low‐dose regimens of thrombolytic agents | no estimate extracted | 4 studies · 302 participants | Very low Downgraded: risk of bias, inconsistency, indirectness |
Duration of thrombolysis (to end of treatment) High‐dose vs low‐dose regimens of thrombolytic agents | no estimate extracted | 4 studies · 302 participants | Very low Downgraded: risk of bias, inconsistency, indirectness |
CVA ( High‐dose vs low‐dose regimens of thrombolytic agents | no estimate extracted | 4 studies · 302 participants | Very low Downgraded: risk of bias, inconsistency, indirectness |
Major bleeding ( High‐dose vs low‐dose regimens of thrombolytic agents | no estimate extracted | 4 studies · 302 participants | Very low Downgraded: risk of bias, inconsistency, indirectness |
Continuous infusion compared to forced (or pulse) infusion of thrombolytic agents
Population: patients with less than 42 days' lower limb ischaemiaa
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
30‐Day amputation‐free survival Continuous infusion vs forced (or pulse) infusion of thrombolytic agents | no estimate extracted | 4 studies · 304 participants | Very low Downgraded: risk of bias, inconsistency, indirectness |
Amputation ( Continuous infusion vs forced (or pulse) infusion of thrombolytic agents | no estimate extracted | 3 studies · 164 participants | Very low Downgraded: risk of bias, inconsistency, indirectness |
30‐Day mortality Continuous infusion vs forced (or pulse) infusion of thrombolytic agents | no estimate extracted | 4 studies · 304 participants | Very low Downgraded: risk of bias, inconsistency, indirectness |
Vessel patency (up to 30 days) Continuous infusion vs forced (or pulse) infusion of thrombolytic agents | no estimate extracted | 4 studies · 304 participants | Very low Downgraded: risk of bias, inconsistency, indirectness |
Duration of thrombolysis (to end of treatment) Continuous infusion vs forced (or pulse) infusion of thrombolytic agents | no estimate extracted | 4 studies · 304 participants | Very low Downgraded: risk of bias, inconsistency, indirectness |
CVA ( Continuous infusion vs forced (or pulse) infusion of thrombolytic agents | no estimate extracted | 4 studies · 304 participants | Very low Downgraded: risk of bias, inconsistency, indirectness |
Major bleeding ( Continuous infusion vs forced (or pulse) infusion of thrombolytic agents | no estimate extracted | 4 studies · 304 participants | Very low Downgraded: risk of bias, inconsistency, indirectness |
Thrombolysis with or without adjunctive antiplatelet agents
Population: patients with less than 42 days' lower limb ischaemia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
30‐Day amputation‐free survival | no estimate extracted | 1 study · 70 participants | Ungraded |
Amputation ( | no estimate extracted | 1 study · 70 participants | Ungraded |
30‐Day mortality | no estimate extracted | 1 study · 70 participants | Ungraded |
Vessel patency ( | OR 1.2 [0.39, 3.69] | 1 study · 70 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Duration of thrombolysis ( | no estimate extracted | 1 study · 70 participants | Low Downgraded: risk of bias, imprecision |
CVA ( | no estimate extracted | 1 study · 70 participants | Low Downgraded: risk of bias, imprecision |
Major bleeding ( | OR 0.25 [0.01, 4.9] | 1 study · 70 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |