Endovascular thrombectomy with versus without intravenous thrombolysis in patients with acute basilar artery occlusion: a systematic review and meta-analysis.

BACKGROUND AND PURPOSE: The benefit and safety of intravenous thrombolysis before endovascular thrombectomy in patients with acute ischemic stroke caused by basilar artery occlusion (BAO) remains unclear. This article aims to investigate the clinical outcomes and safety of endovascular thrombectomy with versus without intravenous thrombolysis in acute BAO stroke patients. METHODS: We conducted a comprehensive search of PubMed, Embase, Cochrane, and Web of Science databases to identify relevant literature pertaining to patients with acute BAO who underwent endovascular thrombectomy alone or intravenous thrombolysis bridging with endovascular thrombectomy (bridging therapy), until January 10, 2024. The primary outcome was functional independence, defined as a score of 0-2 on the modified Rankin Scale at 90 days. The safety outcome was mortality at 90 days and symptomatic intracranial hemorrhage within 48 h. Effect sizes were computed as risk ratio (RR) with random-effect models. This study was registered in PROSPERO (CRD42023462293). RESULTS: A total of 528 articles were obtained through the search and articles that did not meet the inclusion criteria were excluded. Finally, 2 RCTs and 10 cohort studies met the inclusion criteria. The findings revealed that the endovascular thrombectomy alone group had a lower rate of functional independence compared to the bridging therapy group (29% vs 38%; RR 0.78, 95% CI 0.68-0.88, p < 0.001), lower independent ambulation (39% vs 45%; RR 0.89, 95% CI 0.82-0.98, p = 0.01), and higher mortality (36% vs 28%, RR 1.22, 95% CI 1.08-1.37, p = 0.001). However, no differences were detected in symptomatic intracranial hemorrhage between the two groups (6% vs 4%; RR 1.12, 95% CI 0.74-1.71, p = 0.58). CONCLUSION: Intravenous thrombolysis plus endovascular thrombectomy seemed to led to better functional independence, independent ambulation, and lower risk of mortality without increasing the incidence of intracranial hemorrhage compared to endovascular thrombectomy alone. However, given the non-randomized nature of this study, further studies are needed to confirm these findings.

A Corpus-Based Investigation of Extra-Textual, Connective, and Emphasizing Additions in English-Chinese Conference Interpreting.

Findings from conference interpreting research in the Chinese context have suggested that interpreters barely produce extra-textual additions in rigidly structured press conferences, and that adding connectives and intensifiers is only required to help the English-speaking audience capture the logic embedded in implicit Chinese interclausal relations. Previous research in the Chinese context has tended to draw data almost exclusively from the Chinese Premier's Press Conference interpreting, which features interpreting from Chinese into English. In order to enrich conference interpreting corpora in Asia and to examine additions in the opposite interpreting direction for the same language pair, this study drew on authentic materials of six interpreted press conferences held at the American Institute in Taiwan (AIT). Contrary to previous research, our results showed that conference interpreters exhibited a certain degree of "visibility" through producing extra-textual additions, which is typical of interpreting in various community-based settings. Moreover, the addition of extra connectives and intensifiers that are common in Chinese-to-English interpreting was also identified. It is proposed that the interpreters' production of extra-textual additions is connected with the specific context of the AIT, whereas the connective and emphasizing additions are to a large extent caused by the grammaticalization process wherein particular linguistic devices change into discourse markers to fulfill the communicative needs in both English and Chinese.