Fig 1.
Flow chart of study selection.
Table 1.
Summary and characteristics of included studies.
Table 2.
Stroke Therapy Academic Industry Roundtable (STAIR) score of included studies.
Fig 2.
Forest plot of SMDs of rtPA’s effect on infarction volume.
Data of all studies and the pooled effect across all studies were provided. The overall effect was not significant (p = 0.37) and heterogeneity was high (I2 = 74%). SMD, standardized mean difference.
Fig 3.
Sensitivity meta-analyses of rtPA’s effect on infarction volume.
The figure showed all 95%CI of SMDs after omitting each study as vertical line. The results remained stable using the leave-one-out method. CI, confidence interval; SMD, standardized mean difference.
Fig 4.
Funnel plot showing publication bias of rtPA’s effect on infarction volume.
The funnel plot was nearly symmetrical by visual inspection and no significant publication bias was detected by Egger’s test (p = 0.276).
Table 3.
Meta-regression results of rtPA’s effect on infarction volume.
Table 4.
Subgroup meta-analysis results of rtPA’s effect on infarction volume.
Fig 5.
Forest plot of SMDs of endogenous tPA’s effect on infarction volume.
The overall effect was not significant (p = 0.47) and heterogeneity was extremely high (I2 = 85%). SMD, standardized mean difference.
Fig 6.
Sensitivity meta-analyses of endogenous tPA’s effect on infarction volume.
The figure showed all 95%CI of SMDs after omitting each study as horizontal line. Endogenous tPA had enlarged infarction volume when leaving one study out. The result was unstable and need to be confirmed by expanding researches. CI, confidence interval; SMD, standardized mean difference.
Fig 7.
Funnel plot showing publication bias of endogenous tPA’s effect on infarction volume.
The funnel plot was nearly symmetrical except one study and no significant publication bias was detected by Egger’s test (p = 0.120).
Table 5.
Subgroup meta-analysis results of rtPA’s effect on infarction volume.
Fig 8.
Forest plot of SMDs of rtPA’s effect on BBB.
RtPA had significantly increased BBB permeability (95%CI of SMD, 0.62 to 1.23) and heterogeneity was extremely high (I2 = 85%). BBB, blood brain barrier; SMD, standardized mean difference; CI, confidence interval.
Fig 9.
Sensitivity meta-analyses of rtPA’s effect on BBB.
The figure showed all 95%CI of SMDs after omitting each study as horizontal line. The result stayed stable using leave-one-out method. BBB, blood brain barrier; CI, confidence interval; SMD, standardized mean difference.
Fig 10.
Filled funnel plot of rtPA’s effect on BBB using Trim and Fill method.
Although there was significant publication bias detected by Egger’s test (p = 0.022), the result stayed stable after filling a study in square. BBB, blood brain barrier.
Fig 11.
Forest plot of SMDs of rtPA’s effect on brain edema.
RtPA had significantly exacerbated brain edema (95%CI of SMD, 0.00 to 0.50) and heterogeneity was moderate (I2 = 39%). SMD, standardized mean difference; CI, confidence interval.
Fig 12.
Sensitivity meta-analyses of rtPA’s effect on brain edema.
The figure showed all 95% CI of SMDs after omitting each study as horizontal line. The result was unstable after leaving some studies out, which indicated that more researches need to be done to confirm the result. CI, confidence interval; SMD, standardized mean difference.
Fig 13.
Funnel plot showing publication bias of rtPA’s effect on brain edema.
The funnel plot was nearly symmetrical except one study by visual inspection and no significant publication bias was detected by Egger’s test (p = 0.140).
Fig 14.
Forest plot of SMDs of rtPA’s effect on intracerebral hemorrhage.
RtPA had significantly induced intracerebral hemorrhage (95%CI of SMD, 0.67 to 1.24) and heterogeneity was moderate (I2 = 43%). SMD, standardized mean difference; CI, confidence interval.
Fig 15.
Sensitivity meta-analyses of rtPA’s effect on intracerebral hemorrhage.
The figure showed all 95% CI of SMDs after omitting each study as horizontal line. The result was stable using the leave-one-out method. CI, confidence interval; SMD, standardized mean difference.
Fig 16.
Funnel plot showing publication bias of rtPA’s effect on intracerebral hemorrhage.
The funnel plot was nearly symmetrical by visual inspection and no significant publication bias was detected by Egger’s test (p = 0.179).
Fig 17.
Forest plot of SMDs of rtPA’s effect on neurological function.
The overall effect was not significant (p = 0.56) and heterogeneity was high (I2 = 57%). The result indicated that rtPA had no influence on neurological function of the survivals after mechanical stroke. SMD, standardized mean difference.
Fig 18.
Sensitivity meta-analyses of rtPA’s effect on neurological function.
The figure showed all 95% CI of SMDs after omitting each study as horizontal line. The result was stable using the leave-one-out method. CI, confidence interval; SMD, standardized mean difference.
Fig 19.
Funnel plot showing publication bias of rtPA’s effect on neurological function.
The funnel plot was nearly symmetrical by visual inspection and no significant publication bias was detected by Egger’s test (p = 0.674).
Table 6.
Subgroup meta-analysis results of rtPA’s effect on neurological function deficit.
Fig 20.
Forest plot of RRs of rtPA’s effect on mortality rate.
RtPA had significantly increased mortality rate (95%CI of RR, 1.15 to 6.89) and heterogeneity was high (I2 = 82%). RR, risk ratio; CI, confidence interval.
Fig 21.
Sensitivity meta-analyses of rtPA’s effect on mortality rate.
The figure showed all 95% CI of RRs after omitting each study as horizontal line. The result was stable using the leave-one-out method. CI, confidence interval; RR, risk ratio.
Fig 22.
Filled funnel plot of rtPA’s effect on mortality rate using Trim and Fill method.
Although there was significant publication bias detected by Egger’s test (p = 0.000), no extra study need to be filled and the result stayed stable after using Trim and Fill method.
Table 7.
Subgroup meta-analysis results of rtPA’s effect on mortality rate.