GRADE summary of findings for thrombolysis followed by AC vs AC alone in patients with RVT
| No. of studies . | Study design . | No. of patients (%) . | Effect . | Certainty . | Importance . | ||
|---|---|---|---|---|---|---|---|
| Thrombolysis followed by AC . | AC alone . | Relative (95% CI) . | Absolute (95% CI) . | ||||
| Mortality (follow-up: range, 6 months to 5.7 years; assessed with: all-cause mortality) | |||||||
| 131 | Nonrandomized studies | 0/4 (0.0) | 1/3 (33.3) | Not estimable | Not estimable | ⊕○○○ Very low∗,†  | Critical | 
| Bleeding (follow-up: median, 5.7 years; assessed with: not specified) | |||||||
| 131 | Nonrandomized studies | 3/4 (75.0) | 0/3 (0.0) | Not estimable | Not estimable | ⊕○○○ Very low∗,†,‡  | Critical | 
| Thrombus recurrence (follow-up: mean, 5.7 years) | |||||||
| 131 | Nonrandomized studies | 0/4 (0.0) | 0/3 (0.0) | Not estimable | Not estimable | ⊕○○○ Very low∗,†  | Critical | 
| Thrombus progression (follow-up: mean, 6 months) | |||||||
| 130 | Nonrandomized studies | 1/3 (33.3) | — | — | — | ⊕○○○ Very low∗,†  | Critical | 
| Proteinuria (follow-up: median, 5.7 years) | |||||||
| 131 | Nonrandomized studies | 1/4 (25.0) | 0/3 (0.0) | Not estimable | Not estimable | ⊕○○○ Very low∗,†  | Critical | 
| Chronic kidney disease (follow-up: range, 6 months to 5.7 years) | |||||||
| 230,31 | Nonrandomized studies | 1/7 (14.3) | 0/3 (0.0) | Not estimable | Not estimable | ⊕○○○ Very low∗,†  | Critical | 
| High blood pressure (follow-up: range, 6 months to 5.7 years) | |||||||
| 230,31 | Nonrandomized studies | 1/7 (14.3) | 0/3 (0.0) | Not estimable | ⊕○○○ Very low∗,†  | Critical | |
| Long-term pathological kidney features (follow-up: median, 5.7 years; assessed with: pathological kidney features, defined as proteinuria, kidney atrophy, hypertension, or chronic kidney disease) | |||||||
| 131 | Nonrandomized studies | 3/4 (75.0) | 2/3 (66.7) | Not estimable | Not estimable | ⊕○○○ Very low∗,†  | Critical | 
| Atrophic nonfunctioning kidney (follow-up: mean, 6 months; assessed with: renal scintigraphy) | |||||||
| 130 | Nonrandomized studies | 3/3 (100.0) | — | — | — | ⊕○○○ Very low∗,†  | Critical | 
| Thrombus resolution (follow-up: range, 6 months to 5.7 years; assessed with: complete or partial resolution) | |||||||
| 230,31 | Nonrandomized studies | 5/7 (71.4) | 3/3 (100.0) | Not estimable | Not estimable | ⊕○○○ Very low∗,†  | Important | 
| Complete clot resolution (follow-up: range, 6 months to 5.7 years) | |||||||
| 230,31 | Nonrandomized studies | 1/7 (14.3) | 1/3 (33.3) | Not estimable | Not estimable | ⊕○○○ Very low∗,†  | Important | 
| No. of studies . | Study design . | No. of patients (%) . | Effect . | Certainty . | Importance . | ||
|---|---|---|---|---|---|---|---|
| Thrombolysis followed by AC . | AC alone . | Relative (95% CI) . | Absolute (95% CI) . | ||||
| Mortality (follow-up: range, 6 months to 5.7 years; assessed with: all-cause mortality) | |||||||
| 131 | Nonrandomized studies | 0/4 (0.0) | 1/3 (33.3) | Not estimable | Not estimable | ⊕○○○ Very low∗,†  | Critical | 
| Bleeding (follow-up: median, 5.7 years; assessed with: not specified) | |||||||
| 131 | Nonrandomized studies | 3/4 (75.0) | 0/3 (0.0) | Not estimable | Not estimable | ⊕○○○ Very low∗,†,‡  | Critical | 
| Thrombus recurrence (follow-up: mean, 5.7 years) | |||||||
| 131 | Nonrandomized studies | 0/4 (0.0) | 0/3 (0.0) | Not estimable | Not estimable | ⊕○○○ Very low∗,†  | Critical | 
| Thrombus progression (follow-up: mean, 6 months) | |||||||
| 130 | Nonrandomized studies | 1/3 (33.3) | — | — | — | ⊕○○○ Very low∗,†  | Critical | 
| Proteinuria (follow-up: median, 5.7 years) | |||||||
| 131 | Nonrandomized studies | 1/4 (25.0) | 0/3 (0.0) | Not estimable | Not estimable | ⊕○○○ Very low∗,†  | Critical | 
| Chronic kidney disease (follow-up: range, 6 months to 5.7 years) | |||||||
| 230,31 | Nonrandomized studies | 1/7 (14.3) | 0/3 (0.0) | Not estimable | Not estimable | ⊕○○○ Very low∗,†  | Critical | 
| High blood pressure (follow-up: range, 6 months to 5.7 years) | |||||||
| 230,31 | Nonrandomized studies | 1/7 (14.3) | 0/3 (0.0) | Not estimable | ⊕○○○ Very low∗,†  | Critical | |
| Long-term pathological kidney features (follow-up: median, 5.7 years; assessed with: pathological kidney features, defined as proteinuria, kidney atrophy, hypertension, or chronic kidney disease) | |||||||
| 131 | Nonrandomized studies | 3/4 (75.0) | 2/3 (66.7) | Not estimable | Not estimable | ⊕○○○ Very low∗,†  | Critical | 
| Atrophic nonfunctioning kidney (follow-up: mean, 6 months; assessed with: renal scintigraphy) | |||||||
| 130 | Nonrandomized studies | 3/3 (100.0) | — | — | — | ⊕○○○ Very low∗,†  | Critical | 
| Thrombus resolution (follow-up: range, 6 months to 5.7 years; assessed with: complete or partial resolution) | |||||||
| 230,31 | Nonrandomized studies | 5/7 (71.4) | 3/3 (100.0) | Not estimable | Not estimable | ⊕○○○ Very low∗,†  | Important | 
| Complete clot resolution (follow-up: range, 6 months to 5.7 years) | |||||||
| 230,31 | Nonrandomized studies | 1/7 (14.3) | 1/3 (33.3) | Not estimable | Not estimable | ⊕○○○ Very low∗,†  | Important | 
F/U, follow up.
Risk of bias was assessed using ROBINS-I, we have concerns because of selection bias and confounding.
We downgraded twice for imprecision because of the small sample size and small number of events.
Niada et al30: dilated lateral ventricles on F/U: 1 of 3 probably secondary to an intraventricular hemorrhage.