Trial

Intervention

Study type

Inclusion criteria

What did they find?

Comments

Mr. Clean

2014

IV tPA vs endovascular therapy in addition to IV tPA

Randomized multicenter double blind

Adults > 18, Acute ischemic stroke with proximal large vessel occlusion evidenced on angiographic imaging presenting within 6 hours of sx onset who received IV tPA within 4.5 hours

Endovascular therapy group:  Improved neurological outcome at 90d in the, 13.5 % absolute increase in functional independence at 90d

NNT 7 

Trial stopped early due to benefit

EXTEND 1A

2015

IV tPA vs endovascular therapy in addition to IV tPA

Prospective, Randomized, open label, blinded, multicenter

Adults > 18, Anterior circulation ischemic stroke who received IV tPA within 4.5 hours after onset of sx due to large, proximal occlusion with evidence of an ischemic penumbra

Endovascular therapy group:  Improved neurological outcomes at 3d and 90d,31% absolute increase in neurological function

NNT 3

Stopped early due to benefit

ESCAPE

2015

Usual Standard of care by accepted stroke guidelines vs endovascular therapy in addition to standard care

Prospective

Randomized

Open-label Blinded

Multicenter

Adults > 18, acute stroke due to a proximal intracranial artery occlusion of the anterior circulation with small infarct core (ASPECT 6-10), collateral flow to an ischemic penumbra surrounding an ischemic core, time from CT to groin puncture < 1h

Mortality benefit in the intervention group at 90d, improved neurological outcomes at 90d

Stopped early due to benefit

SWIFT-PRIME

2015

IV tPa vs IV tPa and endovascular therapy with specific stent product

Multicenter, global, two-arm, prospective, randomized, open

Age> 18, tPa given within 4.5 hours of symptoms onset, proximal large vessel occlusion, pre-stroke mRS less than or equal to 1

Endovascular therapy group:  Improved functional outcome as measured by mRS at 90d,

REVASCAT

2015

IV tPa alone compared to IV tPa and mechanical thrombectomy within 8 hours of symptom onset

Multicenter, randomized, prospective, double blind, open label

Received IV tPa within 4.5 hours of sx onset, Proximal large vessel occlusion, no prestroke disability,

 Improvement in distribution of mRS in the thrombectomy group (OR 1.7)