Advanced Practice: Endovascular Therapy Trials
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) |
References