1. Modified Rankin score 0-2
EXTEND-IA
Trial design: Patients with acute ischemic stroke presenting within 4.5 hours of symptom onset were randomized to endovascular thrombectomy with the Solitaire FR stent retriever + intravenous alteplase or intravenous alteplase alone. They were followed for 90 days.
Results
(p = 0.01)
Primary outcome: Perfusion at 24 hours for endovascular + alteplase group vs. alteplase: 100% vs. 37%, p <
Modified Rankin score of 0-2: 71% vs. 40%; p = 0.01
Symptomatic ICH: 0% vs. 6%, p = 0.49; mortality: 9.0% vs. 20.0%, p = 0.18 %
Conclusions
Among patients with acute ischemic stroke due to proximal large arterial occlusion, endovascular treatment + intravenous thrombolysis is superior to intravenous thrombolysis alone in improving perfusion, neurological, and functional outcomes
In line with other recent trials suggesting benefit with endovascular therapy; may change practice
Modified Rankin score 0-2
Endovascular +
IV alteplase
(n = 35)
IV alteplase
(n = 35)
Campbell BC, et al. N Engl J Med 2015;372: