Summary of the major endovascular stroke therapy trials
| Trial | Design | Baseline | Recanalization Rates | Good Clinical Outcome | Mortality | SICH | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| NIHSS | (90-day mRS ≤ 2) | ||||||||||
| Rx | Ctrl | Rx | Ctrl | Rx | Ctrl | Rx | Ctrl | Rx | Ctrl | ||
| PROACT II*(n = 180) (IAT, 121) | RCT, IA pro-UK + IV heparin vs IV heparin | 17 | 17 | 66% | 18% | 40% | 25% | 25% | 27% | 10% | 2% |
| MELT Japan† (n = 114), (IAT, 57) | RCT, IA UK vs medical treatment | 14 | 14 | 73.7% | – | 49.1% | 38.6% | 5.3% | 3.5% | 9% | 2% |
| IMS I (n = 80), (IAT, 62) | POL, IV rtPA + IA rtPA | 18 | – | 56% | – | 43% | – | 16% | – | 6.3% | – |
| IMS II (n = 81) (IAT, 55) | POL, IV rtPA + IA rtPA/EKOS | 19 | – | 58% | – | 46% | – | 16% | – | 9.9% | |
| MERCI (n = 141) | POL, IA MERCI, IA lytics allowed, IV disallowed | 20 | – | 60.3% | – | 27.7% | – | 43.5% | – | 7.8% | – |
| 48%‡ | |||||||||||
| Multi MERCI (n = 164) | POL, IA MERCI, IA + IV lytics allowed | 19 | – | 68% | – | 36% | – | 34% | – | 9.8%, PH-2: 2.4% | – |
| 55%‡ | |||||||||||
| Penumbra (n = 125) | POL, IA Penumbra, IA lytics allowed | 17 | – | 81.6%‡ | – | 25% | – | 32.8% | – | 11.2%, PH-2: 1.6% | – |
Note:—Rx indicates treatment; Ctrl, control; RCT, randomized controlled trial; EKOS, EKOS MicroLysUS infusion catheter; PH, parenchymal hematoma; POL, prospective open-label study; IAT: number of patients treated with IAT; NIHSS, National Institutes of Health Stroke Scale; mRS, modified Rankin Scale; SICH, symptomatic intracranial hemorrhage; IA, intra-arterial; IV, intravenous; UK, urokinase; rtPA, recombinant tissue plasminogen activator.
* Primary end point (90-day mRS ≤2) was reached (P = .04).
† Secondary end point (90-day mRS ≤1) was reached (42.1% vs 22.8%, P = .045).
‡ Device alone.