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The guidelines recommend intravenous thrombolysis (IVT) for eligible patients with acute ischemic stroke (AIS) and intracranial proximal occlusion of the anterior circulation before starting endovascular treatment (EVT).
However, based on observational studies and data from two recently completed randomized controlled trials, it is unclear whether there is an additional benefit of IVT in patients eligible for EVT.
The MR CLEAN-NO IV trial aims to evaluate the effectiveness and safety of direct EVT and bridging therapy (IVT+EVT) in patients with AIS caused by anterior circulation occlusion.
The research results will be announced at the ME II.
Thursday Main Event of the 2021 International Stroke Conference (ISC2021).
Author: Medical team doctors report NMT NMT ISC finishing compiler, please do not reprint without authorization.
Study Introduction MR CLEAN-NO IV is a randomized controlled, open-label, blinded outcome trial.
The study included AIS patients with proximal intracranial carotid artery, middle cerebral artery M1 segment or middle cerebral artery M2 segment occlusion within 4.
5 hours of onset and baseline NIHSS≥2.
The main exclusion criteria are severe disability before stroke and any contraindications to IVT.
Patients were randomly assigned to the direct EVT group or the bridging treatment group at a ratio of 1:1 (EVT was performed after alteplase 0.
9 mg/kg IVT).
The primary end point was the 90-day mRS score.
Secondary endpoints include eTICI score and final infarct volume.
Safety endpoints include symptomatic intracranial hemorrhage (sICH) and new embolism revealed by angiography.
Main research results The research results failed to find that the curative effect of direct thrombectomy is better or not inferior to bridging therapy.
Based on mRS 0-2 points, bridging therapy has an advantage of about 2%. There was no significant difference in safety between the two groups.
Symptomatic cerebral hemorrhage is about 5% (Figure 1-3).
Figure 1 Figure 2 Figure 3 Conclusion The results show that direct EVT is neither superior nor inferior to bridging therapy.
There was no significant difference in safety outcomes between the two groups.
Yimaitong compiled from: Intravenous Thrombolysis Followed by Endovascular Thrombectomy versus Direct Endovascular Thrombectomy: A Randomized Controlled Trial.
Press and hold the QR code to follow the report ☟☟☟ or click "Read the original text" to see more ISC 2021 topic related content!
However, based on observational studies and data from two recently completed randomized controlled trials, it is unclear whether there is an additional benefit of IVT in patients eligible for EVT.
The MR CLEAN-NO IV trial aims to evaluate the effectiveness and safety of direct EVT and bridging therapy (IVT+EVT) in patients with AIS caused by anterior circulation occlusion.
The research results will be announced at the ME II.
Thursday Main Event of the 2021 International Stroke Conference (ISC2021).
Author: Medical team doctors report NMT NMT ISC finishing compiler, please do not reprint without authorization.
Study Introduction MR CLEAN-NO IV is a randomized controlled, open-label, blinded outcome trial.
The study included AIS patients with proximal intracranial carotid artery, middle cerebral artery M1 segment or middle cerebral artery M2 segment occlusion within 4.
5 hours of onset and baseline NIHSS≥2.
The main exclusion criteria are severe disability before stroke and any contraindications to IVT.
Patients were randomly assigned to the direct EVT group or the bridging treatment group at a ratio of 1:1 (EVT was performed after alteplase 0.
9 mg/kg IVT).
The primary end point was the 90-day mRS score.
Secondary endpoints include eTICI score and final infarct volume.
Safety endpoints include symptomatic intracranial hemorrhage (sICH) and new embolism revealed by angiography.
Main research results The research results failed to find that the curative effect of direct thrombectomy is better or not inferior to bridging therapy.
Based on mRS 0-2 points, bridging therapy has an advantage of about 2%. There was no significant difference in safety between the two groups.
Symptomatic cerebral hemorrhage is about 5% (Figure 1-3).
Figure 1 Figure 2 Figure 3 Conclusion The results show that direct EVT is neither superior nor inferior to bridging therapy.
There was no significant difference in safety outcomes between the two groups.
Yimaitong compiled from: Intravenous Thrombolysis Followed by Endovascular Thrombectomy versus Direct Endovascular Thrombectomy: A Randomized Controlled Trial.
Press and hold the QR code to follow the report ☟☟☟ or click "Read the original text" to see more ISC 2021 topic related content!
