Comparison of control and intra-arterial arms and study results
| Trial | Control arm | Intra-arterial arm | Predominant intra-arterial modality | Primary endpoint | Primary endpoint result (p value or 95% CI) |
|---|---|---|---|---|---|
| PROACT II10 | IV heparin | IA prourokinase+IV heparin | IA thrombolytic | mRS 0–2 at 90 days | IA therapy superior (0.04) |
| MELT11 | Not specified | IA urokinase+IV heparin | IA thrombolytic | mRS 0–2 at 90 days | No difference (0.35) |
| IMS III2 | IV tPA | IA thrombectomy+IV tPA | Merci Retriever | mRS 0–2 at 90 days | No difference (95% CI −6.1 to 9.1) |
| SYNTHESIS4 | IV tPA | IA thrombectomy±IA thrombolysis+IV heparin | Wire manipulation and IA thrombolytic | mRS 0–1 at 90 days | No difference (0.37) |
| MR RESCUE3 | IV tPA if candidates | IA thrombectomy+IV tPA if candidates+IV heparin | Merci Retriever | mRS shift based on penumbral profile | No difference (0.99)* |
| MR CLEAN8 | IV tPA if candidates | IA thrombectomy+IV tPA if candidates | Retrievable stents | mRS shift analysis | IA therapy superior (95% CI 1.21 to 2.30) |
*Comparison of endovascular versus medical arms is a secondary outcome analysis.
IA, intra-arterial; IMS, Interventional Management of Stroke; IV, intravenous; MR RESCUE, Mechanical Retrieval and Recanalization of Stroke Clots Using Embolectomy; mRS, modified Rankin Scale; tPA, tissue plasminogen activator.