Table 1

Study details

Study name	Trial period	Location	Enrolled centers (n)	Study design	Randomized patients (n)	Intervention	Control	Inclusion criterion: NIHSS	Inclusion criterion: age (years)	Inclusion criterion: occluded vessel	Stroke imaging	Primary outcome	Safety measures
ESCAPE	2013−2014	Canada, USA, South Korea, Europe	22	RCT	316	IV tPA if eligible plus endovascular treatment	IV tPA if eligible	>5	≥18	Middle cerebral artery with or without occlusion of the internal carotid artery	Non-contrast CT and CTA, multiphase CT	mRS after 90 days	Mortality and other
EXTEND-1A	2012−2014	Australia, New Zealand	10	RCT	70	IV tPA if eligible plus endovascular thrombectomy	IV tPA if eligible	0−42	≥18	Internal carotid artery or middle cerebral artery and mismatch on CT perfusion or MR	Non-contrast CT, CTA/MRA and CT perfusion or diffusion MRI	Reperfusion at imaging after 24 h, early neurologic improvement	Mortality. Symptomatic intracranial hematoma
IMS-III	2006−2012	USA, Canada, Australia, Europe	58	RCT	656	IV tPA if eligible plus endovascular treatment	IV tPA if eligible	≥10*	18−82	Anterior or posterior circulation	Non contrast CT, CTA†	mRS ≤2 after 90 days	Mortality within 90 days, symptomatic ICH within 24±6 h
MR CLEAN	2010−2014	Europe	16	RCT	502	IV tPA if eligible plus intra-arterial treatment with thrombolysis or mechanical thrombectomy, or both	IV tPA if eligible	≥2	≥18	Distal carotid artery, middle or anterior cerebral artery	Non-contrast CT or MRI. CTA/MRA/DSA	mRS ≤2 after 90 days	Neurologic deterioration within 24 h from inclusion in the study
SWIFT-PRIME	2012−2014	USA, Europe	39	RCT	196	IV tPA plus endovascular thrombectomy	IV tPA	≥8 and <30	18−80	Distal carotid artery or middle cerebral artery	Non-contrast CT or MRI. CTA/MRA	mRS after 90 days	Mortality within 90 days
REVASCAT	2012−2014	Europe	4	RCT	206	IV tPA if eligible plus endovascular thrombectomy	IV tPA	≥6	18−85 (80)‡	Middle cerebral artery with or without occlusion of the internal carotid artery	Non-contrast CT or MRI. CTA/MRA or angiogram	mRS after 90 days	Mortality within 90 days

*NIHSS >7 if occlusion of M1, internal carotid artery, or basilar artery on CTA at institutions where baseline CTA imaging is standard of care for acute stroke patient. Baseline CTA in n=306. No baseline CTA in n=350.
†Arterial occlusion on CTA or MRA of the internal carotid artery, M1, or M2. CTA was performed in 306 of 656 patients and mismatch, using CT or MRI, with a Tmax above 6 s delay perfusion volume and either CT-regional cerebral blood flow or diffusion weighted imaging infarct core volume.
‡After enrollment of 160 patients, the inclusion criteria were modified to include patients up to the age of 85 years with an Alberta Stroke Program Early CT score of >8.
Studies: ESCAPE, Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion with Emphasis on Minimizing CT to Recanalization Times; EXTEND, Extending the Time for Thrombolysis in Emergency Neurological Deficits; IMS-III, Interventional Management of Stroke-III; MR CLEAN, Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in The Netherlands; REVASCAT, Randomized Trial of Revascularization with Solitaire FR Device versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting within Eight Hours of Symptom Onset; SWIFT-PRIME, Solitaire with the Intention for Thrombectomy as Primary Endovascular Treatment; CTA, CT angiography; DSA, digital subtraction angiography; ICH, intracerebral hemorrhage; IV tPA, intravenous tissue plasminogen activator; MRA, MR angiography; mRS, modified Rankin Scale; NIHSS, National Institutes of Health Stroke Scale; RCT, randomized controlled trial.