Table 3

Comparison of control and intra-arterial arms and study results

TrialControl armIntra-arterial armPredominant intra-arterial modalityPrimary endpointPrimary endpoint result (p value or 95% CI)
PROACT II10IV heparinIA prourokinase+IV heparinIA thrombolyticmRS 0–2 at 90 daysIA therapy superior (0.04)
MELT11Not specifiedIA urokinase+IV heparinIA thrombolyticmRS 0–2 at 90 daysNo difference (0.35)
IMS III2IV tPAIA thrombectomy+IV tPAMerci RetrievermRS 0–2 at 90 daysNo difference (95% CI −6.1 to 9.1)
SYNTHESIS4IV tPAIA thrombectomy±IA thrombolysis+IV heparinWire manipulation and IA thrombolyticmRS 0–1 at 90 daysNo difference (0.37)
MR RESCUE3IV tPA if candidatesIA thrombectomy+IV tPA if candidates+IV heparinMerci RetrievermRS shift based on penumbral profileNo difference (0.99)*
MR CLEAN8IV tPA if candidatesIA thrombectomy+IV tPA if candidatesRetrievable stentsmRS shift analysisIA 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.