Overall results of IA therapy
| Study | n | Mean age | Mean NIHSS at intake | Mean TT (min) | Treatment | Rec (%) | Definition rec | sICH (%) | Mortality (%) | Favorable outcome (%) | Definition of favorable outcome | Occlusion site |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Urbach et al12 | 12 | 51 | NR | 190 | IAT (UK) | 4 (33) | Good/moderate | 1 (8) | 4 (33) | 4 (33) | BI >90 at 3 months | T |
| Endo et al13 | 16 | 68 | NR (>24) | NR (<360) | IAT (UK/rtPA) | 3 (19) | Successful | 1 (6) | 10 (62.5) | 0 (0) | mRS 0–2 at 1 months | EC |
| 5 | IAT (UK/rtPA)+PTA/CEA | 5 (100) | Successful | 0 (0) | 0 (0) | 4 (80) | mRS 0–2 at 1 months | |||||
| Zaidat et al14 | 5 | 69 | 15* | 143 | IAT (UK)+IVT (rtPA) | 4 (80) | Partial/complete | 1 (20) | 1 (20) | 3 (60) | mRS 0–2 at 3 months | 3 T, 2 L |
| 13 | 15* | 175 | IAT (UK) | 8 (62) | Partial/complete | 2 (15) | 8 (62) | 3 (23) | mRS 0–2 at 3 months | 7 T, 4 L, 2 cervical | ||
| Arnold et al21 | 24 | 60 | 19* | 237 | IAT (UK)±angioplasty, stent | 15 (62.5) | TIMI 2/3 | 1 (4) | 10 (42) | 4 (17) | mRS 0–2 at 3 months | T |
| Eckert et al22 | 43 | 55 | NR (>9) | NR (<360) | IAT (UK/rtPA/rtPA+lys-plasminogen) | 13 (30) | TIMI 2/3 | NR | 15 (35) | 6 (14) | BI >90 at 3 months | 35 T, 8 tandem |
| Sorimachi et al23 | 11 | 71 | 23 | 212 | IAT (UK)+MCD | 10 (91) | Opened | 0 (0) | 1 (9) | 4 (36) | mRS 0–2 at 3 months | EC |
| Jovin et al24 | 15 | 59 | 16 | 300 | Stent+angioplasty+8 IVT (rtPA) | 15 (100) | Successful | 0 (0) | 3 (20) | 5 (33) | mRS 0–2 at 1 months | 5 EC, 10 tandem |
| Nedeltchev et al25 | 25 | 59 | 12* | 169 | Stent+IAT (UK)±aspiration | 21 (84) | TIMI 2/3 | 2 (8) | 5 (20) | 14 (56) | mRS 0–2 at 3 months | 21 EC, 4 T |
| Mori et al26 | 14 | 76 | 20 | 183 | Stent retrieval+aspiration | 7 (50) | TIMI 2/3 | 0 (0) | 2 (14) | 6 (43) | mRS 0–2 at 3 months | 6 EC, 8 IC |
| Suh et al27 | 30 | 66 | 15* | NR | 16 IAT, 9 IAT+stenting/thrombectomy, 3 IAT+angioplasty, 2 stent only | 14 (47) | TICI 2/3 | 9 (30) | 6 (20) | 11 (37) | mRS 0–2 at 1 year | 26 EC, 7 IC |
| Arnold et al28 | 43 | 60 | NR | 257 | IAT (UK) | 26 (58) | TIMI 2/3 | 4 (9) | 16 (37) | 10 (23) | mRS 0–2 at 3 months | 30 T, 13 EC |
| Miyamoto et al15 | 10 | 77 | 11 | 330 | Stent+angioplasty+IVT (UK)+for intracranial IAT (UK) | 10 (100) | Complete | 0 (0) | 1 (10) | 6 (60) | mRS 0–2 at 3 months | 5 EC, 5 tandem |
| Kim et al29 | 10 | 60 | 13 | 289 | IAT (UK) | 6 (60) | TIMI 2/3 | 1 (10) | 0 (0) | 5 (50) | mRS 0–2 at 3 months | Tandem |
| Lin et al20† | 40 | 68 | 17* | 343 | IAT (rtPA/UK)+mechanical (MERCI retrieval/angioplasty/stent) | 26 (65) | TIMI 2/3 | 3 (7.5) | 14 (35) | 17 (23) | mRS 0–2 at 3 months | 61 T, 14 L |
| 18 | 71 | 18* | 374 | Mechanical (MERCI retriever/angioplasty/stent) | 6 (33) | TIMI 2/3 | 3 (17) | 8 (44) | mRS 0–2 at 3 months | |||
| 17 | 63 | 17* | 338 | IAT (rtPA/UK) | 3 (18) | TIMI 2/3 | 2 (12) | 6 (35) | mRS 0–2 at 3 months | |||
| Yoo et al11 | 16 | 69 | 18 | 246 | IAT (UK)+IVT (rtPA)/MERCI retriever/MCD/angioplasty/stent | 12 (75) | Mori 2–4 | 1 (6) | 5 (31) | 2 (13) | mRS 0–2 at 3 months | 11 T, 5 L |
| Shi et al10 | 18 | 68 | 20 | 258 | Merci retriever+IVT (rtPA)±IAT (rtPA/UK/tenecteplase) | 12 (67) | TIMI 2/3 | 2 (11) | 6 (33) | 5 (28) | mRS 0–2 at 3 months | 1 EC, 17 T |
| 81 | 68 | 20 | Merci retriever±IAT (rtPA/UK/tenecteplase) | 50 (62) | TIMI 2/3 | 9 (11) | 41 (51) | 23 (28) | mRS 0–2 at 3 months | 27 EC, 54 T | ||
| Miteff et al30 | 6 | 70 | 20 | 389 | Stent retrieval | 6 (100) | TIMI 2/3 | 0 (0) | 0 (0) | 3 (50) | mRS 0–2 at 3 months | 3 tandem, 3 T |
| 5 | 65 | 16 | 313 | Stent retrieval+Penumbra/MERCI/IAT (UK) | 4 (80) | TIMI 2/3 | 1 (20) | 1 (20) | 3 (60) | mRS 0–2 at 3 months | 2 T, 2 tandem, 1 EC | |
| Costalat et al17 | 14 | 70 | 15 | 243 | Stent retriever±IVT (warfarin) | 10 (71) | TICI 3 | 0 (0) | 2 (14) | 6 (43) | mRS 0–2 at 3 months/NIHSS 0–1 at 3 months | T/L |
| Watanabe et al31 | 10 | 81 | 18* | 148 | IAT (UK)±MCD | 5 (50) | TICI 2/3 | 2 (20) | 4 (40) | 1 (10) | mRS 0–2 at 3 months | T |
| Fesl et al32 | 14 | 59 | 19* | 252 | Aspiration±other mechanical | 11 (79) | TIMI 2/3 | 7 (50) | 6 (43) | 3 (21) | mRS 0–2 at 3 months | T |
| Papanagiotou et al33 | 22 | 65 | 17 | 246 | Stent±angioplasty±IVT (rtPA) | 21 (95) | TIMI 2/3 | 4 (18) | 3 (14) | 9 (41) | mRS 0–2 at 3 months | 4 EC, 18 tandem |
| Malik et al34 | 77 | 63 | 15 | 433 | Stent±angioplasty | 58 (75) | TIMI 2/3 | 8 (10) | 19 (25) | 32 (42) | mRS 0–2 at 3 months | Tandem |
| Hauck et al35 | 22 | 65 | 14 | NR | Stent±IVT (rtPA) | 17 (77) | TIMI 2/3 | 0 (0) | 7 (32) | 11 (50) | mRS 0–2 at 3 months | EC |
| Pagola et al19 | 41 | 70 | 19 | 290 | IAT (rtPA)±MCD | 25 (61) | TICI 2/3 | 4 (10) | 18 (44) | 5 (12) | mRS 0–2 at 3 months | NR |
| 29 | 71 | 18 | 300 | Stent retriever | 24 (83) | TICI 2/3 | 3 (10) | 8 (28) | 6 (31) | mRS 0–2 at 3 months | ||
| 2 | 71 | 21 | 330 | Combined | 2 (100) | TICI 2/3 | 0 (0) | 1 (50) | 1 (50) | mRS 0–2 at 3 months | ||
| Hwang et al36 | 20 | 65 | 18 | 127 | Aspiration | 17 (85) | TICI 2/3 | 3 (15) | 0 (0) | 9 (45) | mRS 0–2 at 3 months | T/L |
| 19 | 66 | 16 | MCD±8 IAT (UK) | 6 (32) | TICI 2/3 | 2 (10.5) | 2 (10.5) | 3 (16) | mRS 0–2 at 3 months | |||
| Fischer et al37 | 32 | 62 | 17 | 280 | IAT (UK)±IVT (rtPA) | 15 (47) | TIMI 2/3 | 1 (3) | 10 (31) | 5 (16) | mRS 0–2 at 3 months | 107 T, 76 tandem, 18 EC, 5 IC |
| 78 | Mechanical (angioplasty/MCD/stent retrievers/stents/aspiration)±IVT (rtPA) | 64 (82) | TIMI 2/3 | 5 (6) | 24 (31) | 23 (29) | mRS 0–2 at 3 months | |||||
| 91 | IAT (UK)+mechanical±IVT (rtPA) | 78 (86) | TIMI 2/3 | 6 (7) | 26 (29) | 26 (29) | mRS 0–2 at 3 months | |||||
| Yoon et al38 | 26 | 73 | 13 | 240 | Stent-retriever±IAT (UK)/MCD/angioplasty/aspiration±IVT (rtPA) | 20 (77) | TICI 2b/3 | 0 (0) | 10 (38) | 10 (38) | mRS 0–2 at 3 months | IC |
| Mpotsaris et al39 | 41 | 62 | 16 | NR | Stent retriever±stent (Wallstent)±34 IVT (rtPA). | 35 (85) | TIMI 2/3 | 3 (7) | 15 (37) | 15 (37) | mRS 0–2 at 3 months | Tandem |
| Lee et al 40 | 10 | 69 | 18 | NR | Stent retriever+aspiration+IVT (rtPA)±stent | 6 (60) | TICI 2/3 | 0 (0) | 4 (40) | 0 (0) | mRS 0–2 at 3 months | T/L |
| 16 | 66 | 16 | NR | IAT (UK)±7 IVT (tPA) | 12 (75) | TICI 2/3 | 1 (6) | 8 (50) | 1 (6) | mRS 0–2 at 3 months | ||
| Matsubara et al41‡ | 14 | 68 | 16 | 175 | Stent/angioplasty/aspiration±IVT (tPA) | 14 (100) | TICI 2/3 | 1 (7) | 4 (29) | 4 (29) | mRS 0–2 at 3 months | 10 tandem, 6 EC |
| Dalyai et al16 | 17 | 62 | 17 | NR | Stent+angioplasty±IVT (rtPA) | 16 (94) | ‘Successful’ | 3 (18) | 9 (53) | 9 (53) | mRS 0–2 at 3 months | 6 EC, 11 tandem |
| Kwak et al42 | 35 | 65 | 12* | 450 | Stent+angioplasty±8 IV rtPA | 35 (100) | TICI 2/3 | 1 (3) | 22 (63) | 4 (11) | mRS 0–2 at 3 months | Tandem |
Data in italics are extrapolated.
*Data presented as median.
†Favorable outcome rates were only reported for entire patient group, not for each treatment.
‡Originally there were 16 patients, but in two cases the occlusion was caused by a dissection of the ICA. They were excluded and the reported percentages were used for the 14 remaining cases.
ACA, anterior cerebral artery; BI, Barthel Index; CEA, carotid endarterectomy; EC, extracranial; IAT, intra-arterial thrombolysis; IC, intracranial; ICA, internal carotid artery; L, L-occlusion; MCA, medial cerebral artery; MCD, mechanical clot disruption; mRS, modified Rankin Scale; NIHSS, National Institutes of Health Stroke Scale; NR, not retrievable; prox, proximal; PTA, percutaneous transluminal angioplasty; rec, recanalization; rtPA, recombinant tissue plasminogen activator; sICH, symptomatic intracranial hemorrhage; T, T-occlusion; thrombus extending in both the ACA and MCA; thrombus extending in either the ACA or MCA; TICI, Thrombolysis In Cerebral Infarction; TIMI, Thrombolysis In Myocardial Infarction; TT, time to treatment; UK, urokinase.