Brief summary of recently published trials comparing best medical therapy alone with best medical therapy plus embolectomy
| MR CLEAN | EXTEND-IA | ESCAPE | |
|---|---|---|---|
| Number randomized | 500 | 70 | 315 |
| Inclusion criteria | |||
| NIHSS range | 2+ | 2+ | 6+ |
| Time from onset to groin puncture | 0–6 h | 0–6 h | 0–12 h |
| Imaging required prior to treatment | NCCT, CTA/MRA | NCCT, CTA/MRA, CTP/MRP | NCCT, CTA |
| Imaging exclusion criteria (other than acute hemorrhage) | None | Ischemic core <70 mL on CTP or MRI | NCCT ASPECTS <6, CTA with no collateral filling |
| Target imaging to groin puncture | Not specified | Not specified | NCCT to puncture <60 min |
| Results | |||
| mRS 0–2, medical | 19.1% | 40% | 29.3% |
| mRS 0–2, medical+IAT | 32.6% | 71% | 53% |
| Recanalization (% TICI 2b/3) | 58.7% | 86% | 72.4% |
| Number needed to treat to have one additional patient independent at 90 days | 4 | 4 | |
ASPECTS, Alberta Stroke Program Early CT Score; CTA, CT angiography; CTP, CT perfusion; IAT, intra-arterial thrombolysis; MRA, MR angiography; MRP, MR perfusion; mRS, modified Rankin Scale; NCCT, non-contrast CT; TICI, Thrombolysis In Cerebral Ischemia.