6/28/23, 11:19 PM MR CLEAN Pathway Feedback Search Clinical Topics Home Studies MR CLEAN MR CLEAN Disease Acute ischemic stroke Trial question What is the role of intraarterial treatment in patients with acute ischemic stroke? Study design Multi-center Open label RCT Population Characteristics of study participants 42.0% female N = 500 58.0% male 500 patients (208 female, 292 male) Inclusion criteria: patients with acute ischemic stroke caused by a proximal intracranial occlusion of the anterior circulation Key exclusion criteria: arterial BP > 185/110 mmHg, blood glucose < 2.7 or > 22.2 mmol/L, intravenous treatment with thrombolytic therapy Interventions N=233 intervention (intraarterial treatment within 6h of symptom onset with intraarterial thrombolysis, mechanical treatment, or both plus usual care with intravenous administration of alteplase) N=267 control (usual care alone with intravenous administration of alteplase) https://web.pathway.md/studies/rece8y0gwK1P5K5rs 1/2 6/28/23, 11:19 PM MR CLEAN Pathway Primary outcome Modified Rankin Scale scores at 90 days 4.0 4 3.0 3 2.0 1.0 Borderline significant increase 0.0 Intervention Control Borderline significant increase in mRS scores at 90 days (3 vs. 4; aOR 1.67, 95% CI 1.21 to 2.3) Secondary outcomes Borderline significant increase in mRS score of 0-2 at 90 days (32.6% vs. 19.1%; aOR 2.16, 95% CI 1.39 to 3.38) Borderline significant increase in Barthel index of 19 or 20 at day 90 (46% vs. 29.8%; aOR 2.1, 95% CI 1.4 to 3.2) Borderline significant increase in no intracranial occlusion on follow-up CT angiography (75.4% vs. 32.9%; aOR 6.88, 95% CI 4.34 to 10.94) Safety outcomes No significant difference in mortality or the occurrence of symptomatic intracerebral hemorrhage. Significant difference in clinical signs of new ischemic stroke in a different vascular territory (5.6% vs. 0.4%). Conclusion In patients with acute ischemic stroke caused by a proximal intracranial occlusion of the anterior circulation, intervention was superior to control with respect to mRS scores at 90 days. Reference Berkhemer OA, Fransen PS, Beumer D et al. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med. 2015 Jan 1;372(1):11-20. Open reference URL https://web.pathway.md/studies/rece8y0gwK1P5K5rs 2/2