6/29/23, 1:11 AM RESCUE-Japan LIMIT Pathway Feedback Search Clinical Topics Home Studies RESCUE Japan LIMIT RESCUE Japan LIMIT Disease Acute ischemic stroke Trial question What is the role of endovascular therapy in patients with acute stroke with a large ischemic region? Study design Multi-center Open label RCT Population Characteristics of study participants 44.0% female N = 203 56.0% male 203 patients (90 female, 113 male) Inclusion criteria: patients with occlusion of large cerebral vessels and sizable strokes on imaging Key exclusion criteria: significant cerebral mass effect with midline shift; acute intracranial hemorrhage on CT or MRI; high risk of hemorrhage; known allergy to contrast agents Interventions N=101 endovascular therapy (acute thrombectomy plus best medical treatment) N=102 medical care (best medical treatment alone) Primary outcome Percentage of patients with modified Rankin scale score of 0-3 at 90 days 31.0 % 31 https://web.pathway.md/studies/rec36CHQqt0997B3f 1/2 6/29/23, 1:11 AM RESCUE-Japan LIMIT Pathway 3 23.3 % 15.5 % 12.7 Significant increase 7.8 % NNH = 5 0.0 % Endovascular therapy Medical care Significant increase in the percentage of patients with mRS score of 0-3 at 90 days (31% vs. 12.7%; RR 2.43, 95% CI 1.35 to 4.37) Secondary outcomes Borderline significant increase in the percentage of patients with of 8 points on the NIHSS score at 48 hours (31% vs. 8.8%; RR 3.51, 95% CI 1.76 to 7) No significant difference in the percentage of patients mRS score of 0-2 at 90 days (14% vs. 7.8%; RR 1.79, 95% CI 0.78 to 4.07) Safety outcomes No significant differences in symptomatic intracranial hemorrhage at 48 hours, death at 90 days, recurrence of an ischemic stroke at 90 days. Significant difference in intracranial hemorrhage within 48 hours (58.0% vs. 31.4%). Conclusion In patients with occlusion of large cerebral vessels and sizable strokes on imaging, endovascular therapy was superior to medical care with respect to the percentage of patients with mRS score of 0-3 at 90 days. Reference Shinichi Yoshimura, Nobuyuki Sakai, Hiroshi Yamagami et al. Endovascular Therapy for Acute Stroke with a Large Ischemic Region. N Engl J Med. 2022 Apr 7;386(14):1303-1313. Open reference URL https://web.pathway.md/studies/rec36CHQqt0997B3f 2/2