Table 4.

Landmark Trials of Endovascular Thrombectomy in Acute Ischemic Stroke.

Trials	N=	NIHSS	Premorbid Condition	Treatment Window (h)	Treatment vs. Control Arms	Territory of Vessel Occlusion	Neuroimaging & Selection Criteria	TICI 2b/3 (%)	Symptomatic ICH (%)	90-Days mRS 0–2 (%)	Mortality (%)
MR CLEAN [97]	502	≥2	None	≤6	IA UK/TPA/device + IV TPA vs. IV TPA	ICA, M1, M2, A1, or A2	CT, MRI, CTA, MRA, DSA No criteria	58.7	7.7 vs. 6.4	32.6 vs. 19.1 (p < 0.05)	18.9 vs. 18.4
ESCAPE [98]	316	>5	Barthel index ≥ 90	≤12	Stent retriever + IV TPA vs. IV TPA	MCA trunk and immediate branches and intracranial ICA	NCCT, mCTA Small infarct core (ASPECTS 6–10); Good-to-moderate collateral flow	72.4	3.6 vs. 2.7	53 vs. 29.3 (p < 0.001)	10.4 vs. 19
SWIFT PRIME [94]	196	8–29	mRS 0–1	≤6	Stent retriever + IV TPA vs. IV TPA	Intracranial ICA, M1, or both	NCCT, CTA, MRA, MRI-DWI, CTP, MRP Small infarct core (ASPECTS > 5)	88	0 vs. 3	60 vs. 35 (p < 0.001)	9 vs. 12
EXTEND-IA [96]	70	None	mRS 0–1	≤6	Stent retriever + IV TPA vs. IV TPA	ICA or MCA	NCCT, CTA, CTP Evidence of salvageable tissue and ischemic core < 70 mL on CTP	86	11 vs. 15	71 vs. 40 (p = 0.01)	9 vs. 20
REVASCAT [95]	206	≥6	mRS 0–1	≤8	Stent retriever + IV TPA vs. IV TPA	Intracranial ICA or M1	NCCT, MRI-DWI Absence of large ischemic core; ASPECTS >7 on NCCT or >6 on MRI DWI	65.7	1.9 vs. 1.9	44 vs. 28 (OR 2.1)	19 vs. 16
DAWN [100]	206	≥10	mRS 0–1	≤24	Trevo retriever + IV TPA vs. IV TPA	Intracranial ICA and/or MCA-M1	NCCT, MRI, MRA, CTA, MRI-DWI, CTP <1/3 MCA territory involved Clinical Imaging Mismatch: Group A—Age ≥ 80, NIHSS ≥ 10, infarct volume < 21 mL Group B—Age < 80, NIHSS ≥ 10, infarct volume < 31 mL Group C—Age < 80, NIHSS ≥ 20, infarct volume 31–51 mL.	84—Modified TICI ≥ 2b 72.6—Original TICI ≥ 2b 10.4—TICI 3	6 vs. 3	49 vs. 13 (PPS > 0.999); Utility-weighted mRS mean score—5.5 vs. 3.4 (PPS > 0.999); NNT—2 and 2.8 for lower disability and functional independence, respectively	19 vs. 18
DEFUSE-3 [101]	182	≥6	mRS 0–2	≤16	Trevo Retriever/Solitaire device/Penumbra system + IV TPA vs. IV TPA	ICA or M1; Cervical or intracranial carotid occlusions with or without tandem MCA lesion	CTA, MRA, CTP, MRP, MRI-DWI Target Mismatch Profile: Infarct volume (ischemic core) < 70 mL Ratio of volume of ischemic tissue to infarct volume of ≥1.8 Absolute volume of potential reversible ischemia (penumbra) ≥ 15 mL	13—TICI 2a 57—TICI 2b 19—TICI 3	7 vs. 4	45 vs. 17 (OR 2.67; p < 0.001)	14 vs. 26

Abbreviations: A1 = first segment of anterior cerebral artery; A2 = second segment of anterior cerebral artery; ASPECTS = Alberta Stroke Program Early Computed Tomography Score; CT = computed tomography; CTA = computed tomography angiography; CTP = computed tomography perfusion; DSA = digital subtraction angiography; DWI = diffusion weighted imaging; IA = intra-arterial; ICA = internal carotid artery; IV TPA = intravenous recombinant tissue plasminogen activator; M1 = first segment of middle cerebral artery; M2 = second segment of middle cerebral artery; MCA = middle cerebral artery; mCTA = multiphasic computed tomography angiography; MRA = magnetic resonance angiography; MRP = magnetic resonance perfusion; mRS = modified Rankin Scale; NCCT = non-contrast computed tomography; NIHSS = National Institutes of Health Stroke Scale; NNT = number-needed-to-treat; OR = odds ratio; PPS = posterior probability of superiority; TICI = thrombolysis in cerebral infarction; UK = urokinase.