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ACP Journal Club |21 May 2013

Adding endovascular therapy to t-PA did not improve 90-day survival or functional independence after stroke

Graeme J. Hankey, MD

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Broderick JP, Palesch YY, Demchuk AM, et al; Interventional Management of Stroke (IMS) III Investigators. Endovascular therapy after intravenous t-PA versus t-PA alone for stroke. N Engl J Med. 2013;368:893-903. 23390923

Emergency Med:

Neurology:

Does adding endovascular therapy after IV tissue plasminogen activator (t-PA) therapy improve functional outcomes in moderate-to-severe acute ischemic stroke?
Randomized controlled trial (Interventional Management of Stroke [IMS] III study). ClinicalTrials.gov NCT00359424.
{Concealed}*.†
Blinded† (outcome assessors).
90 days.
58 centers in the USA, Canada, Europe, and Australia.
656 patients 18 to 82 years of age (median age 68 to 69 y, 52% men) who had a moderate-to-severe neurologic deficit (National Institutes of Health Stroke Scale score ≥ 10 or a score of 8 or 9 with angiographic evidence of occlusion in specified arteries) and received IV t-PA ≤ 3 hours after symptom onset.
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Hankey GJ. Adding endovascular therapy to t-PA did not improve 90-day survival or functional independence after stroke. Ann Intern Med. 2013;158:JC12. doi: 10.7326/0003-4819-158-10-201305210-02012

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Published: Ann Intern Med. 2013;158(10):JC12.

DOI: 10.7326/0003-4819-158-10-201305210-02012

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