EXTEND-IA Randomized Trial of Intra-Arterial Clot Retrieval in Ischemic Stroke

Grant number: 1043242 | Funding period: 2013 - 2015

Completed

Abstract

Most strokes are caused by a blocked blood vessel in the brain. Current treatments to dissolve the blockage improve recovery for many patients but often fail to unblock larger brain arteries. The EXTEND-IA trial will use advanced brain imaging to identify patients who have the most to gain if the blocked artery can be re-opened. The trial will test whether a new minimally invasive clot removal procedure performed after standard clot-dissolving treatment improves recovery after stroke.

Related publications (23)

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Background and ObjectivesThe relevance of impaired microvascular tissue-level reperfusion despite complete upstream macrovascular ..

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The relationship between reperfusion and edema is unclear, with experimental and clinical data yielding conflicting results. We in..

Association between pre-treatment perfusion profile and cerebral edema after reperfusion therapies in ischemic stroke.

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The relationship between reperfusion and edema is unclear, with experimental and clinical data yielding conflicting results. We in..

Tenecteplase Thrombolysis in Posterior Circulation Stroke

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Does Intravenous Thrombolysis Within 4.5 to 9 Hours Increase Clot Migration Leading to Endovascular Inaccessibility?

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Background and Purpose: Distal clot migration is a recognized event following intravenous thrombolysis (IVT) in the setting of acu..

Cost-Effectiveness of Tenecteplase Before Thrombectomy for Ischemic Stroke

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2020-12-01

Background and Purpose: Tenecteplase improved functional outcomes and reduced the requirement for endovascular thrombectomy in isc..

Association of Reperfusion After Thrombolysis With Clinical Outcome Across the 4.5-to 9-Hours and Wake-Up Stroke Time Window A Meta-Analysis of the EXTEND and EPITHET Randomized Clinical Trials

Bruce CV Campbell, Henry Ma, Mark W Parsons, Leonid Churilov, Nawaf Yassi, Timothy J Kleinig, Chung Y Hsu, Helen M Dewey, Kenneth S Butcher, Bernard Yan, Patricia M Desmond, Tissa Wijeratne, Sami Curtze, P Alan Barber, Deidre A De Silva, Vincent Thijs, Christopher R Levi, Christopher F Bladin, Gagan Sharma, Andrew Bivard

2020-11-02

Importance Intravenous alteplase reduces disability after ischemic stroke in patients 4.5 to 9 hours after onset and with wake-up..

Stroke

BCV Campbell, P Khatri

2020-07-11

Stroke is a major cause of death and disability globally. Diagnosis depends on clinical features and brain imaging to differentiat..

SELECTing Patients with Large Ischemic Core Who May Benefit from Endovascular Reperfusion

BCV Campbell

2019-10-01

Advances in stroke medicine

BCV Campbell

2019-05-01

In recent years, reperfusion therapies such as intravenous thrombolysis and endovascular thrombectomy for ischaemic stroke have dr..

Mediation of the Relationship between Endovascular Therapy and Functional Outcome by Follow-up Infarct Volume in Patients with Acute Ischemic Stroke

AMM Boers, IGH Jansen, S Brown, HF Lingsma, LFM Beenen, TG Devlin, LS Román, JH Heo, M Ribó, MA Almekhlafi, DS Liebeskind, J Teitelbaum, P Cuadras, R Du Mesnil De Rochemont, M Beaumont, MM Brown, AJ Yoo, GA Donnan, JL Mas, C Oppenheim

2019-02-01

Importance: The positive treatment effect of endovascular therapy (EVT) is assumed to be caused by the preservation of brain tissu..

Penumbral imaging and functional outcome in patients with anterior circulation ischaemic stroke treated with endovascular thrombectomy versus medical therapy: a meta-analysis of individual patient-level data

BCV Campbell, CBLM Majoie, GW Albers, BK Menon, N Yassi, G Sharma, WH van Zwam, RJ van Oostenbrugge, AM Demchuk, F Guillemin, P White, A Dávalos, A van der Lugt, KS Butcher, A Cherifi, HA Marquering, G Cloud, JM Macho Fernández, J Madigan, C Oppenheim

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Background: CT perfusion (CTP) and diffusion or perfusion MRI might assist patient selection for endovascular thrombectomy. We aim..

Association of follow-up infarct volume with functional outcome in acute ischemic stroke: A pooled analysis of seven randomized trials

AMM Boers, IGH Jansen, LFM Beenen, TG Devlin, LS Roman, JH Heo, M Ribo, S Brown, MA Almekhlafi, DS Liebeskind, J Teitelbaum, HF Lingsma, WH Van Zwam, P Cuadras, RDM De Rochemont, M Beaumont, MM Brown, AJ Yoo, RJ Van Oostenbrugge, BK Menon

2018-12-01

Background Follow-up infarct volume (FIV) has been recommended as an early indicator of treatment efficacy in patients with acute ..

Imaging selection for acute stroke intervention

BCV Campbell, MW Parsons

2018-08-01

This review summarizes the current state of knowledge regarding the use of imaging to guide stroke treatment. Brain imaging plays ..

Tenecteplase versus alteplase before thrombectomy for ischemic stroke

BCV Campbell, PJ Mitchell, L Churilov, N Yassi, TJ Kleinig, RJ Dowling, B Yan, SJ Bush, HM Dewey, V Thijs, R Scroop, M Simpson, M Brooks, H Asadi, TY Wu, DG Shah, T Wijeratne, T Ang, F Miteff, CR Levi

2018-04-25

BACKGROUND: Intravenous infusion of alteplase is used for thrombolysis before endovascular thrombectomy for ischemic stroke. Tenec..

Effect of general anaesthesia on functional outcome in patients with anterior circulation ischaemic stroke having endovascular thrombectomy versus standard care: a meta-analysis of individual patient data

BCV Campbell, WH van Zwam, M Goyal, BK Menon, DWJ Dippel, AM Demchuk, S Bracard, P White, A Dávalos, CBLM Majoie, A van der Lugt, GA Ford, NP de la Ossa, M Kelly, R Bourcier, GA Donnan, YBWEM Roos, OY Bang, RG Nogueira, TG Devlin

2018-01-01

Background General anaesthesia (GA) during endovascular thrombectomy has been associated with worse patient outcomes in observatio..

Endovascular thrombectomy for ischemic stroke increases disability-free survival, quality of life, and life expectancy and reduces cost

BCV Campbell, PJ Mitchell, L Churilov, M Keshtkaran, KS Hong, TJ Kleinig, HM Dewey, N Yassi, B Yan, RJ Dowling, MW Parsons, TY Wu, M Brooks, MA Simpson, F Miteff, CR Levi, M Krause, TJ Harrington, KC Faulder, BS Steinfort

2017-12-14

Background: Endovascular thrombectomy improves functional outcome in large vessel occlusion ischemic stroke. We examined disabilit..

Endovascular stent thrombectomy: The new standard of care for large vessel ischaemic stroke

BCV Campbell, GA Donnan, KR Lees, W Hacke, P Khatri, MD Hill, M Goyal, PJ Mitchell, JL Saver, HC Diener, SM Davis

2015-08-01

Background: Results of initial randomised trials of endovascular treatment for ischaemic stroke, published in 2013, were neutral b..

Endovascular Therapy Proven for Stroke - Finally!

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2015-08-01

Cardiologists often remark that the field of ischaemic stroke follows in the footsteps of cardiology, just one to two decades late..

State of Acute Endovascular Therapy: Report from the 12th Thrombolysis, Thrombectomy, and Acute Stroke Therapy Conference

P Khatri, W Hacke, J Fiehler, JL Saver, HC Diener, M Bendszus, S Bracard, J Broderick, B Campbell, A Ciccone, A Dávalos, S Davis, AM Demchuk, D Dippel, G Donnan, D Fiorella, M Goyal, MD Hill, EC Jauch, TG Jovin

2015-06-04

Endovascular therapy for ischemic stroke with perfusion-imaging selection

BCV Campbell, PJ Mitchell, TJ Kleinig, HM Dewey, L Churilov, N Yassi, B Yan, RJ Dowling, MW Parsons, TJ Oxley, TY Wu, M Brooks, MA Simpson, F Miteff, CR Levi, M Krause, TJ Harrington, KC Faulder, BS Steinfort, M Priglinger

2015-03-12

Background: Trials of endovascular therapy for ischemic stroke have produced variable results. We conducted this study to test whe..

Imaging selection in ischemic stroke: Feasibility of automated CT-perfusion analysis

BCV Campbell, N Yassi, H Ma, G Sharma, S Salinas, L Churilov, A Meretoja, MW Parsons, PM Desmond, MG Lansberg, GA Donnan, SM Davis

2015-01-01

Background: Advanced imaging may refine patient selection for ischemic stroke treatment but delays to acquire and process the imag..

University of Melbourne Researchers

Bruce Campbell