T h e n e w e ngl a nd j o u r na l o f m e dic i n e
n engl j med nejm.org 1
Endovascular Therapy for Ischemic Stroke
with Perfusion-Imaging Selection
B.C.V. Campbell, P.J. Mitchell, T.J. Kleinig, H.M. Dewey, L. Churilov, N. Yassi,
B. Yan, R.J. Dowling, M.W. Parsons, T.J. Oxley, T.Y. Wu, M. Brooks,
M.A. Simpson, F. Miteff, C.R. Levi, M. Krause, T.J. Harrington, K.C. Faulder,
B.S. Steinfort, M. Priglinger, T. Ang, R. Scroop, P.A. Barber, B. McGuinness,
T. Wijeratne, T.G. Phan, W. Chong, R.V. Chandra, C.F. Bladin, M. Badve, H. Rice,
L. de Villiers, H. Ma, P.M. Desmond, G.A. Donnan, and S.M. Davis,
for the EXTEND-IA Investigators*
The authors’ full names, academic de-
grees, and affiliations are listed in the Ap-
pendix. Address reprint requests to Dr.
Campbell at the Department of Neurolo-
gy, Royal Melbourne Hospital, Grattan
St., Parkville, VIC 3050, Australia, or at
* A complete list of investigators in the
Extending the Time for Thrombolysis in
Emergency Neurological Deficits —
Intra-Arterial (EXTEND-IA) trial is pro-
vided in the Supplementary Appendix,
available at NEJM.org.
This article was published on February 11,
2015, at NEJM.org.
Copyright ? 2015 Massachusetts Medical Society.
A BS TR AC T
Trials of endovascular therapy for ischemic stroke have produced variable results.
We conducted this study to test whether more advanced imaging selection, recently
developed devices, and earlier intervention improve outcomes.
We randomly assigned patients with ischemic stroke who were receiving 0.9 mg of
alteplase per kilogram of body weight less than 4.5 hours after the onset of ische-
mic stroke either to undergo endovascular thrombectomy with the Solitaire FR
(Flow Restoration) stent retriever or to continue receiving alteplase alone. All the
patients had occlusion of the internal carotid or middle cerebral artery and evidence
of salvageable brain