Endovascular treatment to improve outcomes for Medium Vessel Occlusion
Research type
Research Study
Full title
A Multicentre, Prospective, Randomized, Parallel Group, Open-label Design to Determine the Efficacy and Safety of Endovascular Thrombectomy for ischemic stroke patients with symptomatic Acute Medium Vessel Intracranial Occlusions (ESCAPE-MeVO Trial)
IRAS ID
312281
Contact name
Liqun Zhang
Contact email
Sponsor organisation
Governors of the University of Calgary
Clinicaltrials.gov Identifier
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
Most strokes are caused by the blockage of one or more blood vessels in the brain, resulting in death of brain tissue due to lack of blood supply; hence, early re-opening of the vessel to resume the blood supply is crucial for the best possible outcome. A clot-busting (thrombolytic) drug was the only approved treatment for almost 20 years until 2015 when a new era began. Randomised controlled trials (RCTs) have consistently shown that direct removal of the blood clot in the brain by endovascular thrombectomy (also called clot retrieval), in addition to best medical treatment (with or without intravenous thrombolysis), improves functional outcome in stroke patients who have large vessel occlusion compared to best medical treatment alone.
However, no RCT has ever assessed whether thrombectomy is a safe and more effective treatment in stroke due to medium vessel occlusion (MeVO) compared to best medical treatment. In patients with MeVO, early re-opening of the vessel can only be achieved in around 50% of cases when thrombolysis is given, and 20% when thrombolysis cannot be given; this results in 30% of patients with MeVO having poor outcomes.
In recent years, advanced imaging used in routine clinical practice enables MeVO to be reliably detected, and surgeons’ thrombectomy experience and the improvements in devices make thrombectomy in MeVO technically feasible. ESCAPE-MeVO is an international, multicentre, randomized controlled trial designed to test the safety and efficacy of thrombectomy in stroke patients with MeVO compared with best medical treatment.
Participants will return to clinic on Day 90 for follow-up. A telephone or video follow up is possible if the participant is not able to attend in person due to COVID-19 restrictions or other reasons. Telephone visits will be conducted on Day 30 and Day 365, at which point participants will conclude study participation.REC name
Yorkshire & The Humber - Bradford Leeds Research Ethics Committee
REC reference
22/YH/0094
Date of REC Opinion
7 Jul 2022
REC opinion
Further Information Favourable Opinion