Rational
Despite successful angiographic reperfusion, still 50% of acute ischemic stroke patients with anterior circulation large vessel occlusion are functionally independent at 90 days. IA-SUCCESS trial aims to determine whether the intra-arterial thrombolysis is efficient as an add-on to endovascular thrombectomy ± prior intravenous thrombolysis in the setting of successful brain reperfusion on cerebral angiogram, allowing recanalization of distal arterial occlusions and improvement of upstream brain reperfusion by targeting microvascular obstruction.
Objectives
The primary outcome is the severity of disability according to the distribution of the modified Rankin Scale (mRS) score at 90 ± 15 days, assessed by an independent qualified nurse certified in the assessment of the mRS and blinded to the randomization group. The key secondary outcomes are excellent (mRS 0-1) and favorable outcome (mRS 0-2) at 90 days, symptomatic intracranial hemorrhage and 90-day mortality.
