Endovascular Thrombectomy for Stroke
(SELECT LATE Trial)
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial examines whether combining endovascular thrombectomy with standard medical care benefits people who have experienced a stroke due to a large artery blockage in the brain. The goal is to determine if this approach improves recovery and daily functioning after three months. Participants will receive either medical care alone or medical care plus thrombectomy, which involves removing the clot to restore blood flow. Eligible participants include those who have had a stroke within the last 24 to 72 hours and have a blockage in a major brain artery. As an unphased trial, this study offers participants the chance to contribute to important research that could enhance stroke recovery strategies.
What prior data suggests that endovascular thrombectomy is safe for stroke patients?
A previous study showed that endovascular thrombectomy (EVT) helps stroke patients recover better. Specifically, patients who underwent EVT tended to improve more than those who did not have the procedure. Research also shows that EVT does not increase the risk of serious complications, such as brain bleeding or death. The treatment is generally considered safe, yielding good results in both short-term and long-term recovery. These findings suggest that EVT is a well-tolerated procedure for treating certain types of strokes.12345
Why are researchers excited about this trial?
Endovascular Thrombectomy is unique because it directly removes the blood clot blocking an artery in the brain, restoring blood flow and potentially saving brain tissue. Unlike standard medical management for strokes, which focuses on medication and monitoring to prevent further damage, this procedure physically intervenes to clear the blockage. Researchers are excited about this treatment as it has the potential to significantly improve functional outcomes by quickly and effectively addressing the root cause of the stroke.
What evidence suggests that endovascular thrombectomy is effective for stroke?
Studies have shown that endovascular thrombectomy (EVT), a procedure to remove clots blocking blood flow in the brain, effectively treats sudden strokes caused by blocked blood vessels. In this trial, some participants will receive EVT in addition to medical management. Research indicates that EVT significantly improves recovery chances compared to medication alone. For example, one study found that EVT led to better recovery within 90 days for patients with large blood vessel blockages. Another review showed that EVT was successful for strokes in the front part of the brain when treated between 6 and 24 hours after symptoms started. These findings suggest that EVT can be a powerful tool in reducing stroke-related disability.26789
Who Is on the Research Team?
Amrou Sarraj, MD
Principal Investigator
University Hospitals
Are You a Good Fit for This Trial?
Inclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants receive medical management with or without endovascular thrombectomy for acute ischemic stroke
Follow-up
Participants are monitored for safety and effectiveness after treatment
Long-term Follow-up
Participants are assessed for long-term outcomes and quality of life measures
What Are the Treatments Tested in This Trial?
Interventions
- Endovascular Thrombectomy
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
Active Control
Medical management with endovascular thrombectomy (EVT) - EVT will be provided in addition to medical management and is a procedure to remove a thrombus in one of the brain arteries that is obstructing the blood flow. Removing this occlusion results in restoration of blood flow to ischemic brain tissue and salvage of the parts that are still viable, which is expected to improve functional outcomes. Endovascular thrombectomy procedure will be performed using stent retrievers, aspiration devices or combination approach at the discretion of the treating physician, using devices approved by the local regulatory authority. For patients treated in the United States of America, only US Food and Drug Administration-approved neurothrombectomy devices can be used.
Medical management without endovascular thrombectomy comprises various measures to prevent further deterioration, enhance patients' outcomes and prevent occurrence of a secondary stroke in short and long term. This includes 1) evidence-based practices for blood pressure management 2) Neurocritical care monitoring with appropriate osmotic therapy and neurosurgical interventions such as hemicraniectomy for management of cerebral edema that occurs due to infracted brain tissue based on local institutional protocol, 3) stroke etiology identification by requisite neurology , cardiology, immunology evaluations and 4) short and long-term strategies for secondary stroke prevention, including anticoagulation, antiplatelet therapy, medical optimization and modification of stroke risk factors such as hypertension, hyperlipidemia, diabetes and other potential comorbidities.
Find a Clinic Near You
Who Is Running the Clinical Trial?
Amrou Sarraj
Lead Sponsor
Patient-Centered Outcomes Research Institute
Collaborator
Citations
Efficacy and Safety of Endovascular Thrombectomy in ...
Results: Seven studies involving 718 patients (305 EVT, 413 BMT) were included. EVT significantly improved FFO (11.8% vs. 1.6%; OR 5.39, 95% CI ...
Safety and Efficacy of Endovascular Thrombectomy for ...
There is limited evidence regarding outcomes of endovascular thrombectomy (EVT) in patients with acute ischemic stroke after cardiac surgery (CS) ...
Temporal trends, outcomes, and predictors for ...
Outcomes included reperfusion, symptomatic intracerebral hemorrhage (SICH), early neurological deterioration (END), in-hospital and 90-day mortality, and ...
Trial of Endovascular Thrombectomy for Large Ischemic ...
Endovascular thrombectomy has been shown to be more effective in reducing disability than medical therapy alone in selected patients with ischemic stroke.
Endovascular thrombectomy for acute ischaemic stroke ...
Data on functional outcome were available for 244 (96%) of 253 patients at 12-month follow-up (123 [98%] of 125 in the thrombectomy group and ...
Long-term efficacy and safety of endovascular thrombectomy ...
EVT has been shown to result in better clinical outcomes than in patients who did not receive this intervention; it has also decreased mortality ...
Efficacy and Safety of Endovascular Thrombectomy for ...
We performed a systematic review and meta-analysis to examine the outcomes of EVT in patients with acute ischemic stroke beyond 24 hours from onset.
Endovascular Treatment in Acute Ischemic Stroke Due to ...
Patients receiving EVT had similar rates of 3-month excellent functional outcome compared with BMT alone (risk ratio [RR] 1.02; 95% CI 0.93–1.12 ...
Outcomes After Endovascular Thrombectomy With or ...
The most recent meta-analysis of all 6 trials found that using EVT without alteplase resulted in worse disability outcomes at 90 days, but this ...
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