Inclusion criteria | |
1. Clinical diagnosis of acute ischemic stroke | |
2. Age ≥ 18 | |
3. Proximal intracranial anterior circulation occlusion (distal intracranial carotid artery or middle (M1/M2)) cerebral artery confirmed by neuro-imaging (CTA or MRA) | |
4. Presence of poor, moderate, or good collateral flow as shown by CTA | |
5. Non-contrast CT or MRI ruling out intracranial hemorrhage | |
6. Start of EVT (groin puncture) possible between 6 and 24 h after symptom onset or last seen well between 6 and 24 h including wake-up strokes | |
7. A score of at least 2 on the NIHSS | |
8. Written informed consent (deferred) | |
Exclusion criteria | |
1. Pre-stroke disability which interferes with the assessment of functional outcome at 90 days, i.e., mRS > 2 | |
2. Cerebral infarction in the previous 6 weeks with residual neurological deficit or signs of large recent infarction on neuroimaging in the territory of the middle cerebral artery | |
3. Clinical evidence of hemorrhagic diathesis, confirmed by an INR > 3 and/or a platelet count < 40 × 109/L and/or an APTT > 50 s | |
4. Clearly demarcated hypodensity on non-contrast CT in > 1/3 of the middle cerebral artery territory, consistent with current symptoms | |
5. Distal intracranial carotid artery occlusion/M1 occlusion, NIHSS ≥ 10, and infarct core ≤ 25 ml and total ischemic volume/infarct core ratio ≥ 2 on CT perfusion or MR diffusion/perfusion | |
6. Participation in other trials except for MR ASAP and ARTEMIS |