CHOICE Trial

JAMA

February 10, 2022

Effect of Intra-arterial Alteplase vs Placebo Following Successful Thrombectomy on Functional Outcomes in Patients with Large Vessel Occlusion Acute Ischemic Stroke.

What is the research question?

will the addition of intra adjunct intra-arterial thrombolysis following mechanical thrombectomy improve the neurological functional outcomes in patients with large vessel occlusion acute ischemic stroke?


What did they do?

This is a phase IIb randomized controlled clinical trial in 7 stroke centers in Spain and included 121 adults who underwent a successful angiographic thrombectomy for a large vessel occlusion acute ischemic stroke. Treatment with intra-arterial alteplase compared with placebo resulted in an improved neurological outcome with a modified Rankin Scale score of 0 or 1 in 59.0% vs 40.4% of patients at 90 days. This difference was statistically significant.


What did they find?

Among patients with large vessel occlusion acute ischemic stroke and successful reperfusion following thrombectomy, the use of adjunct intra-arterial alteplase compared with placebo resulted in a greater likelihood of excellent neurological outcome at 90 days; however, the findings should be considered preliminary until replicated.

CHOICE Trial