Grant: Project Grant

The most common cause of stroke is when a clot blocks an artery that supplies blood to the brain. Every second lost in removing that clot results in more damage to the brain. There are two established treatments to remove the clot. A clot busting drug can be given as an injection through the veins. This drug however only works in a minority of patients. Alternatively, thin tubes and wires can be inserted through the groin and taken up to the brain to remove the clot (endovascular treatment). This latter treatment works 80 to 90% of the time with clots blocking big arteries. For every three patients treated this way, one extra patient lives a functionally independent life - making this treatment one of the most effective treatments in all of medicine. At least two out of every five patients with strokes due to clots however have clots in smaller arteries. The clot busting drug works, at best, around 50% of the time. Until now, tubes and wires that can safely reach these smaller arteries and remove clots were not available. Moreover, newer imaging techniques are helping physicians identify these clots better. These advances in technology mean that physicians can now reliably and safely treat patients with these smaller clots using miniaturized tubes and wires. If we prove that endovascular treatment with tubes and wires is safe and effective in removing clots in these smaller arteries in the brain, we could offer patients with such strokes a better chance at improving. We therefore need a study that randomizes subjects to the new treatment vs. what they currently receive as standard care. The ESCAPE-MeVO study seeks to do this. This study will recruit around 600 subjects across centres in Canada, US, and Europe and will follow the highest standards of ethical conduct of research, patient confidentiality and data collection.