In 3 recent randomized controlled trials of intra-arterial treatment of acute ischemic stroke - IMS-III, SYNTHESIS and MR RESCUE - intra-arterial treatment increased the proportion of patients with recanalization and the treatment appeared safe. However, the trials did not show an effect on functional recovery, although a substantial effect could not be excluded. The delay between onset of symptoms and treatment was long, and stent retrievers were used in only a few patients. In our view, a rational and ethical approach would now be to treat quickly with IV rtPA and when possible, refer and include in new randomized clinical trials that compare intra-arterial treatment with standard care, such as MR CLEAN or BASICS in the Netherlands.
Nederlands Tijdschrift voor Geneeskunde
Erasmus MC: University Medical Center Rotterdam

Dippel, D., Boiten, J., Vos, J. A., & Majoie, C. B. (2013). Intra-arterial treatment of ischemic stroke - Still no evidence but reason for further study. Nederlands Tijdschrift voor Geneeskunde (Vol. 157). Retrieved from