Tests clot-dissolving drug delivered directly into artery for stroke
Tests direct clot-dissolving treatment in adults with a stroke from a medium-sized artery blockage.
Plain-language title generated from the registry record
Registry title: OPtimizing REperfusion by Primary Intra-Arterial ThRomboLysis for Medium Vessel Occlusion
Key facts
- Where
- Guangzhou, ChinaSee the site
- Phase
- Phase 3
AI summary: who the study is looking for
From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.
The trial is looking for adults with a sudden stroke caused by a blocked medium-sized brain artery, who can start treatment within 24 hours of when they were last known well.
- Age
- 18 years or older.
- Sex
- All sexes can join.
- Disease stage
- Acute ischemic stroke from a blocked medium-sized brain artery (confirmed on CT or MR angiography), with a stroke severity score (NIHSS) of 6 or more. Treatment must start within 6 hours of last known well, or within 6 to 24 hours if scans show brain tissue that can still be saved.
Main reasons for not taking part
- Bleeding inside the skull
- Pre-stroke disability score (mRS) of 2 or more
- Pregnant or breastfeeding women
- Active or recent bleeding, or a bleeding or clotting disorder
- Severe kidney problems, or life expectancy under 6 months
Read by machine on 9 November 2026.
Where in China
- Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityGuangzhou, ChinaTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
- Trial code
- NCT07137832
- Record updated
- 24 August 2026
- Original description
PEARL-MeVO is an investigator-initiated, multicenter, prospective, randomized controlled, open-label, blinded endpoint (PROBE) clinical trial aiming at evaluating the efficacy and safety of primary intra-arterial thrombolysis in improving 90-day functional outcome in acute ischemic stroke patients due to medium vessel occlusion (MeVO) within 24 hours of symptom onset.Read full original descriptionShow less
OPtimizing REperfusion by Primary Intra-Arterial ThRomboLysis for Medium Vessel Occlusion (PEARL-MeVO): A Multicenter, Prospective, Randomized Controlled, Open-label, Blinded-Endpoint Clinical Trial
PEARL-MeVO is an investigator-initiated, multicenter, prospective, randomized controlled, open-label, blinded endpoint (PROBE) clinical trial aiming at evaluating the efficacy and safety of primary intra-arterial thrombolysis in improving 90-day functional outcome in acute ischemic stroke patients due to medium vessel occlusion (MeVO) within 24 hours of symptom onset.
Inclusion: Aged 18 years or older; Clinical diagnosis of acute ischemic stroke; CT angiography (CTA) or MR angiography (MRA) confirmed primary isolated medium vessel occlusion (i.e. an occlusion of the co-/non-dominant M2, the M3/M4 segment of the MCA, the A1/A2/A3 segment of the ACA, or the P1/P2/P3 segment of the PCA); Baseline NIHSS ≥6; Treatment (arterial puncture) can be initiated 5.1 Within 6 hours of last known well (LKW) OR 5.2 Within 6 to 24 hours of LKW AND evidence of salvageable brain tissue on CT perfusion or perfusion-diffusion MRI (ischemic core volume <50mL, hypo-perfused tissue volume to ischemic core volume ratio >1.4, mismatch volume >10mL). Hypo-perfused tissue is defined as Tmax >6s on CT perfusion or perfusion MRI. Ischemic core is defined as rCBF <30% on CT perfusion or ADC <620μm2/s on diffusion MRI; Signed informed consent.
Exclusion: Any active or recent bleeding (gastrointestinal, urinary tract bleeding, etc.), or previous parenchymal organ surgery or biopsy in the last 1 month; Evidence of intracranial hemorrhage; Pre-stroke mRS score ≥ 2; Severe allergy to contrast agents (non-mild rash allergy) or absolute contraindication to iodine contrast; Known genetic or acquired bleeding disposition or anticoagulant factors deficiency; Anticipated life expectancy <6 months due to advanced disease (e.g., malignancy, severe cardiopulmonary disease, etc.); Any condition that, in the judgment of the investigator, makes the patient unsuitable for this study or where this study may impose a significant risk to the patient (e.g., inability to understand and/or comply with study procedures and/or follow-up due to psychiatric disorders, cognitive or emotional impairment); Coagulation disorder with INR >1.7 or use of new oral anticoagulants within 48 hours prior to symptom onset; Platelet count <50×10\^9/L; Known severe renal insufficiency with glomerular filtration rate <30 ml/min or blood creatinine >220 μmol/L (2.5 mg/dl); Rapidly improving symptoms, in the judgment of the managing clinician that the improvement is likely to result in the patient having an NIHSS score of <6 at randomization; The intervention procedure is unlikely to be completed as assessed by the investigator; Suspected cerebral vasculitis, septic embolization, or vascular occlusion due to infective endocarditis; Suspected arterial dissection; Systolic blood pressure >185 mmHg or diastolic blood pressure >110 mmHg, refractory to treatment; Radiological confirmed evidence of mass effect or intracranial tumour (except small meningioma); Women who are pregnant or breastfeeding; Participation in other clinical trials.