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Clot-Dissolving Treatment Through a Catheter for Stroke From a Blocked Medium-Sized Brain Artery

Tests catheter-delivered clot-dissolving treatment in adults with stroke from a blocked medium-sized artery.

Plain-language title generated from the registry record
Registry title: IAT-MeVO Trial Domain Within the ACT-GLOBAL Adaptive Platform Trial

Key facts

Where
Chengdu, ChinaSee the site

Where in China

  • West China Hospital of Sichuan UniversityChengdu, ChinaNo longer taking part

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Trial details

Who runs it
Bo Wu
Trial code
NCT07336927
Record updated
15 January 2026
Original description
IAT-MeVO is an international, multicenter, prospective, randomised, open-label, blinded end-point assessed (PROBE) trial, to evaluate the efficacy and safety of endovascular therapy (EVT) [intra-arterial thrombolysis (IAT)-based] versus best medical management (BMT) in patients with acute ischemic stroke (AIS) due to medium vessel occlusion (MeVO) who are ineligible for intravenous thrombolysis (IV) within 24 h of onset.Read full original descriptionShow less

Efficacy and Safety of Endovascular Therapy With Intra-Arterial Thrombolysis for Medium Vessel Occlusion Stroke--the IAT-MeVO Trial

IAT-MeVO is an international, multicenter, prospective, randomised, open-label, blinded end-point assessed (PROBE) trial, to evaluate the efficacy and safety of endovascular therapy (EVT) [intra-arterial thrombolysis (IAT)-based] versus best medical management (BMT) in patients with acute ischemic stroke (AIS) due to medium vessel occlusion (MeVO) who are ineligible for intravenous thrombolysis (IV) within 24 h of onset.

Inclusion: Age ≥ 18 y; Diagnosed as acute ischemic stroke; Isolated medium distal vessel occlusion (i.e. an occlusion of the 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) confirmed by CT or MR Angiography; Time from onset (or last-seen-well) to randomization < 24h; Has not received intravenous thrombolysis and is considered unsuitable for it based on the treating clinician's assessment; NIHSS ≥ 5, or NIHSS ≤ 4 with disabling deficit (e.g. severe aphasia, hemianopia, hemiplegia/loss of function in one side) or fluctuating symptoms at the time of randomization; For patients within 6 h of onset: No visually apparent hypodensity is observed on non-contrast CT compared with the contralateral white matter, or no hyperintensity is seen on fluid-attenuated inversion recovery (FLAIR) imaging; For patients presenting 6-24 h after onset: A perfusion imaging-based ischemic core mismatch ratio >1.2 and an infarct core volume <50 mL are required; Pre-stroke mRS ≤ 1;; Patient/Legally Authorized Representative has signed the Informed Consent form.

Exclusion: Concurrent multiple (≥2) intracranial arterial occlusions; Concurrent participation in another investigational drug or device study that could interfere with the present trial; Any evidence of intracranial hemorrhage on qualifying imaging; Any terminal disease with life expectancy <1 year; Clinical assessment of conditions unsuitable for interventional therapy (e.g., severe contrast agent allergy or absolute contraindications to iodine contrast agent; severe renal insufficiency, glomerular filtration rate < 30ml/min or serum creatinine > 220μmol/L (2.5 mg/dl)); Unsuitable for arterial thrombolytic therapy (e.g., known history of hereditary or acquired hemorrhagic disease and/or platelet count <50×109/L; abnormal coagulation function (INR>1.7); oral anticoagulants were taken within 24 - 48 hours before onset within APTT > 3 times normal; recent medical history or clinical manifestations of brain tumors other than meningiomas); Suspected cerebral vasculitis, septic embolism, or infective endocarditis as the cause of vessel occlusion; Suspected arterial dissection; Pregnancy or lactation; Other circumstances that participation is not deemed appropriate.

ClinicalTrials.gov NCT07336927