Active not recruitingNAINTERVENTIONAL

EndovaSCular TreAtment to imProve outcomEs for Medium Vessel Occlusions (ESCAPE-MeVO Trial)

The ESCAPE-MeVO study is for people who have had a stroke due to a blood clot in a medium-sized blood vessel in their brain. This type of stroke, called an ischemic stroke, can lead to serious disability. Currently, a procedure called thrombectomy, which removes the clot, is known to help for larger vessel clots. This study aims to find out if it also helps for medium-sized vessel clots. Patients will be randomly assigned to either receive thrombectomy in addition to usual stroke care, or just usual stroke care. Researchers want to see if the procedure improves their recovery over 12 months. This research will happen in up to 75 hospitals and will involve about 530 patients.

At a glance

Status

Active not recruiting

Phase

Sponsor

Dr. Michael D Hill

Enrolment target

530

Start

15 Apr 2022

Estimated completion

30 Jun 2026

Acute Ischemic Stroke

What is this study about?

A stroke happens when a blood clot blocks a blood vessel in the brain, stopping blood flow. This is called an ischemic stroke and can cause serious problems, or even be life-threatening. Medical experts agree that treating a stroke very quickly is essential to give someone the best chance of recovery.

For strokes caused by clots in large brain blood vessels, a procedure called a 'thrombectomy' is often used. This involves a specialist doctor guiding a tiny device through blood vessels to remove the clot, which helps restart blood flow to the brain. However, it's not yet clear if this same procedure is helpful for strokes caused by clots in medium-sized brain blood vessels. This study, called ESCAPE-MeVO, aims to answer that important question.

Researchers will compare two groups of stroke patients: one group will receive the standard excellent medical care for stroke, and the other group will receive the same excellent standard care PLUS the thrombectomy procedure. This will help doctors understand if adding thrombectomy makes a real difference to recovery for people with medium vessel strokes. All participants will be carefully monitored for a year to see how they are doing.

Key takeaways

Focuses on strokes caused by blood clots in medium-sized brain vessels.
Compares standard stroke care with standard care plus a clot-removal procedure (thrombectomy).
Aims to see if thrombectomy improves recovery for these specific strokes.
Participation lasts for 12 months with a key follow-up at 90 days.
Involves random assignment to one of two treatment groups.
Recruiting about 530 patients across many hospitals.

Who may be eligible?

This study is looking for adults aged 18 or over who have recently had a stroke caused by a blood clot in a medium-sized blood vessel in their brain. The stroke symptoms must have started within the last 12 hours. Doctors will need to confirm that your stroke is considered disabling, based on specific medical scores or symptoms that significantly impact your day-to-day life, like problems with vision, speech, or hand use.

To join, imaging scans of your brain must clearly show the blood clot in a specific medium-sized vessel, and your symptoms should match where the clot is located. You (or a legal representative) will also need to provide consent to participate.

There are also some reasons why you might not be able to join. These include if your brain scans show signs of a old stroke affecting a large portion of your brain, or if there's any sign of bleeding in your brain. People who were already living in a nursing home or needed significant daily help before their stroke, or have other serious health conditions like severe dementia or advanced cancer, might also not be suitable for the study.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you 18 years old or older?
Did your stroke symptoms start within the last 12 hours?
Has your doctor diagnosed an ischemic stroke due to a clot in a medium brain vessel?
Does your stroke currently cause symptoms that significantly affect you?
Are there no signs of bleeding in your brain from imaging scans?
Are you able to provide consent (or have someone legally able to do so for you)?

Answer every question to see your result.

What does participation involve?

If you are eligible and agree to take part, you will be randomly assigned to one of two groups. One group will receive standard stroke care, which is the best treatment available. The other group will receive standard stroke care, plus the thrombectomy procedure to remove the blood clot. The decision about which group you are in is made by chance, like flipping a coin.

The thrombectomy procedure involves a specialist guiding a thin tube through your blood vessels to remove the clot using a tiny device. The medical team will decide the best way to do this. After your initial stroke care in the hospital, you will be asked to return to the clinic for a review at 90 days. Your progress will then be followed for a full 12 months after your stroke.

Potential risks and benefits

Taking part in any medical study has potential benefits and risks. You might benefit from the added thrombectomy procedure if you are in that group, or contribute to important medical knowledge that helps future stroke patients. However, there's no guarantee of personal benefit. The thrombectomy procedure carries risks, as with any medical intervention, including potential complications like bleeding or damage to blood vessels, although these are closely managed by experienced medical teams. Standard stroke care also has its own known risks. You can withdraw from the study at any time, for any reason, without it affecting your medical care.

Locations (53)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

Baptist Health Medical Center
Verified postcode
Little Rock, United States
Sutter Health
Verified postcode
San Francisco, United States
Providence Little company of Mary
Verified postcode
Torrance, United States
Yale School of Medicine
Verified postcode
New Haven, United States
Baptist Health Medical Centre
Verified postcode
Jacksonville, United States
Mayo Clinic
Verified postcode
Jacksonville, United States
Tampa General Hospital
Verified postcode
Tampa, United States
Northwestern Medicine
Verified postcode
Chicago, United States
Rush university Medical Centre
Verified postcode
Chicago, United States
University of Kansas Medical Center
Verified postcode
Kansas City, United States
University of Maryland
Verified postcode
Baltimore, United States
bBston Medican Center
Verified postcode
Boston, United States

Common questions

What is an ischemic stroke?

An ischemic stroke happens when a blood clot blocks a blood vessel in your brain, stopping blood flow and damaging brain tissue.

What is a thrombectomy?

A thrombectomy is a procedure where a specialist removes a blood clot from a blood vessel, usually using a tiny device guided through the body.

Why focus on 'medium vessel occlusions'?

Doctors already know thrombectomy helps for large vessel clots, but they need to find out if it's also effective and safe for clots in smaller, 'medium-sized' brain vessels.

How long will I be in the study?

Your active participation for assessments will involve a hospital stay and a follow-up visit at 90 days, but your overall progress will be tracked for 12 months.

Can I choose which treatment I get?

No, you will be randomly assigned to either receive just standard care or standard care plus the thrombectomy. This helps ensure the study results are fair and unbiased.