Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: A Randomised Controlled Clinical Trial of Adjunctive Mechanical Thrombectomy Compared With Intravenous Thrombolysis in Patients With Acute Ischaemic Stroke Due to an Occluded Major Intracranial Vessel.
Brief Summary: Ischaemic strokes (those caused by blockage in an artery in the brain caused by a blood clot) can be treated with very early use of clot-busting (thrombolytic) drugs to attempt to restore the blood supply and limit the damage, resulting in an increased proportion of people making a recovery to independence after stroke. However, drug treatment only succeed in restoring blood flow in a minority of people with clots in the larger arteries (10-25% depending on the size of the blood vessel) and these people also have the most severe strokes and highest risk of death or dependence as a result of the stroke. Current best treatment is therefore least effective in the group with the most severe strokes. Devices that can be fed through the blood vessels to either remove or break up the blood clot in the brain vessels can open this type of large artery blockage. However, using these devices is a highly skilled procedure and it takes some time both to set up the necessary facilities (including anaesthetic, nurses and medical support) and to reach the blockage. The extra time that is required to use these devices may mean that brain tissue is already irreversibly damaged. If so, then an individual patient cannot benefit and indeed may be harmed by opening the artery. There are no completed clinical trials comparing the outcome in people treated with standard stroke treatment and those treated with devices. PISTE is a randomised, controlled trial to test whether additional mechanical thrombectomy device treatment improves functional outcome in patients with large artery occlusion who are given IV thrombolytic drug treatment as standard care.


Options:
A: Arm Label: thrombectomy; Type: EXPERIMENTAL; Interventions: Procedure: Thrombectomy, Device: Stentriever Solitaire FR® or Penumbra System® | Arm Label: best medical treatment; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: PROCEDURE; Name: Thrombectomy; Assigned to Arm(s): thrombectomy | Intervention Type: DEVICE; Name: Stentriever Solitaire FR® or Penumbra System®; Assigned to Arm(s): thrombectomy
B: Arm Label: IV t-PA with Solitaire™ revascularization device; Type: EXPERIMENTAL; Interventions: Device: Solitaire revascularization device | Arm Label: IV t-PA; Type: ACTIVE_COMPARATOR; Interventions: Drug: Intravenous (IV) recombinant human tissue plasminogen activator (rtPA) | Intervention Type: DRUG; Name: Intravenous (IV) recombinant human tissue plasminogen activator (rtPA); Assigned to Arm(s): IV t-PA | Intervention Type: DEVICE; Name: Solitaire revascularization device; Assigned to Arm(s): IV t-PA with Solitaire™ revascularization device
C: Arm Label: Endovascular treatment; Type: EXPERIMENTAL; Interventions: Device: Solitaire FR device | Arm Label: Medical treatment; Type: ACTIVE_COMPARATOR; Interventions: Other: Medical treatment | Intervention Type: DEVICE; Name: Solitaire FR device; Assigned to Arm(s): Endovascular treatment | Intervention Type: OTHER; Name: Medical treatment; Assigned to Arm(s): Medical treatment
D: Arm Label: Intravenous rtPA; Type: ACTIVE_COMPARATOR; Interventions: Drug: Intravenous rtPA | Arm Label: Intravenous rtPA and Mechanical Thrombectomy; Type: EXPERIMENTAL; Interventions: Device: Mechanical thrombectomy, Drug: Intravenous rtPA | Intervention Type: DEVICE; Name: Mechanical thrombectomy; Assigned to Arm(s): Intravenous rtPA and Mechanical Thrombectomy | Intervention Type: DRUG; Name: Intravenous rtPA; Assigned to Arm(s): Intravenous rtPA, Intravenous rtPA and Mechanical Thrombectomy

Answer: D