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MR RESCUE: A Trial of Imaging Selection and Endovascular Treatment for Ischemic Stroke 

Sponsor: NIH

Investigators: Carlos Kase MD (principal), Viken Babikian MD, Thanh Nguyen MD, Jose Romero MD

MR RESCUE Investigators: CS. Kidwell, R Jahan, J Gornbein, JR Alger, V Nenov, Z Ajani, L Feng, BC Meyer, S Olson, LH Schwamm, AJ Yoo, RS Marshall, P M Meyers, DR Yavagal, M Wintermark, J Guzy, S Starkman, and JL Saver 

N Engl J Med 2013; 368:914-923 March 7, 2013 DOI: 10.1056/NEJMoa1212793

In this study, patients were randomly assigned within 8 hours after the onset of large-vessel, anterior-circulation strokes to undergo mechanical embolectomy (Merci Retriever or Penumbra System) or receive standard care. All patients underwent pretreatment computed tomography or magnetic resonance imaging of the brain. Randomization was stratified according to whether the patient had a favorable penumbral pattern (substantial salvageable tissue and small infarct core) or a nonpenumbral pattern (large core or small or absent penumbra). Outcomes were assessed using the 90-day modified Rankin scale, ranging from 0 (no symptoms) to 6 (dead).

In conclusion, a favorable penumbral pattern on neuroimaging did not identify patients who would differentially benefit from endovascular therapy for acute ischemic stroke, nor was embolectomy shown to be superior to standard care.

(Funded by the National Institute of Neurological Disorders and Stroke; MR RESCUE number, NCT00389467.)