UT Stroke Research

Ischemic stroke symptoms with onset <3 hours. Symptoms must be distinguished from another ischemic event such as syncope, seizure, migraine, and hypoglycemia.
Males and females ages 18-85 years.
A clot causing complete or partial occlusion (TIBI 0, 1, 2, or3) via TCD in any one of the following areas: distal ICA, MCA (M1 or M2), PCA (P1 or P2) distal vertebral or basilar occlusions.
Meet criteria for rT-PA therapy.

Evidence of intracranial hemorrhage (ICH) on baseline CT scan or non-vascular cause of neurological deficit.
Baseline NIHSS >5 or patient with rapidly resolving deficit or rapidly improving symptoms consistent with TIA.
Pre-existing disability with mRS≥2
Absent temporal windows on TCD
Previous stroke, myocardial infarction (MI), post myocardial infarction, pericarditis, intracranial surgery, or documented head trauma within 3 months of baseline.

Age: 18 through 80 years (i.e., candidates must have had their 18th birthday, but not had their 81st birthday)
Initiation of intravenous rt-PA within 3 hours of onset of stroke symptoms. Time of onset is defined as the last time when the subject was witnessed to be at baseline (i.e., subjects who have stroke symptoms upon awakening will be considered to have their onset at beginning of sleep)
An NIHSSS ≥ 10 at the time that intravenous rt-PA is begun

History of stroke in the past 3 months
Previous intra-cranial hemorrhage, neoplasm, subarachnoid hemorrhage, or arteriovenous malformation
Hypertension at time of treatment; systolic BP > 185 or diastolic > 110 mm Hg) or aggressive measures to lower blood pressure to below these limits are needed.
Recent (within 30 days) surgery or biopsy of parenchymal organ or hemorrhage
Recent (within 90 days) severe head trauma or head trauma with loss of consciousness
Known hereditary or acquired hemorrhagic diathesis, coagulation factor deficiency or oral anticoagulant therapy with INR > 1.7 or institutionally equivalent prothrombin time

Patients with at least a serious, measurable deficit on the NIH Stroke Scale in:
- language (aphasia score ± 1)
- motor power (arm or leg ± 1)
- vision (best visual score ± 2)
- attention (attention score ± 2)
Thus eligible patients may have a minimum total score of 1 if the deficit is in language or motor power. There is no maximum score that is exclusionary; even stuporous or comatose patients with severe hemispheric or brainstem deficits will be eligible, as is current practice with intravenous rt-PA. Patients with all ischemic stroke types and in all vascular distributions are eligible.
Must arrive at participating hospital and treatment begun within 3 hours of the onset of symptoms. Patients awakening with new symptoms must use the time of onset as the time last observed to be normal and awake and the total time cannot exceed three hours prior to treatment.
Must be 18 years of age or older.

New focal disabling neurologic deficit consistent w/ acute cerebral ischemia (NIHSS ≥ 6)
Age ≥ 18 ≤ 85
Clot retrieval procedure can be initiated within 8 hours from onset
Large vessel (proximal anterior circulation) occlusion on MR angiography in a target vessel (internal carotid, M1 or M2 MCA)
Informed consent signed by the patient or patient’s legally representative
Pretreatment MRI performed according to MR RESCUE protocol
Premorbid modified Rankin score of 0-1
**patients who “failed” IV tPA w/ persistent target occlusion per a MR RESCUE protocol MRI (MRI must be done post IV tPA infusion)

History of stroke in the past 3 months
Previous intra-cranial hemorrhage, neoplasm, subarachnoid hemorrhage, or arteriovenous malformation
Hypertension at time of treatment; systolic BP > 185 or diastolic > 110 mm Hg) or aggressive measures to lower blood pressure to below these limits are needed.
Recent (within 30 days) surgery or biopsy of parenchymal organ or hemorrhage
Recent (within 90 days) severe head trauma or head trauma with loss of consciousness
Known hereditary or acquired hemorrhagic diathesis, coagulation factor deficiency or oral anticoagulant therapy with INR > 1.7 or institutionally equivalent prothrombin time