Tribulations of stroke trials

The recent JNIS editorial, ‘The tribulations of stroke trials’,1 discusses three recent failed endovascular stroke treatment trials, including the Interventional Management of Stroke III (IMS III) trial. The authors assess the impact of these trials on patient treatment, as well as on future trials. However, some clarifications of the data presented and the statements made in that editorial regarding IMS III are needed. The authors are incorrect to suggest that large vessel occlusion (LVO) was the ‘index disease’ for IMS III. As stated clearly in the protocol and trial design, the index disease for the IMS III trial was major ischemic stroke, as defined by the National Institutes of Health Stroke Scale (NIHSS), and the primary efficacy endpoint was a Rankin Scale score of 0–2 or functional independence at 90 days. Although the primary outcome of IMS III was not revascularization of LVO, the expectation was that endovascular therapy would...

Source: Journal of NeuroInterventional Surgery - June 11, 2016 Category: Neurosurgery Authors: Broderick, J., Tomsick, T. A., on behalf of the IMS III investigators Tags: PostScript Source Type: research