ACT: QuICR & OPTIMISE is a Pragmatic Phase III randomized open-label registry-based trial with blinded end-point assessment. Enrolled acute ischemic stroke patients will be eligible to receive intravenous thrombolysis (Alteplase or Tenecteplase) as per current guidelines. Over the three year study period, 1,600 patients will be treated with tPA or TNK, with followup at 90 days. The primary outcome measure will be a modified Rankin Scale (mRS) 0 or 1 at 90-120 days.

While current guidelines do not recommend endovascular treatment for MeVOs, techniques are improving rapidly, making these occlusions more safely accessible. As such, clinical practice is evolving, and MeVOpatients are increasingly being treated. This practice is heterogeneous though, and experiences are not reported on a large scale. We think that treatment of these patients could be the next frontier in improving outcomes of acute stroke. 

The ESCAPE NEXT Trial is a multicentre, randomized, double-blinded, placebo-controlled, parallel group, single-dose design to determine the efficacy and safety of intravenous Narinitide in subjects with acute ischemic stroke not recieving or ineligable for alteplase undergoing endovascular thrombectomy.