EXtending the Time Window for Thrombolysis in Posterior Circulation Stroke Without Early CT Signs

Summary

The primary hypothesis being tested in this trial is that ischemic stroke patients in posterior circulation at 4.5 - 24 hours post onset of stroke will have improved clinical outcomes when given intravenous tissue plasminogen activator (tPA) compared to standard care.

Timeline

Start

2022-08-17

Primary completion

2024-08-15

Completion

2024-08-15

Outcome

Met primary endpoint

paper A higher percentage of patients in the alteplase group than in the standard-treatment group had functional independence at 90 days (89.6% vs. 72.6%; adjusted risk ratio, 1.16; 95% confidence interval [CI], 1.03 to 1.30; P = 0.01). PMID 40174223 ↗

Publications

• Yan S, Zhou Y, Lansberg MG, Liebeskind DS, Yuan C, Yu H, Chen F, Chen H, Zhang B, Mao L, Zhang X, Wang X, Zhang X, Chen Y, Zhou H, Zhong W, He Y, Chen K, Wang J, Chen H, Huang Y, Campbell BCV, Lou M; EXPECTS Group. Alteplase for Posterior Circulation Ischemic Stroke at 4.5 to 24 Hours. N Engl J Med. 2025 Apr 3;392(13):1288-1296. doi: 10.1056/NEJMoa2413344.

Drugs

Indications