Literature Review

Time for a Time Window Extension: Insights from Late Presenters in the ESCAPE Trial

Pakrit Jittapiromsak

Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke (ESCAPE) trial was published in 2015 and showed good clinical results in the endovascular arm.
This trial enrolled patients up to 12 hours after symptom onset (n=315). However, the benefit in the extended time window was not clearly proven.

This study is a subgroup analysis of late presenters including 59 patients (randomized 5.5-12 hr, expected to be treated after 6 hr). There was no difference in treatment effect between early and late presenters. The results showed favourable clinical outcome in the endovascular arm (mRS 0-2 at 90 days 48.5% vs. 29.2%, p 0.18): more asymptomatic intracerebral hemorrhage was observed, with no difference in symptomatic hemorrhage.