Treatment With Endovascular Intervention for STroke Patients With Existing Disability

TESTED will compare the risks and benefits of endovascular thrombectomy (EVT) to medical management (no EVT) in ischemic stroke patients who have a blockage in one of the large blood vessels in the brain and have a moderate-to-severe disability prior to their stroke.

Inclusion Criteria:

1. Adult patients (≥18 years)

2. Moderate-to-severe pre-stroke functional disability, defined as mRS 3-4, for at least 3 months prior to stroke onset

3. Presenting to study hospital within 24 hours of last known well time

4. Diagnosis of acute ischemic stroke

5. Intracranial causative occlusion of the internal carotid artery or the M1 or dominant M2 segments of the middle cerebral artery visualized on the baseline CT(or MR) angiogram

6. Presenting CT Alberta Stroke Program Early CT (ASPECT) score ≥3 or MRI ASPECT score ≥4

7. Presenting NIH Stroke Scale score ≥6

8. Informed consent from patient if competent or from legally authorized representative

Exclusion Criteria:

1. Known diagnosis of a terminal cancer or terminal illness at the time of stroke

2. Assessment of pre-stroke functional status cannot be performed during the hospital stay

3. Pre-stroke disability deemed temporary in the investigator's opinion (for example, recovering from a general medical illness or traumatic bodily injury)

Conditions:
• Stroke
• Ischemic Stroke