Recently, the cross-disciplinary team of the Oriental Pan-Vascular Instrumentation Innovation Academy, in collaboration with multiple global research teams, published their latest findings online in the prestigious clinical medicine journal, The Lancet (Impact Factor 168.9). The paper titled “Improving Reperfusion Strategies in Acute Ischaemic Stroke (IRIS)” has made significant contributions to enhancing global clinical practice levels for stroke and has expanded the international influence of Chinese scholars in the field of cerebrovascular disease intervention. The Shanghai University of Science and Technology’s Oriental Pan-Vascular Instrumentation Innovation Academy is listed as the co-first author and co-corresponding author of the article.
Over recent years, as clinical research has deepened, arterial thrombectomy has been recognized as the most effective standard treatment for anterior circulation large vessel occlusive acute ischemic stroke. This method significantly improves clinical outcomes and reduces residual symptoms. However, there has been international debate over whether intravenous thrombolysis (IVT) should be performed before arterial thrombectomy (EVT) due to concerns that IVT may increase bleeding risks, delay thrombectomy, and increase treatment costs. Consequently, researchers worldwide have been conducting high-quality clinical studies to address this issue. To date, six high-quality clinical studies on this topic have been published in internationally renowned journals. However, due to differences in study design, enrollment numbers, study populations, and baseline data, the results of these six studies are inconsistent. Therefore, there is an urgent need for a comprehensive analysis based on individual data from high-quality randomized controlled trials (RCT) to obtain higher-level evidence-based medical evidence, which will help guide global stroke treatment practices.
To this end, the cross-disciplinary team from the Oriental Pan-Vascular Instrumentation Innovation Academy, together with experts from the Netherlands, Switzerland, and other countries, initiated and conducted a study to improve reperfusion strategies in acute ischemic stroke. The study used a non-inferiority test design and determined the most peer-accepted non-inferiority margin through extensive surveys conducted by relevant global societies. Ultimately, the study included 2,314 patients from 207 research centers across eight countries, including China, the Netherlands, Switzerland, Australia, New Zealand, Japan, Canada, and Vietnam.
The study results found that, based on a 5% non-inferiority margin, direct thrombectomy was not proven inferior to bridging thrombectomy.
simultaneously, it is particularly noteworthy that the study could not confirm that bridging treatment is superior to direct thrombectomy. The difference between the two treatment methods is minimal, with only a 1.7% outcome difference. This means that for every 57 patients treated with bridging therapy, only one additional patient might benefit compared to direct arterial thrombectomy alone. We should make individualized precision decisions based on cost-effectiveness, patient characteristics, and anticipated delays, with subgroup analysis currently underway.
The publication of these results not only represents a major breakthrough in the field of cerebrovascular disease treatment by the cross-disciplinary team at the Oriental Pan-Vascular Instrumentation Innovation Academy but also marks a high starting point for medical-engineering interdisciplinary research. The academy, with its unique talents and geographical advantages and a concentration of many outstanding academic talents, will serve as a strong driving force for future research and innovation. This achievement will attract more scholars and interdisciplinary experts to join, explore, and innovate together, promoting a leap in medical standards and providing more patients with renewed hope for recovery.
