Emergent Stenting In Acute Vertebrobasilar Occlusions

Study Overview
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Brief Summary
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In the acute posterior circulation strokes, the vertebrobasilar occlusions frequently related to worse outcomes than the anterior ones. However, few studies mentioned the benefit and safety of the emergent stenting in the successful recanalization at these complex occlusions. The investigators investigated whether the improvement of clinical outcome was achieved in postprocedural 3-month.

Detailed Description
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Acute ischemic stroke in posterior circulation account for nearly 20 - 25%, in which large vessel occlusions (LVOs) occur 0.8% - 5.7% of two circulation strokes. Although mechanical thrombectomy (MT) has recently been the gold standard in LVOs treatment, the futile recanalization (defined as unfavorable outcome despite early successful recanalization of target artery) rate was showed in posterior circulation higher than in anterior one. Multiple randomized controlled trials (BEST, BASICS, BAOCHE, ATTENTION) have recently reported the benefit of emergent stenting for acute vertebrobasilar occlusions stroke in order to support the successful recanalization in the setting of failure of mechanical thrombectomy. Moreover, the successful recanalization is one of the independent predictors of favorable outcomes. However, the use of the loading dose dual antiplatelet therapy and peri-procedural complications made the safety of emergent stenting remain uncertain. Therefore, the investigators aimed to investigate the impact of emergent stenting on the improved recanalization and clinical outcome in vertebrobasilar occlusions.

Official Title
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Emergent Stenting In Acute Vertebrobasilar Occlusions

Conditions
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Acute Stroke, Ischemic Stroke, Acute, Vertebro Basilar Ischemia

Intervention / Treatment
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* Procedure: Emergent Stenting


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age > 18 years old Onset to treatment time < 24 hours NIHSS ≥ 10 pc-ASPECTS ≥ 5 on MRI Exclusion Criteria: Premorbid mRS > 2 Unavailable stents Extensive, bilateral brain-stem infarction on neuroimaging Cerebellar mass effect on neuroimaging

Ages Eligible for Study
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Minimum Age: 19 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Emergent Stenting<br>Emergent Stenting In Acute Vertebrobasilar Occlusions | Procedure: Emergent Stenting<br>* Emergent Stenting In Acute Vertebrobasilar Occlusions<br>* Other names: ES;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The favorable 3-month outcome rate | The favorable 3-month outcome rate was accessed by modified Rankin Score (mRS), which comprised of included good (mRS 0 - ≤ 2) and fair (mRS 3). | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The symptomatic intracerebral hemorrhage rate | The symptomatic intracerebral hemorrhage was defined as patient's intracerebral hemorrhage with postprocedural mRS ≥ 5 and there were no other evident causes for the increased mRS | 24 hours after emergent stenting | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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vertebrobasilar occlusions, acute ischemic stroke, emerging stenting