Clinical trial NCT06397638: Rescue Carotid Stenting in Tandem Occlusions: 4-year Experience From a Comprehensive Stroke Centre
Official title: Rescue Carotid Stenting in Tandem Occlusions: 4-year Experience From a Comprehensive Stroke Centre
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Acute Stroke
Ischemic Stroke, Acute
Keywords: tandem occlusions
rescue carotid stenting
anterior circulation
Lead sponsor: Can Tho Stroke International Services Hospital
Sponsor class: OTHER
First posted: 2024-05-03
Enrollment: 90
Sex: ALL
Minimum age (years): 19
Maximum age (years): 100
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: The rescue carotid stenting has recently been an additional treatment followed by mechanical thrombectomy in tandem occlusions of the anterior circulation. Nevertheless, there were few data to date that support this beneficial treatment in Asia. The investigators hypothesized that this treatment related to improvement of clinical outcomes after procedure.

Detailed description: The anterior circulation made commonly up 70-80% of all ischemic strokes. The mechanical thrombectomy is the gold treatment standard in acute ischemic stroke due to large vessel occlusion of anterior circulation. Tandem occlusions are one of the acute lesions relating to the high poor clinical outcome rate. Besides, tandem characteristic is a challenge to perform endovascular therapy and save procedural time in the restoration blood flow to the cerebral artery territory infarction. Many studies demonstrated the roles of rescue carotid stenting with either proximal-to-distal or distal-to-proximal approach in the successful recanalization of tandem occlusions. However, few studies analyzed in detail this beneficial treatment in Asia. Therefore, the investigators conducted this study to assess whether rescue carotid stenting in the tandem occlusions to improve clinical outcomes at 3 months.

Eligibility criteria: Inclusion Criteria:

* Age \> 18 years old
* Onset to treatment time \< 24 hours
* NIHSS \> 5
* DWI-ASPECTS ≥ 5

Exclusion Criteria:

* Premorbid mRS \> 2
* Loss to follow-up after discharge

Primary outcomes:
measure: The good 3-month outcome rate
timeFrame: 3 months
Secondary outcomes:
Other outcomes:
Locations:
city: Cần Thơ
country: Vietnam
facility: Can Tho SIS Hospital
Study officials:
affiliation: Can Tho Stroke International Services General Hospital
name: Cuong C Tran, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Allard J, Delvoye F, Pop R, Labreuche J, Maier B, Marnat G, Sibon I, Zhu F, Lapergue B, Consoli A, Spelle L, Denier C, Richard S, Piotin M, Gory B, Mazighi M; ETIS Investigators. 24-Hour Carotid Stent Patency and Outcomes After Endovascular Therapy: A Multicenter Study. Stroke. 2023 Jan;54(1):124-131. doi: 10.1161/STROKEAHA.122.039797. Epub 2022 Dec 21.
citation: Zevallos CB, Farooqui M, Quispe-Orozco D, Mendez-Ruiz A, Dajles A, Garg A, Galecio-Castillo M, Patterson M, Zaidat O, Ortega-Gutierrez S. Acute Carotid Artery Stenting Versus Balloon Angioplasty for Tandem Occlusions: A Systematic Review and Meta-Analysis. J Am Heart Assoc. 2022 Jan 18;11(2):e022335. doi: 10.1161/JAHA.121.022335. Epub 2022 Jan 13.
citation: Anadani M, Marnat G, Consoli A, Papanagiotou P, Nogueira RG, Siddiqui A, Ribo M, Spiotta AM, Bourcier R, Kyheng M, Labreuche J, de Havenon A, Sibon I, Dargazanli C, Arquizan C, Cognard C, Olivot JM, Anxionnat R, Audibert G, Mazighi M, Blanc R, Lapergue B, Richard S, Gory B; TITAN and ETIS Registry Investigators. Endovascular Therapy of Anterior Circulation Tandem Occlusions: Pooled Analysis From the TITAN and ETIS Registries. Stroke. 2021 Oct;52(10):3097-3105. doi: 10.1161/STROKEAHA.120.033032. Epub 2021 Aug 10.