Clinical trial NCT06365294: Rescue Extracranial Vertebral Stenting in Tandem Occlusions
Official title: Rescue Extracranial Vertebral Stenting in Tandem Occlusions
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Acute Stroke
Ischemic Stroke, Acute
Vertebro Basilar Ischemia
Keywords: tandem occlusions
posterior circulation
rescue extracrnial stenting
Lead sponsor: Can Tho Stroke International Services Hospital
Sponsor class: OTHER
First posted: 2024-04-15
Enrollment: 9
Sex: ALL
Minimum age (years): 18
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 acute vertebrobasilar occlusion associated with the poor prognosis, particularly tandem occlusion. However, few data on the efficacy of the endovascular therapy was indicated in this occlusion. The investigators reported whether the additional rescue extracranial stenting improved clinical outcome by modified Rankin Scale (mRS) score within 3 months after the procedure

Detailed description: Acute vertebrobasilar artery occlusion is one of the cerebrovascular diseases with high disability and mortality rates. Although mechanical thrombectomy has recently been demonstrated an effective treatment for large vessel occlusions of posterior circulation, the treatment strategies depending on the specific pathophysiology. Tandem occlusion in posterior circulation is less frequently than in anterior one, comprises severe stenosis or occlusion of the extracranial vertebral artery ipsilateral to its intracranial and basilar occlusion. The recent studies showed the benefit of the "distal-to-proximal" approach, there were many tecniques to achieved the successful recanalization. Besides, the use of Dotter technique allowed 8F guiding catheter to cross the extracranial lesions easily and save the procedural time. However, the Diagnosis 5F-Dotter, like the Dilator-Dotter, has not been mentioned in previous studies. Therefore, the aim of the our study was to assess the improvement of outcomes at 3 months posttreatment in patients receiving rescue extracranial vertebral stenting

Eligibility criteria: Inclusion Criteria:

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

Exclusion Criteria:

* Premorbid mRS \> 2
* Extensive, bilateral brain-stem infarction on neuroimaging
* Cerebellar mass effect on neuroimaging
* Loss to follow-up

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: Can Tho Stroke International Services Hospital
role: STUDY_DIRECTOR
References:
citation: Cohen JE, Leker RR, Gomori JM, Eichel R, Rajz G, Moscovici S, Itshayek E. Emergent revascularization of acute tandem vertebrobasilar occlusions: Endovascular approaches and technical considerations-Confirming the role of vertebral artery ostium stenosis as a cause of vertebrobasilar stroke. J Clin Neurosci. 2016 Dec;34:70-76. doi: 10.1016/j.jocn.2016.05.005. Epub 2016 Aug 10.
citation: Han N, Ma L, Zhao L, Xu G, Jia Y, Wang H. The Dilator-Dotter technique can successfully treat tandem lesions of posterior circulation. Medicine (Baltimore). 2024 Jan 26;103(4):e37044. doi: 10.1097/MD.0000000000037044.