Clinical trial NCT06120218: Tandem Occlusion After Emergent Stenting in Acute Ischemic Stroke
Official title: Tandem Occlusion After Emergent Stenting in Acute Ischemic Stroke: Preliminary Experience From a Vietnamese Comprehensive Stroke Centre
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Acute Stroke
Ischemic Stroke, Acute
Keywords: Thrombectomy
Extracranial arteries
Endovascular treatment
Antegrade approach
Retrograde approach
Lead sponsor: Can Tho Stroke International Services Hospital
Sponsor class: OTHER
First posted: 2023-11-07
Enrollment: 110
Sex: ALL
Minimum age (years): 19
Maximum age (years): 100
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: In acute ischemic stroke due to tandem occlusion, the emergent stenting has recently become an endovascular treatment option combining with mechanical thrombectomy to achieve recanalization. However, the data on the beneficial endovascular management of tandem occlusion in two circulations is still limited. The purpose of our study was to compare the improvement of clinical outcome between two circulations after emergent stenting at 3 months.

Detailed description: The posterior circulation (about 20 - 25%) is less frequent than the anterior one in the acute ischemic stroke, but high mortality and morbidity in the acute vertebrobasilar thrombosis even successful recanalization are revealed. Besides, tandem occlusion is one of the complex lesions in large vessel occlusions relating to the poor outcome, particularly in the posterior circulation. Recent studies have suggested that emergent stenting could be used as an additional treatment to achieve permanent recanalization together with mechanical thrombectomy in the intracranial segments. Permanent recanalization is one of the most important factors that impact patient outcomes after acute ischemic stroke. However, although there are various approaches for this lesion, the comparision of the effectiveness in the two circulations remains unclear. Thus, the aims of our study were to compare baseline characteristics and clinical outcome of tandem occlusions between anterior and posterior circulation after emergent stenting in extracranial arteries.

Eligibility criteria: Inclusion Criteria:

* Age \> 18 years old
* Premorbid mRS \< 2
* NIHSS \> 5
* ASPECTS ≥ 5 or pc-ASPECTS ≥ 5

Exclusion Criteria:

* Onset to treatment time \> 24 hours
* Loss to follow up after discharge

Primary outcomes:
measure: The favorable 3-month outcome rate
timeFrame: 3 months
Secondary outcomes:
measure: The symptomatic intracerebral hemorrhage rate
timeFrame: 24 hours after emergent stenting
Other outcomes:
Locations:
city: Can Tho
country: Vietnam
facility: Can Tho Stroke International Services Hospital
Study officials:
affiliation: Can Tho Stroke International Services General Hospital
name: Cuong Tran Chi, Doctor
role: STUDY_DIRECTOR
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: 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.