Tandem Occlusion After Emergent Stenting in Acute Ischemic Stroke

NCT ID: NCT06120218

Last Updated: 2024-06-13

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 110 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2020-12-01
• Study Completion Date: 2025-11-30

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.

Conditions

Acute Stroke; Ischemic Stroke, Acute

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Emergent Stenting in Anterior circulation

Emergent Carotid Stenting in acute ischemic stroke caused by tandem occlusions

Group Type: EXPERIMENTAL

Emergent Stenting

Intervention Type: PROCEDURE

Emergent Stenting in acute ischemic stroke caused by tandem occlusions

Emergent Stenting in Posterior circulation

Emergent Extracranial Vertebral Stenting in acute ischemic stroke caused by tandem occlusions

Group Type: EXPERIMENTAL

Emergent Stenting

Intervention Type: PROCEDURE

Emergent Stenting in acute ischemic stroke caused by tandem occlusions

Interventions

Emergent Stenting

Emergent Stenting in acute ischemic stroke caused by tandem occlusions

Intervention Type: PROCEDURE

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

• Minimum Eligible Age: 19 Years
• Maximum Eligible Age: 100 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Can Tho Stroke International Services Hospital

OTHER

Sponsor Role: lead

Responsible Party

Dr. Cuong Tran Chi

Director

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Cuong Tran Chi, Doctor

Role: STUDY_DIRECTOR

Can Tho Stroke International Services General Hospital

Locations

Can Tho Stroke International Services Hospital

Can Tho, , Vietnam

Site Status: RECRUITING

Countries

Vietnam

Central Contacts

Cuong Tran Chi, Doctor

Role: CONTACT

drcuongtran@dotquy.vn

+84886559911

Can Tho Stroke International Services Hospital

Role: CONTACT

cskh@dotquy.vn

+84886559911

Facility Contacts

Cuong Tran Chi, Doctor

Role: primary

drcuongtran@dotquy.vn

+84886559911

References

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.

Reference Type: BACKGROUND

PMID: 36542074 (View on PubMed)

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.

Reference Type: BACKGROUND

PMID: 38277540 (View on PubMed)

Other Identifiers

TOESIS Study

Identifier Type: -

Identifier Source: org_study_id