Tandem Occlusion After Emergent Stenting in Acute Ischemic Stroke

Not Applicable

Recruiting

• Conditions: Acute Stroke; Ischemic Stroke, Acute
• Interventions: Procedure: Emergent Stenting

• Registration Number: NCT06120218
• Lead Sponsor: Can Tho Stroke International Services Hospital

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.

Study Timeline

• Study Start: 2020-12-01
• Study First Submitted: 2023-11-01
• Study First Submitted QC: 2023-11-01
• Study First Posted: 2023-11-07
• Status Verified: 2024-06
• Last Update Submitted: 2024-06-11
• Last Update Posted: 2024-06-13
• Primary Completion: 2025-09-30
• Study Completion: 2025-11-30

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 110

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

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Emergent Stenting in Anterior circulation	Emergent Stenting	Emergent Carotid Stenting in acute ischemic stroke caused by tandem occlusions
Emergent Stenting in Posterior circulation	Emergent Stenting	Emergent Extracranial Vertebral Stenting in acute ischemic stroke caused by tandem occlusions

Primary Outcome Measures

Name	Time	Method
The favorable 3-month outcome rate	3 months	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).

Secondary Outcome Measures

Name	Time	Method
The symptomatic intracerebral hemorrhage rate	24 hours after emergent stenting	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 modified Rankin Score (mRS).

Trial Locations

Locations (1)

Can Tho Stroke International Services Hospital; 🇻🇳 Can Tho, Vietnam