Proximal Internal Carotid Artery Acute Stroke Secondary to Tandem or Local Occlusion Thrombectomy Trial
Recruiting now · Phase 3
Conditions studied: Acute Ischemic Stroke
In brief
The primary objective is to establish the efficacy of intra-arterial (IA) mechanical thrombectomy (MT) with extracranial proximal carotid artery acute stenting versus non-stenting approaches in patients with acute ischemic stroke (AIS) from intracranial vessel occlusion (IVO) in the anterior circulation and have a proximal carotid occlusive disease (occlusion or severe stenosis).
Key facts
- Study ID
- NCT05611242
- Run by
- Mercy Health Ohio
- People needed
- 404
- Starts
- 2024-05-08
- Expected to finish
- 2027-05-08
- Last updated by the study team
- 2025-12-17
Who can join
Age: 18 and older, up to 79. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- 18 to 79 years of age (before the 80th birthday)
- Presenting with symptoms consistent with AIS
- Imaging evidence of an anterior circulation occlusion of the Internal Carotid Artery (ICA) terminus and/or Middle Cerebral Artery Main Stem (MCA M1), or proximal M2 segment AND extra-cranial proximal carotid occlusion / severe stenosis related to atherosclerosis requiring treatment on non-invasive imaging ≥70%
- NIHSS ≥ 4
- Ability to randomize and start endovascular therapy within 16 hours of stroke onset
- Pre-stroke mRS score 0-2
- Ability to obtain signed informed consent
- ASPECTS Score ≥7 via non-contrast CT or MRI (DWI) for subjects ≤6 hours from stroke onset OR ASPECTS Score ≥7 + infarct core volume <50 cc quantified by CTP (rCBF<30%) OR <25 cc quantified by MRI-DWI (AxBxC/2) for subjects with endovascular therapy starting between >6h to 16 hours from stroke onset, given the need for antiplatelet therapy.
- Acute Neurological Deficit with Imaging evidence of Tandem Lesion:
- Extracranial carotid occlusion (70% to 100% Using NACET criteria) With or without intracranial vascular occlusion
- Must be ineligible for IV t-PA therapy or have failed IV t-PA therapy
You may not qualify if…
- Females who are pregnant, or those of child-bearing potential with positive urine or serum beta Human Chorionic Gonadotropin (HCG) test
- Known severe allergy (more than a rash) to contrast media uncontrolled by medications
- Refractory hypertension (defined as persistent systolic blood pressure >185 mmHg or diastolic blood pressure >110 mmHg) despite medication
- CT evidence of the following conditions:
- Midline shift or herniation
- Evidence of intracranial hemorrhage
- Mass effect with effacement of the ventricles
- Acute bilateral strokes
- Contraindication to antiplatelet (Aspirin, Plavix, Ticagrelor, Cangrelor), or thrombolytic therapy, or contrast agents.
- Intracranial tumors other than small meningioma that does not require surgery for one year post randomization
- Known hemorrhagic diathesis, coagulation factor deficiency, or on anticoagulant therapy with an International Normalized Ratio (INR) of >1.7 or Partial Thromboplastin Time (PTT) > 3 times of normal
- Baseline platelet count <100,000 per microliter (μl)
- Life expectancy less than one year prior to stroke onset
- Participation in another randomized clinical trial that could confound the evaluation of the study outcomes
- Any other condition (in the opinion of the site investigator) that precludes an endovascular procedure or poses a significant hazard to the patient if an endovascular procedure was performed
- Proximal carotid stenosis secondary to dissection or vasculitis (.e.g. Takayasu's Arteritis)
Where it is running
- Mobile Infirmary Medical Center — Mobile, Alabama, United States (enrolling)
- University of California, Irvine — Irvine, California, United States (enrolling)
- Pomona Valley — Pomona, California, United States (enrolling)
- Glendale Adventist Medical Center — Glendale, California, United States (enrolling)
- California Pacific Medical Center/Mils Peninsula Medical Center — San Francisco, California, United States (enrolling)
- Boca Raton - Baptist Health — Boca Raton, Florida, United States (enrolling)
- Delray Medical Center — Delray Beach, Florida, United States (enrolling)
- Baptist Health Research Institute — Jacksonville, Florida, United States (enrolling)
- University of Florida Health Jacksonville — Jacksonville, Florida, United States (enrolling)
- University of Miami School of Medicine — Miami, Florida, United States (enrolling)
- Orlando Health, Inc. — Orlando, Florida, United States (enrolling)
- University of South Florida — Tampa, Florida, United States (enrolling)
- St. Mary's Medical Center — West Palm Beach, Florida, United States (enrolling)
- Piedmont Healthcare — Atlanta, Georgia, United States (enrolling)
- WellStar Health System, Inc — Marietta, Georgia, United States (enrolling)
- Ascension/Alexian Brothers Health System — Chicago, Illinois, United States (enrolling)
- University of Chicago — Chicago, Illinois, United States (enrolling)
- Northwestern Medicine Central DuPage Hospital — Winfield, Illinois, United States (enrolling)
- Indiana University Health Methodist Hospital — Indianapolis, Indiana, United States (enrolling)
- Munster Community Hospital — Munster, Indiana, United States (enrolling)
- University of Kansas Medical Center — Kansas City, Kansas, United States (enrolling)
- Baptist Healthcare Systems, Inc — Lexington, Kentucky, United States (enrolling)
- Ochsner Medical Center — New Orleans, Louisiana, United States (enrolling)
- Louisiana State University Health Sciences Center at Shreveport — Shreveport, Louisiana, United States (enrolling)
- Boston Medical Center — Boston, Massachusetts, United States (enrolling)
Full record on ClinicalTrials.gov
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