Carotid Artery Stenting During Endovascular Treatment of Acute Stroke

Launched by UNIVERSITY MEDICAL CENTER GRONINGEN · Jul 15, 2024

Keywords

ClinConnect Summary

This clinical trial is studying whether performing a procedure called carotid artery stenting (CAS) right away during a treatment for acute stroke is safe and effective. The trial focuses on patients who have a specific type of stroke caused by a blockage in a large blood vessel in the brain and also have a significant narrowing or blockage in the carotid artery on the same side. The goal is to determine if treating the carotid artery at the same time as the stroke treatment can improve blood flow to the brain and reduce the risk of a second stroke, while also being mindful of potential risks like bleeding.

To participate in this trial, individuals must be at least 18 years old and have experienced an acute stroke related to a blockage in the main arteries supplying blood to the brain. They should also have a certain level of stroke severity as measured by a specific scale. Participants will be randomly assigned to either receive immediate stenting during their stroke treatment or to have their carotid artery problem treated later on. Throughout the trial, the researchers will keep track of how well the treatments work and whether they cause any complications. This trial is currently looking for volunteers and aims to provide important information about the best ways to treat strokes related to carotid artery issues.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Acute ischemic stroke due to proximal intracranial occlusion in the anterior circulation (intracranial ICA, M1, proximal M2) on the CT angiography
• • 2. Stenosis \>50% according to the NASCET criteria16 or initial occlusion of the ipsilateral cervical carotid artery of presumed atherosclerotic origin on baseline CT angiography
• • 3. Eligible for EVT according to the guidelines: EVT within 6 hours of onset or EVT between 6-24 hours after onset based on perfusion CT imaging selection (conform current guidelines)
• • 4. Baseline National Institute of Health Stroke Scale (NIHSS) score ≥2
• • 5. Age \>18 years
• • 6. Written informed consent (deferred consent)
• Exclusion Criteria:
• • 1. Any intracranial hemorrhage
• • 2. Cervical carotid artery stenosis or occlusion with other causes than presumed atherosclerosis (e.g. carotid artery dissection, floating thrombus, carotid web)
• • 3. Any exclusion criterion for EVT according to the guidelines
• • 4. Pre stroke disability (defined as a modified Rankin Scale score \>2)
• • 5. Recent gastro-intestinal or urinary tract hemorrhage (\<6 weeks)
• • 6. Recent severe head trauma (\<6 weeks)
• • 7. Recent infarction on baseline brain CT in the same vascular territory (\<6 weeks)
• • 8. Known allergy to aspirin and/or clopidogrel
• • 9. Pregnancy