Emergent Stenting In Acute Vertebrobasilar Occlusions (ESVO)

Can Tho Stroke International Services Hospital

Status: Completed

Conditions: Vertebro Basilar Ischemia; Ischemic Stroke, Acute; Acute Stroke

Treatments: Procedure: Emergent Stenting

Study type: Interventional

Funder types: Other

Identifiers

NCT06129721

ESVO Study

Details and patient eligibility

About

In the acute posterior circulation strokes, the vertebrobasilar occlusions frequently related to worse outcomes than the anterior ones. However, few studies mentioned the benefit and safety of the emergent stenting in the successful recanalization at these complex occlusions. The investigators investigated whether the improvement of clinical outcome was achieved in postprocedural 3-month.

Full description

Acute ischemic stroke in posterior circulation account for nearly 20 - 25%, in which large vessel occlusions (LVOs) occur 0.8% - 5.7%. Although mechanical thrombectomy (MT) has recently been the gold standard in LVOs treatment, the futile recanalization (defined as unfavorable outcome despite early successful recanalization of target artery) rate was showed in posterior circulation higher than in anterior one. Multiple randomized controlled trials (BEST, BASICS, BAOCHE, ATTENTION) have recently reported the benefit of endovascular treatment better than of standard medical treatment for acute vertebrobasilar occlusions stroke. Besides, up to 36% LVOs with underlying intracranial stenosis and 64% with tandem lesions occured in the acute vertebrobasilar stroke. This was a reason why emergent stenting was considered to support the successful recanalization in the setting of failure of mechanical thrombectomy. Moreover, the successful recanalization is one of the independent predictors of good outcomes. However, the use of the loading dose dual antiplatelet therapy and peri-procedural complications made the safety of emergent stenting remain uncertain. Therefore, we aimed to investigate whether the impact of emergent stenting on the improved clinical outcome in vertebrobasilar occlusions.

Enrollment: 38 patients

Sex: All

Ages: 19 to 100 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age > 18 years old
• Onset to treatment time < 24 hours
• NIHSS ≥ 10
• pc-ASPECTS ≥ 5 on MRI

Exclusion criteria

• Premorbid mRS > 2
• Extensive, bilateral brain-stem infarction on neuroimaging
• Cerebellar mass effect on neuroimaging

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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38 participants in 1 patient group

Emergent Stenting

Experimental group

Description:

Emergent Stenting In Acute Vertebrobasilar Occlusions

Treatment:

Procedure: Emergent Stenting