Stroke, Thrombolysis and Rescue Stenting

Status: Recruiting
Location: See all (7) locations...
Study Type: Observational
SUMMARY

Intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) are the standard of care for treating selected patients with acute large-vessel occlusion stroke (LVOS). Successful revascularization is strongly correlated with favorable outcomes. Nevertheless, recanalization failure with stent retrieval and contact aspiration has been observed in up to 29% of patients. If primary thrombectomy fails to achieve recanalization, rescue stenting (RS) has proven to be a feasible rescue therapy. Currently, approved evidence-based alternatives for LVOS patients who have failed MT are lacking, but permanent stenting is suggested as a rescue treatment in expert consensus statements. Dual antiplatelet therapy (DAPT), typically consisting of clopidogrel and aspirin, is recommended after stent implantation to reduce the risk of stent thrombosis; however, these medications are not suitable in the acute setting, and optimal platelet inhibition strategies remain unclear. Glycoprotein (GP) IIb/IIIa receptor inhibitors have intravenous administration, a rapid onset of action, and their effects subside within a few hours after discontinuation. For these reasons, an increasing number of studies have investigated their use in conjunction with primary stenting for acute stroke. Currently, there is no evidence supporting the superiority of any particular antithrombotic strategy, so decisions are guided by clinical judgment. An additional challenge for clinicians arises when IVT is combined with stenting. Stroke guidelines recommend starting antiplatelets 24 hours after IVT and the risk associated with antithrombotic therapy within the first 24 hours after IVT remains uncertain. This is multicenter, prospective, observational study of patients with LVOS undergoing mechanical thrombectomy and rescue stenting. The aim of this study is to evaluate real-world antithrombotic strategies in emergency stenting, particularly in patients treated with IVT, and to assess the safety of emergent stenting following intravenous thrombolysis.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Patients with large vessel occlusion strokes undergoing thrombectomy and rescue stenting within 24 hours of stroke onset

• Patients ≥ 18 years of age

Locations
Other Locations
Italy
ASST Papa Giovanni XXIII
RECRUITING
Bergamo
Ospedale Bufalini
RECRUITING
Cesena
Azienda Sanitaria Lecce - Ospedale Vito Fazzi
RECRUITING
Lecce
ASST Grande Ospedale Metropolitano Niguarda
RECRUITING
Milan
ASST Santi Paolo e Carlo
RECRUITING
Milan
Fondazione IRCCS San Gerardo dei Tintori
RECRUITING
Monza
ASL 2 Savonese - Ospedale Santa Corona
RECRUITING
Pietra Ligure
Contact Information
Primary
Elena Ballabio, Medical Doctor
elena.ballabio@asst-santipaolocarlo.it
+393470772687
Backup
Luca Valvassori, MD
luca.valvassori@asst-santipaolocarlo.it
+393395947715
Time Frame
Start Date: 2023-10-21
Estimated Completion Date: 2027-03
Participants
Target number of participants: 400
Treatments
Patients with acute large vessel occlusion stroke undergoing rescue stenting
Related Therapeutic Areas
Sponsors
Leads: ASST Santi Paolo e Carlo

This content was sourced from clinicaltrials.gov