Stent Placement Clinical Trials

• Patients diagnosed with acute ischemic stroke or acute retinal artery ischemia within the last two weeks related to symptomatic non-stenotic carotid disease (SyNC) and high-risk carotid plaque features

‣ Ipsilateral acute ischemic stroke must be determined by acute ischemic infarct on DWI or CT OR

⁃ by neurological symptoms indicating ipsilateral cortical deficits consistent with ischemia in the territory of the internal carotid artery and after exclusion of a significant microangiopathy

⁃ Acute retinal artery ischemia must be determined by ophthalmologic examination

• Patients with no other identifiable cause of stroke, evaluated using standard echocardiographic examinations to exclude cardiogenic or aortogenic sources of embolism

• Symptomatic non-stenotic carotid disease defined as one or more plaques in the ipsilateral internal carotid artery causing 10-49% luminal narrowing AND

• Presence of high-risk plaque features which must be determined through visual inspection on CTA or MRI (Ultrasound findings alone are insufficient; features must be confirmed by CTA or MRI to meet the criteria):

‣ Identification of at least two of the following characteristics Plaque thickness ≥ 3mm Irregular plaque surface Ulceration \<50% plaque calcification Lipid-rich necrotic core

⁃ and/or identification of at least one of the following characteristics Intraplaque haemorrhage

• Presence of carotid web characterized as shelf-like/linear, smooth filling defects

• Plaque assessment including evaluation of the presence of high-risk features by routine imaging (CTA, MRI) confirmed by an independent CoreLab

• Signed Informed Consent Form

• Patient ≥ 18 years

• mRS ≤ 3 at time of randomisation

• Dual antiplatelet therapy (DAPT) according to standard of care before endovascular treatment