Comparing Carotid Artery Stenting Versus No Stenting During Stroke Treatment for Tandem Occlusion in Adults

What this Trial Is About

This research aims to evaluate the best treatment for patients having an acute stroke caused by a blockage in the brains anterior circulation combined with a severe narrowing or blockage in the necks internal carotid artery. This condition, known as tandem occlusion or tandem lesion, affects about 15-20% of patients undergoing a procedure called endovascular thrombectomy. Current evidence is limited, so this phase III multi-center trial will compare two approaches to improve recovery after stroke. Participants will be randomly assigned to one of two groups. One group will receive standard intracranial thrombectomy along with endovascular stenting to reopen the narrowed carotid artery in the neck during the procedure. The other group will undergo thrombectomy alone without stenting. Both groups may receive intravenous thrombolysis as appropriate. The study will enroll 458 adults aged 18 and older at multiple stroke centers and follow them for up to one year. During the study, patients will be monitored for their recovery and brain function, including assessments at 90 days and one year using scales such as the Modified Rankin Scale and National Institutes of Health Stroke Scale. Researchers will also evaluate the reopening of blocked vessels, recurrence of stroke or retinal ischemia, and cognitive function. Safety and functional outcomes will be compared between the two treatment approaches to determine which provides better recovery after acute stroke with tandem occlusion.

Endovascular Acute Stroke Intervention - Tandem OCclusion Trial