Acute Stroke, Ischemic Stroke, Acute, Vertebro Basilar Ischemia
Conditions
Keywords
vertebrobasilar occlusions, acute ischemic stroke, emerging stenting
Brief summary
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.
Detailed 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.
Interventions
PROCEDUREEmergent Stenting
Emergent Stenting In Acute Vertebrobasilar Occlusions
Sponsors
Can Tho Stroke International Services Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
19 Years to 100 Years
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The favorable 3-month outcome rate | 3 months | The favorable 3-month outcome rate was accessed by modified Rankin Score (mRS), which comprised of included good (mRS 0 - ≤ 2) and fair (mRS 3). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The symptomatic intracerebral hemorrhage rate | 24 hours after emergent stenting | The symptomatic intracerebral hemorrhage was defined as patient's intracerebral hemorrhage with postprocedural mRS ≥ 5 and there were no other evident causes for the increased mRS |
Countries
Vietnam
Outcome results
None listed