Endovascular Acute Stroke Intervention - Tandem OCclusion Trial
Status:
Recruiting
Trial end date:
2026-01-01
Target enrollment:
Participant gender:
Summary
Patients with tandem occlusion or tandem lesion (TL), that is, stroke with an acute
intracranial anterior circulation occlusion and an ipsilateral cervical ICA (c-ICA)
high-grade stenosis or occlusion, constitute about 15-20% of patients undergoing endovascular
thrombectomy (EVT).
However, the optimal treatment of acute stroke patients with TL remains uncertain, as
relatively few patients with TL were included in the major randomized controlled trials of
EVT and management of the c-ICA was generally not specified by protocol nor analyzed
post-hoc.
Recent large multi-centre retrospective cases series suggest that acutely stented patients
may have more favorable outcomes than patients treated with angioplasty alone or those with
no acute ICA intervention, but high quality randomized trial data are lacking.
EASI-TOC, a phase 3, academic multi-centre, controlled trial (PROBE design) with embedded
pilot phase, will seek to determine if in patients undergoing acute intracranial thrombectomy
for anterior circulation stroke with concurrent ipsilateral symptomatic high-grade (≥70%)
atherosclerotic stenosis or occlusion of the extracranial ICA, endovascular ICA
revascularization with stenting is superior to intracranial thrombectomy alone with regards
to functional outcome at 90 days. Patients will be randomized to Acute stenting or No acute
stenting (1:1 allocation).
Phase:
N/A
Details
Lead Sponsor:
Centre hospitalier de l'Université de Montréal (CHUM)
Collaborators:
Canadian Stroke Consortium (CSC) Dalhousie University Laval University McGill University McMaster University Queen's University University of British Columbia University of Calgary University of Ottawa