Optical Coherence Tomography Guided Antithrombotic Treatment After Endovascular Thrombectomy of the Posterior Circulation
Status:
Recruiting
Trial end date:
2021-12-14
Target enrollment:
Participant gender:
Summary
Evidence regarding the role of early (<24 hours) antithrombotics post-revascularization with
either intravenous thrombolysis (IVT), endovascular thrombectomy (EVT), or a combination of
both remains scarce. In 2018 the American Heart Association/American Stroke Association
changed their recommendation, stating that the risk of antithrombotic therapy within the
first 24 hours after treatment with IVT (with or without EVT) is uncertain. This was changed
after data emerged that early antithrombotics may be safe and may improve outcomes in select
patients undergoing EVT.
Recently the investigators showed for the first time that significant residual basilar
thrombus can exist after EVT despite complete angiographic revascularization using
endovascular optical coherence tomography imaging. This residual thrombus could cause ongoing
function-limiting strokes with occlusion of vital basilar perforators after EVT. Therefore,
the investigators propose a prospective,non-randomized safety study to evaluate optical
coherence tomography guided antithrombotic management for patients with confirmed residual
thrombus after EVT for basilar occlusion.