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Intra-Arterial Thrombolysis After SUCCESSful Reperfusion in Anterior Circulation Ischemic Stroke

RecruitingPhase 3Ages 18 Years - anyAllCentral Hospital, Nancy, France
NCT06768138 on ClinicalTrials.gov ↗
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In plain words

What the trial is, and whether it could suit you

Stroke is a leading cause of disability and mortality worldwide. Despite the clinical benefit of mechanical thrombectomy, 1 out of 2 patients treated are functionally independent at 90 days. Achieving the best possible angiographic reperfusion is a key determinant of clinical outcome in acute ischemic stroke patients with anterior circulation large vessel occlusion. Mechanical thrombectomy is standard treatment for large vessel occlusion stroke patients within 24. In the setting of successful (eTICI ≥2b), adjunct intra-arterial thrombolysis may be a promising therapeutic option allowing recanalization of distal arterial occlusions (not accessible to mechanical devices) and improvement of upstream brain reperfusion by targeting microvascular obstruction. The IA-SUCCESS randomized trial aims to assess the clinical and safety of adjunct intra-arterial thrombolysis vs. no adjunct intra-arte

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📋 Eligibility rules (as published)
Inclusion Criteria: * Age ≥ 18 years * Pre-stroke mRS 0-2 * Acute ischemic stroke with anterior circulation large vessel occlusion defined as intracranial internal carotid artery, M1, or M2 occlusion proven on CT or MRI * NIHSS score ≥ 5 at admission * Acute reperfusion strategy started within 24h after stroke onset according to the international guidelines * DWI-ASPECTS ≥ 2 (MRI) or CT-ASPECTS ≥ 3 * Delay from imaging to puncture within 3 hours for transferred patients * eTICI 2b-2c-3 after intravenous thrombolysis alone, bridging therapy, or mechanical thrombectomy alone and confirmed by catheter angiogram * Person affiliated to or beneficiary of a social security plan Exclusion Criteria: * Person who do not speak French * Contraindications for intra-arterial thrombolysis: Platelet count \<100 000/mm3, INR \>1.7, AOD use \<48h or biological confirmation of activity and effective heparin treatment * Bleeding-risk complications during the mechanical thrombectomy procedure (e.g carotid dissection, complicated femoral approach) * Bleeding-risk complications consecutive to a fall associated with stroke * More than 5 thrombectomy device * Intracerebral hemorrhage * Occlusion or high grade stenosis treated by stenting * Patient expected to be unable to present or be available for 3-month visit follow-up * Participation in another clinical trial within 30 days prior to the inclusion which the experiment may affect the 90-day mRS score * Woman of childbearing age without effective contraception * Person referred in articles L.1121-5, L. 1121-7 and L.1121-8 of the French Public Health Code
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What it tests

  • Intra-arterial infusion of Alteplase
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Where

1 site
CHRU Nancy
Nancy, France
🤝 Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible — always decide together with your own doctor.
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