Informations générales (source: ClinicalTrials.gov)
Contact Aspiration Versus Stent Retriever for Recanalisation of Acute Stroke Patients With Basilar Artery Occlusion: The Posterior Circulation ASTER Randomized Trial (pc-ASTER)
Interventional
N/A
Hopital Foch (Voir sur ClinicalTrials)
novembre 2022
juillet 2027
29 juin 2024
Acute ischemic stroke (AIS) patients with basilar artery occlusion (BAO) present a
devastating, life-threatening prognosis.
Urgent recanalization with endovascular mechanical thrombectomy is routinely performed in
patients with BAO although the level of evidence is lower than that in anterior
circulation occlusions (randomization in this population versus medical treatment alone
having been impossible in recent studies). Recently, a large retrospective study supports
the interest of thrombectomy in this population .
Speed and grade of the recanalisation have a major impact on clinical outcome. Favorable
outcome at 90 days is strongly associated with the successful recanalization status at
the end of the endovascular procedure (OR=4.57, 95%CI=1.24-16.87, P=0.023).
First pass effect has been shown to be a strong marker of efficacy of endovascular
procedure with significant correlation with clinical outcome.
Thrombectomy with Stent retrievers dramatically changed the prognosis of anterior
circulation large vessel occlusion strokes and currently used in BAO patients (posterior
circulation). Contact aspiration (CA) is currently used in anterior large vessel
occlusions (COMPASS trial, Lancet 2019), with similar rates of recanalization and
favorable outcomes (Boulanger M, 2019), as well as in BAO patients .
However, the benefit of CA compared to SR for the treatment of BAO remains under debate
with the superiority of first line CA compared to SR or no difference. Available data are
based on retrospective studies with no data from RCT.
In this context, a randomized controlled trial is needed to assess the benefit of CA
versus SR.
Etablissements
| Les établissements d'Île-de-France ayant mis à jour leurs données Origine et niveau de fiabilité des données | |||||
|---|---|---|---|---|---|
| HOPITAL FOCH | ARTURO CONSOLI | 05/05/2025 07:12:11 | Contacter | ||
| HOPITAL FONDATION A. DE ROTHSCHILD | Michel PIOTIN | 21/06/2024 13:34:41 | Contacter | ||
| Les établissements sans correspondance certaine dans le répertoire FINESS dont les données sont issues de ClinicalTrials.gov Origine et niveau de fiabilité des données | |||||
| APHP - Pitié Salpêtrière - Paris - France | Frédéric CLARENCON | Contact (sur clinicalTrials) | |||
| Chru Nancy - Nancy - France | Benjamin GORY | Contact (sur clinicalTrials) | |||
| Chu Bordeaux - Bordeaux - France | Gaultier MARNAT | Contact (sur clinicalTrials) | |||
| CHU Caen - Caen - France | Charlotte BARBIER | Contact (sur clinicalTrials) | |||
| CHU de Reims - Reims - France | Sébastien SOIZE | Contact (sur clinicalTrials) | |||
| CHU de Tours - Tours - France | Grégoire BOULOUIS | Contact (sur clinicalTrials) | |||
| CHU Limoges - Limoges - France | Charbel MOUNAYER | Contact (sur clinicalTrials) | |||
| CHU Montpellier - Montpellier - France | Vincent COSTALAT | Contact (sur clinicalTrials) | |||
| Chu Nantes - Nantes - France | Hubert DESAL | Contact (sur clinicalTrials) | |||
| CHU Rennes - Rennes - France | Jean-Christophe FERRE | Contact (sur clinicalTrials) | |||
| Hôpital FOCH - Suresnes - France | Arturo CONSOLI | Contact (sur clinicalTrials) | |||
Critères
Tous
Inclusion Criteria:
Age ≥ 18 years
- AIS with BAO on non-invasive imaging (CT or MRI)
- Eligible for thrombectomy : groin puncture undergone within 24 hours of first
symptoms or of last time the patient was seen normal
- Being covered by a national health insurance
- Informed consent obtained from the patients/his proxy or following an emergency
procedure
Age ≥ 18 years
- AIS with BAO on non-invasive imaging (CT or MRI)
- Eligible for thrombectomy : groin puncture undergone within 24 hours of first
symptoms or of last time the patient was seen normal
- Being covered by a national health insurance
- Informed consent obtained from the patients/his proxy or following an emergency
procedure
- Known or suspected pre-existing (chronic) large vessel stenosis / occlusion in the
symptomatic territory (basilar artery)
- Severe contrast medium allergy or absolute contraindication to use of iodinated
products
- Clinical history, past imaging or clinical judgment suggesting intracranial stenosis
of the basilar artery
- Pregnancy (urine or serum beta HCG test for women of child-bearing potential)
- Person deprived of liberty
- Patient benefiting from a legal protection (guardianship or curatorship)