Rescue Distal Thrombectomy for Stroke
(2BE3-PhaseII Trial)
What You Need to Know Before You Apply
What is the purpose of this trial?
The goal of this clinical trial is to determine whether rescue distal mechanical thrombectomy can improve outcomes in patients with persistent distal occlusions after successful proximal mechanical thrombectomy for acute ischemic stroke.
Many patients with acute ischemic stroke caused by large vessel occlusion undergo emergency treatment with proximal mechanical thrombectomy, which removes the main clot and restores flow in a large artery. However, in some patients, one or more smaller distal arteries remain occluded after successful proximal recanalization. It is not yet known whether treating these persistent distal occlusions improves angiographic or clinical outcomes.
This study will compare two approaches:
Rescue distal mechanical thrombectomy: an additional distal mechanical thrombectomy procedure is performed during the same endovascular session.
Conservative management: no additional distal endovascular intervention is performed after successful proximal mechanical thrombectomy.
The main questions the study aims to answer are:
* Is rescue distal mechanical thrombectomy feasible in this setting?
* Is it safe?
* Does it improve angiographic and clinical outcomes?
Participants will be randomly assigned during the index endovascular procedure to one of the two study groups and will be followed with imaging and clinical assessments during hospitalization and at 90 days.
Approximately 72 participants will take part in this study at the Centre hospitalier de l'Université de Montréal (CHUM).
Are You a Good Fit for This Trial?
Inclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants undergo standard proximal mechanical thrombectomy, followed by randomization to either rescue distal mechanical thrombectomy or conservative management during the same endovascular session.
Follow-up
Participants are monitored for safety and effectiveness, with imaging and clinical assessments during hospitalization and at 90 days.
What Are the Treatments Tested in This Trial?
Interventions
- Rescue Distal Thrombectomy
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
Active Control
Participants first undergo standard proximal mechanical thrombectomy for acute ischemic stroke due to large vessel occlusion. If a persistent distal medium-vessel occlusion remains after successful proximal recanalization, they are randomized to rescue distal mechanical thrombectomy during the same endovascular session.
Participants first undergo standard proximal mechanical thrombectomy for acute ischemic stroke due to large vessel occlusion. If a persistent distal medium-vessel occlusion remains after successful proximal recanalization, they are randomized to no additional distal endovascular intervention and continue with standard medical and post-procedural care.
Find a Clinic Near You
Who Is Running the Clinical Trial?
Centre hospitalier de l'Université de Montréal (CHUM)
Lead Sponsor
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