Combined use of contact aspiration and the ...
Document type :
Article dans une revue scientifique: Article original
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Title :
Combined use of contact aspiration and the stent retriever technique versus stent retriever alone for recanalization in acute cerebral infarction: the randomized ASTER 2 study protocol.
Author(s) :
Lapergue, Bertrand [Auteur]
Université de Versailles Saint-Quentin-en-Yvelines [UVSQ]
Labreuche, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Blanc, Raphaël [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Marnat, Gaultier [Auteur]
Département de Neuro-Radiologie [Bordeaux] [DNR - Bordeaux]
Consoli, Arturo [Auteur]
Service de neuroradiologie [Suresnes]
Rodesch, Georges [Auteur]
Hôpital Foch [Suresnes]
Saleme, Suzanna [Auteur]
CHU Limoges
Costalat, Vincent [Auteur]
Département de Neuroradiologie[Montpellier]
Bracard, Serge [Auteur]
Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy]
Desal, Hubert [Auteur]
Service de neurologie [Nantes]
Duhamel, Alain [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Mazighi, Mikael [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Spelle, Laurent [Auteur]
Service de neurologie [Le Kremlin Bicêtre]
Houdart, Emmanuel [Auteur]
Service de Neuroradiologie [CHU Lariboisière]
Shotar, Eimad [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Ben Maacha, Malek [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Lopez, Delphine [Auteur]
Hôpital Foch [Suresnes]
Ferre, Jean-Christophe [Auteur]
Département de Radiologie [CHU de Rennes]
Prevot, Claire [Auteur]
Université de Versailles Saint-Quentin-en-Yvelines [UVSQ]
Gory, Benjamin [Auteur]
Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy]
Piotin, Michel [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Université de Versailles Saint-Quentin-en-Yvelines [UVSQ]
Labreuche, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Blanc, Raphaël [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Marnat, Gaultier [Auteur]
Département de Neuro-Radiologie [Bordeaux] [DNR - Bordeaux]
Consoli, Arturo [Auteur]
Service de neuroradiologie [Suresnes]
Rodesch, Georges [Auteur]
Hôpital Foch [Suresnes]
Saleme, Suzanna [Auteur]
CHU Limoges
Costalat, Vincent [Auteur]
Département de Neuroradiologie[Montpellier]
Bracard, Serge [Auteur]
Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy]
Desal, Hubert [Auteur]
Service de neurologie [Nantes]
Duhamel, Alain [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Mazighi, Mikael [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Spelle, Laurent [Auteur]
Service de neurologie [Le Kremlin Bicêtre]
Houdart, Emmanuel [Auteur]
Service de Neuroradiologie [CHU Lariboisière]
Shotar, Eimad [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Ben Maacha, Malek [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Lopez, Delphine [Auteur]
Hôpital Foch [Suresnes]
Ferre, Jean-Christophe [Auteur]
Département de Radiologie [CHU de Rennes]
Prevot, Claire [Auteur]
Université de Versailles Saint-Quentin-en-Yvelines [UVSQ]
Gory, Benjamin [Auteur]
Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy]
Piotin, Michel [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Journal title :
Journal of Neurointerventional Surgery
Abbreviated title :
J Neurointerv Surg
Volume number :
12
Pages :
471-476
Publication date :
2020-01-11
ISSN :
1759-8486
English keyword(s) :
acute ischemic stroke
mechanical thrombectomy
contact aspiration
stent retriever
randomized controlled trial
anterior circulation
France
mechanical thrombectomy
contact aspiration
stent retriever
randomized controlled trial
anterior circulation
France
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Rationale Mechanical thrombectomy (MT) using a stent retriever (SR) device is currently the recommended treatment in ischemic stroke due to anterior circulation large vessel occlusion. Combining contact aspiration (CA) ...
Show more >Rationale Mechanical thrombectomy (MT) using a stent retriever (SR) device is currently the recommended treatment in ischemic stroke due to anterior circulation large vessel occlusion. Combining contact aspiration (CA) with SR is a promising new treatment, although it was not found to be superior to SR alone as first-line treatment for achieving successful reperfusion. Aim To determine whether endovascular treatment combining first-line use of CA and SR is more efficient than SR alone. Methods The ASTER 2 clinical trial is a prospective, randomized, multicenter, open-label trial with a blinded endpoint. We included patients admitted with suspected anterior circulation ischemic stroke secondary to large vessel occlusion <8 hours from symptom onset. They were randomly allocated in a 1:1 ratio to one of two treatment groups (combined CA and SR or SR alone). In the case of failure of the assigned technique after three attempts, other adjunctive techniques were applied. Study outcome The primary outcome is the rate of successful/complete reperfusion (modified Thrombolysis In Cerebral Infarction (mTICI) score 2c/3) after the entire endovascular procedure. Secondary outcomes include reperfusion rates after the assigned first-line intervention alone and at the end of the procedure, procedural times, change in NIH Stroke Scale score at 24 hours, intracerebral hemorrhage at 24 hours, procedure-related serious adverse events, the modified Rankin Scale score, and all-cause mortality at 90 days and 1 year. The cost effectiveness of the two procedures will also be analyzed. Discussion This is the first head-to-head randomized trial to directly compare the efficacy of the combined use of CA and SR versus SR alone. This prospective trial aims to demonstrate the synergistic effects of CA and SR devices in first-line endovascular treatment.Show less >
Show more >Rationale Mechanical thrombectomy (MT) using a stent retriever (SR) device is currently the recommended treatment in ischemic stroke due to anterior circulation large vessel occlusion. Combining contact aspiration (CA) with SR is a promising new treatment, although it was not found to be superior to SR alone as first-line treatment for achieving successful reperfusion. Aim To determine whether endovascular treatment combining first-line use of CA and SR is more efficient than SR alone. Methods The ASTER 2 clinical trial is a prospective, randomized, multicenter, open-label trial with a blinded endpoint. We included patients admitted with suspected anterior circulation ischemic stroke secondary to large vessel occlusion <8 hours from symptom onset. They were randomly allocated in a 1:1 ratio to one of two treatment groups (combined CA and SR or SR alone). In the case of failure of the assigned technique after three attempts, other adjunctive techniques were applied. Study outcome The primary outcome is the rate of successful/complete reperfusion (modified Thrombolysis In Cerebral Infarction (mTICI) score 2c/3) after the entire endovascular procedure. Secondary outcomes include reperfusion rates after the assigned first-line intervention alone and at the end of the procedure, procedural times, change in NIH Stroke Scale score at 24 hours, intracerebral hemorrhage at 24 hours, procedure-related serious adverse events, the modified Rankin Scale score, and all-cause mortality at 90 days and 1 year. The cost effectiveness of the two procedures will also be analyzed. Discussion This is the first head-to-head randomized trial to directly compare the efficacy of the combined use of CA and SR versus SR alone. This prospective trial aims to demonstrate the synergistic effects of CA and SR devices in first-line endovascular treatment.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
CHU Lille
CHU Lille
Submission date :
2023-11-15T09:35:57Z
2023-12-18T09:06:49Z
2023-12-18T09:06:49Z