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Rescue Distal Thrombectomy in Treatment for Persistent Distal Occlusions
Sponsor: Centre hospitalier de l'Université de Montréal (CHUM)
Summary
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).
Official title: Treatment of Persistent Distal Occlusion After Successful Proximal Recanalization in Thrombectomy - A PHASE II Trial
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
72
Start Date
2026-09-01
Completion Date
2029-12-31
Last Updated
2026-04-16
Healthy Volunteers
No
Conditions
Interventions
Proximal mechanical thrombectomy
Mechanical thrombectomy performed for the qualifying proximal large vessel occlusion before assessment of eligibility for randomization.
Rescue distal mechanical thrombectomy
Rescue distal mechanical thrombectomy performed during the same endovascular session after successful proximal recanalization to treat persistent distal medium-vessel occlusion identified on angiography.
Conservative management
No additional distal endovascular intervention after successful proximal mechanical thrombectomy. Participants continue with standard medical and post-procedural care.
Locations (1)
Centre hospitalier de l'Université de Montréal (CHUM)
Montreal, Quebec, Canada