Glenzocimab in Anterior stroke with Large Ischemic Core eligible for Endovascular therapy

Prior treatment

• Participation in another interventional clinical investigational drug or medical device trial within 30 days prior to the inclusion
• Patients known to have already received other humanized fragment of monoclonal antibody (risk of anaphylaxis)
• Patients known to be under ongoing immunosuppressive therapy
• Gastrointestinal or urinary tract haemorrhage in previous 21 days

Other illness

• Persons deprived of their liberty by a judicial or administrative decision, persons subject to psychiatric care under sections L3212-1 and L3123-1 and persons admitted to a health or social institution for purposes other than research (L1121-6).
• Significant pre-stroke disability (mRS>2)
• Patients known to be under ongoing anti-cancer treatment (radiotherapy, chemotherapy, immunotherapy)
• Patient with intracranial haemorrhage
• Known hypersensitivity to glenzocimab or to any of the excipients
• Known hypersensitivity to the gadolinium used for the brain MRI perfusion, or one of its excipients
• Known Severe renal insufficiency (Grades 4-5) with a glomerular filtration rate < 30mL/Min/1.73m2

Lab values

• Patients receiving anticoagulants within the last 24 hours and: For heparin, an elevated aPTT -greater than upper limit of normal for laboratory; For vitamin K antagonists (ex: warfarin), an INR >1.7; For direct thrombin inhibitors or direct factor Xa inhibitors, a plasmatic dosage of the drug greater than upper limit of normal for laboratory
• Patients under or needing immediate dual anti-platelet therapy (DAPT) within the first 24 hours after the cessation of glenzocimab or placebo infusion
• Platelet count <100 000 mm3

Other

• Possible tandem occlusion on the baseline imaging requiring an eventual stenting
• Adults subject to a legal protection measure (L1121-8)
• Significant mass effect with midline shift as confirmed on CT/MRI
• Pregnant or breastfeeding woman

• Age >18 years old
• Acute ischemic stroke due to an isolated proximal anterior large vessel occlusion (M1 and M2 segment of the middle cerebral artery, terminal internal carotid artery (TICA)
• Indication of EVT within the time window of 0 to 24 hours in participants treated with or without intravenous thrombolysis
• Presenting with a baseline infarct core volume assessed on the MRI (DWI sequence) or CT scan with an ASPECTS<6
• All women in age of procreating must have a negative serum/urine pregnancy test at baseline
• Affiliation to social security or any health insurance
• Informed consent signed : By the patient; Or informed consent signed by a family member/ trustworthy person if his condition does not allow him to express his consent by written (L1111-6); In a situation urgently and in absence of family members/trustworthy person, the patient can be enrolled. The consent to participate to the research will be requested as soon as the condition of the patient will allow him to consent.