Compares two clot-removal methods for blocked basilar artery in stroke
Tests two clot-removal methods in adults with a blocked basilar artery during acute stroke.
Plain-language title generated from the registry record
Registry title: Contact Aspiration Versus Stent Retriever for Recanalisation of Acute Stroke Patients With Basilar Artery Occlusion: The Posterior Circulation ASTER Randomized Trial Protocol
Key facts
- Where
- Bordeaux, Caen, Limoges, Montpellier, Nancy, Nantes, Paris, Reims, Rennes, Suresnes, and Tours, FranceSee the 12 sites
Where in France
- CHU BordeauxBordeaux, FranceTaking people
- CHU CaenCaen, FranceNot yet recruiting
- CHU LimogesLimoges, FranceNot yet recruiting
- CHU MontpellierMontpellier, FranceNot yet recruiting
- CHRU NancyNancy, FranceTaking people
- CHU NantesNantes, FranceNot yet recruiting
- APHP Pitié SalpétrièreParis, FranceNot yet recruiting
- Fondation Adolphe de RothschildParis, FranceTaking people
- CHU de ReimsReims, FranceNot yet recruiting
- CHU RennesRennes, FranceNot yet recruiting
- Hopital FochSuresnes, FranceTaking people
- CHU de ToursTours, FranceNot yet recruiting
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Hopital Foch
- Trial code
- NCT05320263
- Record updated
- 1 March 2023
- Original description
Acute ischemic stroke (AIS) patients with basilar artery occlusion (BAO) present a devastating, life-threatening prognosis.Read full original descriptionShow less
Contact Aspiration Versus Stent Retriever for Recanalisation of Acute Stroke Patients With Basilar Artery Occlusion: The Posterior Circulation ASTER Randomized Trial
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.
Inclusion: 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.
Exclusion: Severe contrast medium allergy or absolute contraindication to use of iodinated products; Pregnancy (urine or serum beta HCG test for women of child-bearing potential); Known or suspected pre-existing (chronic) large vessel stenosis / occlusion in the symptomatic territory (basilar artery); Clinical history, past imaging or clinical judgment suggesting intracranial stenosis of the basilar artery; Person deprived of liberty; Patient benefiting from a legal protection (guardianship or curatorship).