Compares direct transfer to angiography suite for acute stroke treatment
Compares two routes to clot removal in adults with suspected large vessel stroke.
Plain-language title generated from the registry record
Registry title: Delay AvoIding Primary Evaluation for ThRombectomy of Acute StrokE Patients With Large Vessel OCclusion in the Angiography SuiTe
Key facts
- Where
- Camden, Charleston, El Paso, Hackensack, Harlingen, Hollywood, Houston, Miami, New Haven, New York, Newark, Plano, St Louis, Toledo, and Wyoming, United StatesSee the 15 sites
Where in United States
- Cooper University HospitalCamden, United StatesTaking people
- Medical University of South CarolinaCharleston, United StatesTaking people
- Texas Tech University Health Sciences Center-El PasoEl Paso, United StatesTaking people
- HMH-Hackensack University Medical CenterHackensack, United StatesTaking people
- Valley Baptist Medical CenterHarlingen, United StatesTaking people
- Memorial Healthcare SystemHollywood, United StatesTaking people
- The University of Texas Health Science Center at HoustonHouston, United StatesTaking people
- University of Miami/ Jackson Memorial HospitalMiami, United StatesTaking people
- Yale New Haven HospitalNew Haven, United StatesTaking people
- The Research Foundation for SUNY on behalf of University at BuffaloNew York, United StatesTaking people
- Rutgers New Jersey Medical SchoolNewark, United StatesTaking people
- Texas Stroke InstitutePlano, United StatesTaking people
- Saint Louis UniversitySt Louis, United StatesTaking people
- ProMedica Toledo HospitalToledo, United StatesTaking people
- University of Michigan Health - WestWyoming, United StatesTaking people
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
- Santiago Ortega Gutierrez
- Trial code
- NCT06825897
- Record updated
- 26 October 2026
- Original description
The purpose of this study is to compare two strategies for treating adults with suspected large vessel occlusion stroke within 7 hours of symptom onset. Researchers will evaluate whether direct transfer to the neurointerventional angiography suite improves recovery and reduces disability compared to the conventional approach of first being evaluated in the emergency department. The study will also assess safety and other health outcomes to guide care for stroke patients.Read full original descriptionShow less
Delay Avoiding Primary Evaluation for Thrombectomy for Acute Stroke Patients With Large Vessel Occlusion in the Angiography Suite (DIRECT) Trial
The purpose of this study is to compare two strategies for treating adults with suspected large vessel occlusion stroke within 7 hours of symptom onset. Researchers will evaluate whether direct transfer to the neurointerventional angiography suite improves recovery and reduces disability compared to the conventional approach of first being evaluated in the emergency department. The study will also assess safety and other health outcomes to guide care for stroke patients.
Inclusion: To be eligible for participation in the DIRECT trial, an individual must meet all of the following criteria:; Age: ≥ 18 years of age; Clinical Presentation: Present to a participating TSC with signs or symptoms suggestive of acute LVO stroke; Stroke Severity: Baseline NIHSS of 10 or higher; Time since LKW: Time from LKW to arrival at the TSC must be within 7 hours; Additional criteria; For all Interfacility Transfers:; If imaging was performed at the outside facility, the time from the first imaging to arrival at the thrombectomy center must exceed 90 minutes; For all the Conventional Triage Arm, participants must also meet the following criteria:; Presence of a qualifying LVO by CTA or MRA imaging; or; For Large Core Patients: Patients with large core infarcts (CT-ASPECT score ≤ 5, DWI-ASPECT score ≤ 5, or infarct volume ≥ 70 cc) will be enrolled, irrespective of treatment decisions regarding embolectomy; For all DTAS Arm:; Patients who do not have LVO occlusions in the angiography suite assessment (ICH, distal occlusions or mimics) will be enrolled, irrespective of treatment decisions regarding embolectomy.
Exclusion: Hemorrhagic Stroke: Presence of intracranial hemorrhage on brain imaging in the conventional strategy as Heidelberg that renders thrombectomy contraindicated; An individual who meets any of the following criteria will be excluded from participation in the trial:; Time Restrictions: Presentation to a thrombectomy-capable center more than 7 hours from LSW; Imaging Criteria for Interfacility Transfer Patients: At sites enrolling transfer patients, any patient arriving from an outside hospital with time from imaging study at the presenting hospital to arrival at the TSC not exceeding 90 minutes.