REperfusion With P2Y12 Inhibitors in Addition to mEchanical thRombectomy for perFUsion Imaging Selected Acute Stroke patiEnts

• Status: Not yet recruiting
• Trial end date: 2026-09-15
• Target enrollment: 0
• Participant gender: All

Summary

The main objective is to evaluate the efficacy of IV administration of the P2Y12 inhibitor (cangrelor) in addition to mecanich thrombectomy and WMD versus mecanich thrombectomy and WMD alone on the functional prognosis at 3 months, in patients with acute ischemic stroke eligible for mecanich thrombectomy on the basis of infusion imaging between 0 and 24 hours after the onset of symptoms.

• Phase: Phase 3
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Fondation Ophtalmologique Adolphe de Rothschild
• Treatments: Cangrelor

Criteria

Inclusion Criteria:

• 18 years or older

• Occlusion of a large vessel of the intrâcranial anterior circulation (carotid T and/or ACM) on Angioscanner or Angio MRI.

• Time of onset of symptoms less than or equal to 24 hours (at the time of medical imaging)

• mecanich thrombectomy indication and one of the following two imaging criteria :

1. In perfusion imaging: initial volume of infarction less than 70 ml, a ratio between the volume of ischaemic tissue and the initial volume of infarction of 1.8 or more, and an absolute difference between these two volumes (absolute volume of potentially reversible ischaemia (penumbra)) of 15ml or more.

OR (if infusion imaging is not available or unobtainable) :

2. Clinical-radiological mismatch: volume of the nucleus calculated in CTP or DWI by RAPID <25ml if NIHSS between 10 and 20 and <50ml if NIHSS >20.

• mRS pré-AVC ≤ 2

• NIHSS ≥ 6

Exclusion Criteria:

• Contraindication to TM

• Patient older than 80 years with >10 microbleeds on pre-treatment MRI

• Pre-existing disability: mRS ≥3

• Last seen normal >24 hours

• Tandem ICA-MCA occlusions requiring stenting

• ASPECT < 6 on NCCT or DWI-MRI

• History of intracranial bleeding

• Evidence of active bleeding or acute trauma (fracture) on examination.

• Recent surgery with significant risk of rebleeding

• Known hypersensitivity to cangrelor or any of the excipients (mannitol, sorbitol)

• Oral anticoagulation with INR >1.7

• Heparin or direct oral anticoagulants within the previous 48 hours previous

• Platelet count <100,000 mm3

• Female of childbearing age

• Patient with legal protection

• Not affiliated to a national insurance scheme

• Opposition of the patient or (in case of emergency inclusion) of the trusted person