Thrombectomy Under Reopro Versus Alteplase to Treat Stoke
Status:
Terminated
Trial end date:
2015-02-01
Target enrollment:
Participant gender:
Summary
Intravenous (IV) Alteplase (rt-PA) is the gold standard for brain infarction within 4 h 30 of
symptoms onset. Efficacy of this therapy is limited in the setting of large artery
occlusions. For middle cerebral artery occlusions (MCA)or internal carotid artery occlusions
(ICA), recanalization rates will drop as low as 10%. This element is critical as prognosis is
linked to recanalization. Arterial re-occlusions are frequent and may reach 30%, which limits
IV thrombolysis efficacy.With the endovascular approach, recanalization rates may reach 90%
with last generation devices. A recent meta-analysis has shown that the best candidates for
thrombectomy are MCA occlusions. In the coronary literature, endovascular therapy efficacy is
increased in association with antiplatelets such as abciximab. The aim of the study was to
assess the feasibility of thrombectomy associated with abciximab on revascularisation (TICI
score), as well as safety (symptomatic intracranial bleeding), in order to design a clinical
trial versus the gold standard for acute ischemic stroke revascularization strategies using
IV rt-PA.This is a controlled, pilot study, evaluating feasibility and safety of thrombectomy
with abciximab versus IV rt-PA in acute ischemic stroke patients within 4h30 of symptoms
onset.