In:
International Journal of Stroke, SAGE Publications
Abstract:
Rationale: Mechanical thrombectomy (MT) associated with the best medical treatment (BMT) has recently shown efficacy for the management of acute ischemic stroke (AIS) secondary to a large vessel occlusion. However, evidence is lacking regarding the benefit of MT for more distal occlusions. Aim: To evaluate the efficacy in terms of good clinical outcome at 3 months of MT associated with the BMT over the BMT alone in AIS related to a distal occlusion. Methods: The DISCOUNT trial is a multicenter open-label randomized controlled trial involving 22 French University hospitals. Adult patients (≥18 years) with an AIS involving the anterior or posterior circulation secondary to a distal vessel occlusion within 6 hours of symptom onset or within 24 hours if no hyperintense signal on fluid attenuation inversion recovery acquisition will be randomized 1:1 to receive either MT associated with the BMT (experimental group) or BMT alone (control group). The number of patients to be included is 488. Study outcomes: The primary outcome is the rate of good clinical outcome at 3 months defined as a modified Rankin scale (mRS) ≤ 2 and evaluated by an independent assessor blinded to the intervention arm. Secondary outcomes include recanalization of the occluded vessel within 48h, angiographic reperfusion in the experimental group, 3-month excellent clinical outcome (mRS ≤ 1), all adverse events, and death. A cost utility analysis will estimate the incremental cost per Quality-Adjusted Life Year (QALY) gained. Discussion: If positive, this study will open new insights in the management of acute ischemic strokes.
Type of Medium:
Online Resource
ISSN:
1747-4930
,
1747-4949
DOI:
10.1177/17474930231205213
Language:
English
Publisher:
SAGE Publications
Publication Date:
2023
detail.hit.zdb_id:
2211666-7
Permalink