Effect of emergent carotid stenting during endovascular therapy for acute anterior circulation stroke patients with tandem occlusion: A multicenter, randomized, clinical trial (TITAN) protocol.

International Journal of Stroke : Official Journal of the International Stroke Society
François ZhuBenjamin Gory

Abstract

There is no consensus on the optimal endovascular management of the extracranial internal carotid artery steno-occlusive lesion in patients with acute ischemic stroke due to tandem occlusion. We hypothesized that intracranial mechanical thrombectomy plus emergent internal carotid artery stenting (and at least one antiplatelet therapy) is superior to intracranial mechanical thrombectomy alone in patients with acute tandem occlusion. TITAN is an investigator-initiated, multicenter, prospective, randomized, open-label, blinded-endpoint (PROBE) study. Eligibility requires a diagnosis of acute ischemic stroke, pre-stroke modified Rankin Scale (mRS)≤2 (no upper age limit), National Institutes of Health Stroke Scale (NIHSS)≥6, Alberta Stroke Program Early Computed Tomography Score (ASPECTS)≥6, and tandem occlusion on the initial catheter angiogram. Tandem occlusion is defined as large vessel occlusion (intracranial internal carotid artery , M1 and/or M2 segment) and extracranial severe internal carotid artery stenosis ≥90% (NASCET) or complete occlusion. Patients are randomized in two balanced parallel groups (1:1) to receive either intracranial mechanical thrombectomy plus internal carotid artery stenting (and at least one antiplatel...Continue Reading

Associated Clinical Trials

References

Jan 20, 2018·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·U Sadeh-GonikB Gory
Mar 27, 2018·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·B GoryUNKNOWN Thrombectomy In TANdem lesions (TITAN) investigators
Dec 26, 2018·Stroke; a Journal of Cerebral Circulation·Ashutosh P JadhavTudor G Jovin
Dec 26, 2018·Stroke; a Journal of Cerebral Circulation·François ZhuUNKNOWN TITAN (Thrombectomy in Tandem Lesions) Investigators
Mar 21, 2019·Stroke; a Journal of Cerebral Circulation·Gregory JacquinChristian Stapf
Oct 3, 2019·Stroke; a Journal of Cerebral Circulation·Mohammad AnadaniUNKNOWN TITAN (Thrombectomy In TANdem Lesions) Investigators

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Citations

Nov 11, 2020·Stroke; a Journal of Cerebral Circulation·Gaultier MarnatUNKNOWN TITAN and ETIS Investigators*
Feb 27, 2021·Frontiers in Neurology·Guillaume CharbonnierThierry Moulin
Apr 3, 2021·Therapeutic Advances in Neurological Disorders·Peter B SpornsMarios Psychogios
May 6, 2021·Journal of Neurointerventional Surgery·Martha MarkoUNKNOWN ESCAPE-NA1 investigators
Jun 9, 2021·Der Nervenarzt·Marios-Nikos PsychogiosLeo H Bonati
Aug 11, 2021·Stroke; a Journal of Cerebral Circulation·Mohammad AnadaniUNKNOWN TITAN and ETIS Registry Investigators

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