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Rescue Distal Thrombectomy in Treatment for Persistent Distal Occlusions

NCT07533253 · Status: NOT_YET_RECRUITING · Phase: NA · Type: INTERVENTIONAL · Enrollment: 72

Last updated 2026-04-16

No results posted yet for this study

Summary

The goal of this clinical trial is to determine whether rescue distal mechanical thrombectomy can improve outcomes in patients with persistent distal occlusions after successful proximal mechanical thrombectomy for acute ischemic stroke.

Many patients with acute ischemic stroke caused by large vessel occlusion undergo emergency treatment with proximal mechanical thrombectomy, which removes the main clot and restores flow in a large artery. However, in some patients, one or more smaller distal arteries remain occluded after successful proximal recanalization. It is not yet known whether treating these persistent distal occlusions improves angiographic or clinical outcomes.

This study will compare two approaches:

Rescue distal mechanical thrombectomy: an additional distal mechanical thrombectomy procedure is performed during the same endovascular session.

Conservative management: no additional distal endovascular intervention is performed after successful proximal mechanical thrombectomy.

The main questions the study aims to answer are:

* Is rescue distal mechanical thrombectomy feasible in this setting?
* Is it safe?
* Does it improve angiographic and clinical outcomes?

Participants will be randomly assigned during the index endovascular procedure to one of the two study groups and will be followed with imaging and clinical assessments during hospitalization and at 90 days.

Approximately 72 participants will take part in this study at the Centre hospitalier de l'Université de Montréal (CHUM).

Conditions

  • Acute Ischemic Stroke

Interventions

PROCEDURE

Proximal mechanical thrombectomy

Mechanical thrombectomy performed for the qualifying proximal large vessel occlusion before assessment of eligibility for randomization.

PROCEDURE

Rescue distal mechanical thrombectomy

Rescue distal mechanical thrombectomy performed during the same endovascular session after successful proximal recanalization to treat persistent distal medium-vessel occlusion identified on angiography.

OTHER

Conservative management

No additional distal endovascular intervention after successful proximal mechanical thrombectomy. Participants continue with standard medical and post-procedural care.

Sponsors & Collaborators

  • Centre hospitalier de l'Université de Montréal (CHUM)

    lead OTHER

Study Design

Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Model
PARALLEL

Eligibility

Min Age
18 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2026-09-01
Primary Completion
2029-03-31
Completion
2029-12-31

Countries

  • Canada

Study Locations

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT07533253 on ClinicalTrials.gov