ABSTRACT NUMBER: ESOC2026OT80 ENDOVASCULAR ACUTE STROKE INTERVENTION TANDEM OCCLUSION TRIAL (EASI-TOC): A TRIAL OF ACUTE CERVICAL INTERNAL CAROTID ARTERY STENTING DURING ENDOVASCULAR THROMBECTOMY FOR ANTERIOR CIRCULATION STROKE (NCT04261478)

Abstract Background and aims Stroke patients with tandem carotid lesions constitute about 15-20% of patients undergoing endovascular thrombectomy (EVT). However, the optimal treatment of acute stroke in these patients remains uncertain with regards to addressing the ICA lesion during EVT or not. Methods To determine if acute cervical ICA stenting in addition to intracranial thrombectomy is superior to intracranial thrombectomy alone without acute cervical ICA stenting with regards to functional outcome at 90 days. Results EASI-TOC is an ongoing Canadian, pragmatic Phase III, multi-centre, prospective, randomized, open-label, blinded endpoint (PROBE) controlled trial. It will enroll 458 adult tandem patients undergoing EVT and randomize them (1:1) to either undergo acute ICA stenting during EVT (either before or after intracranial thrombectomy, as per clinician judgement) or undergo intracranial thrombectomy alone without ICA stenting. Conclusions The primary outcome is the proportion of patients achieving a favorable modified Rankin scale score (mRS 0-2) at 90 days and primary analysis will be by intention-to-treat. Our primary hypothesis assumes a greater proportion of patients with 90-day mRS 0-2 in the stenting group versus the no stenting group (55% versus 40%). Safety outcomes will include symptomatic intracerebral hemorrhage, procedural complications and death. Conflict of interest