ICARUS - early intracranial stent implantation
This international, multicenter study investigates intracranial stent implantation as a treatment option for occlusions of large cerebral arteries when removal of the thrombus using endovascular stent therapy has failed.
Background
Endovascular therapy (e.g. using stent retrievers or catheters) in combination with intravenous lysis of the thrombus is now considered the standard treatment for acute ischemic stroke due to occlusion of a large cerebral artery in the anterior ciculation. Unfortunately, this procedure fails to open the occluded vessel in around 10 to 20 percent of cases. Patients affected are then faced with a dramatically worse prognosis. Up to 70% of them suffer death or severe disability. One of the most common reasons for the procedure not achieving the desired result is atherosclerotic changes in the cerebral vessels.
Aim
The aim of this randomized study is to investigate whether the implantation of a stent in patients who have suffered a stroke after occlusion of a large cerebral artery and have been treated unsuccessfully with standard endovascular therapy leads to better treatment results than further treatment with standard endovascular therapy. The primary endpoint of the study is disability and dependence in everyday life. Only patients with intracranial atherosclerosis will be included in the study.
ICARUS Study
IntraCranialAtherosclerosisRelatedlarge-vessel occlusion treated with UrgentStenting- a pragmatic, international, multicentre, randomized trial (ICARUS)
Head
Prof. Marios-Nikos Psychogios, Head of Diagnostic and Interv. Neuroradiology, and Prof. Urs Fischer, Head of Neurology, USB
Study design
International, multicenter, pragmatic, randomized clinical trial
Study centers
50-60 centers in Switzerland, Germany, Great Britain, Belgium, Spain, Finland, Italy and Sweden
Number of planned study participants
Initially 296, then up to 498
Project duration
2024-2028
Supported by the DKF through
Methodological consulting, statistics, regulatory affairs, data management, quality affairs
Funding
SNSF project funding
Can permanent disability and dependency in everyday life after a stroke be reduced by early stent implantation?
Study methodology
International, multicenter, pragmatic, 1:1 randomized, open-label superiority trial
Significance of the study
This study can show whether strokes in patients with intracranial atherosclerosis caused by occlusion of a large cerebral artery of the anterior circulation, which could not be opened by standard endovascular therapy, are better treated by stenting.
October 2024