Intra-Arterial Thrombolysis After SUCCESSful Reperfusion in Anterior Circulation Ischemic Stroke

Summary

Stroke is a leading cause of disability and mortality worldwide. Despite the clinical benefit of mechanical thrombectomy, 1 out of 2 patients treated are functionally independent at 90 days. Achieving the best possible angiographic reperfusion is a key determinant of clinical outcome in acute ischemic stroke patients with anterior circulation large vessel occlusion. Mechanical thrombectomy is standard treatment for large vessel occlusion stroke patients within 24. In the setting of successful (eTICI ≥2b), adjunct intra-arterial thrombolysis may be a promising therapeutic option allowing recanalization of distal arterial occlusions (not accessible to mechanical devices) and improvement of upstream brain reperfusion by targeting microvascular obstruction. The IA-SUCCESS randomized trial aims to assess the clinical and safety of adjunct intra-arterial thrombolysis vs. no adjunct intra-arterial thrombolysis after successful angiographic reperfusion in patients with acute anterior circulation large vessel occlusion stroke.

Timeline

Start

2025-06-01

Primary completion

2028-09-16

Completion

2029-07-01

Publications

• Gory B, Richard S, Pop R, Wolff V, Cherifi A, Bretzner M, Henon H, Marnat G, Sibon I, Gentric JC, Timsit S, Di Caterino F, Charbonnier G, Caroff J, Denier C, Consoli A, Lapergue B, Allard J, Gerschenfeld G, Dumas V, Lamy M, Richter SJ, Castagnet H, Veunac L, Bourgeois-Beauvais Q, Desilles JP, Seners P, Naggara O, Januel AC, Fontaine L, Boulouis G, Pasi M, Dargazanli C, Arquizan C, Heck O, Garambois K, Comby PO, Bejot Y, Zhu F, Liao L, Loukoul WA, Derelle AL, Anxionnat R, Kamga MM, Hachit H, Guillemin F, Turc G, Hossu G. Intra-Arterial thrombolysis after SUCCESSful angiographic recanalization in acute large-vessel occlusion stroke of the anterior circulation (IA-SUCCESS): a multicentre, randomised, clinical trial protocol. Eur Stroke J. 2026 Jul 6;11(7):aakag080. doi: 10.1093/esj/aakag080.

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