Journal Article

Statistical analysis plan for the multicenter, open, randomized controlled clinical trial to assess the efficacy and safety of intravenous tirofiban vs aspirin in acute ischemic stroke due to tandem lesion, undergoing recanalization therapy by endovascular treatment (ATILA trial)

Ainz-Gómez, Leire, de Albóniga-Chindurza, Asier, Escudero-Martínez, Irene, Terceño Izaga, Mikel, Freijo Guerrero, María del Mar, Pardo-Galiana, Blanca, Fernández Prudencio, Luis, Rosso Fernández, Clara, Valverde Moyano, Roberto, Oteros Fernández, Rafael, Medina-Rodríguez, Manuel, García Molina, Estefania, González García, Alejandro, Bravo Rey, Isabel, Zamora, Aynara, Castellanos Rodrigo, María del Mar, Ramírez Moreno, Jose María, Morales Caba, Lluis, Vielba-Gomez, Isabel, Bashir Viturro, Saima, Zapata-Arriaza, Elena, Jiménez Jorge, Silvia, Baena-Palomino, Pablo, Montaner, Joan, Aguilar-Pérez, Marta, Delgado-Acosta, Fernando, Gamero-García, Miguel Ángel, González Díaz, Eva, Díaz Pérez, Jose, Amaya Pascasio, Laura, Hidalgo, Carlos, Moniche Álvarez, Francisco, Jiménez-Gómez, Elvira, Mosteiro, Sonia

2024

Overview

Rationale In-stent reocclusion after endovascular therapy has a negative impact on outcomes in acute ischemic stroke (AIS) due to tandem lesions (TL). Optimal antiplatelet therapy approach in these patients to avoid in-stent reocclusion is yet to be elucidated. Aims To assess efficacy and safety of intravenous tirofiban versus intravenous aspirin in patients undergoing MT plus carotid stenting in the setting of AIS due to TL. Sample size estimates Two hundred forty patients will be enrolled, 120 in every treatment arm. Methods and design A multicenter, prospective, randomized, controlled (aspirin group), assessor-blinded clinical trial will be conducted. Patients fulfilling the inclusion criteria will be randomized at MT onset to the experimental or control group (1:1). Intravenous aspirin will be administered at a 500-mg single dose and tirofiban at a 500-mcg bolus followed by a 200-mcg/h infusion during the first 24 h. All patients will be followed for up to 3 months. Study outcomes Primary efficacy outcome will be the proportion of patients with carotid in-stent thrombosis within the first 24 h after MT. Primary safety outcome will be the rate of symptomatic intracranial hemorrhage. Discussion This will be the first clinical trial to assess the best antiplatelet therapy to avoid in-stent thrombosis after MT in patients with TL. Trial registration The trial is registered as NCT05225961. February, 7th, 2022.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Aggregation / Antiplatelet therapy / Aspirin / Biomedicine / Blood platelets / Brain / Clinical outcomes / Clinical trials / Complications and side effects / Health Sciences / Hemorrhage / Intravenous therapy / Ischemia / Lesions / Medicine / Medicine & Public Health / Patient safety / Prevention / Protocol / Risk factors / Statistics / Statistics for Life Sciences / Stroke / Stroke (Disease) / Study Protocol / Tandem occlusion / Vascular surgery