Abstract Body: Context: Mechanical thrombectomy (MT) has shown efficacy for the management of acute ischemic stroke (AIS) related to a large vessel occlusion. However, evidence is lacking regarding its efficacy in distal occlusions.
Objective: To evaluate whether MT improves the rate of good clinical outcome at 3 months in AIS related to a distal occlusion.
Methods: DISCOUNT is a multicenter open-label randomized controlled trial in 22 French University hospitals. We included adult patients with an AIS involving the anterior or posterior circulation related to a distal vessel occlusion within 6 hours of symptom onset or within 24 hours if no hyperintense signal on fluid attenuation inversion recovery acquisition. Patients were randomized 1:1 in the experimental group (MT in addition to the best medical treatment) or the control group (best medical treatment alone). The primary outcome is the rate of good clinical outcome at 3 months defined as a modified Rankin scale (mRS) ≤ 2 and evaluated by an independent assessor blinded to the intervention arm. Secondary outcomes include recanalization of the occluded vessel within 48h, angiographic reperfusion in the experimental group, 3-month excellent clinical outcome (mRS ≤ 1), all adverse and serious adverse events, and death.
Results: We will present the results of the interim analysis that was planned after the follow-up of the first 163 randomized patients focusing on the mRS 0-2 at 3 months and on safety outcomes (mainly symptomatic intracranial hemorrhages and perforations).