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Non-acute Carotid Artery OcclusionASCENTNCT07803419

Endovascular Treatment for Symptomatic Non-acute Carotid Occlusion

A study testing Guideline-Based Best Medical Treatment, Endovascular Recanalization With Proximal Balloon Protection and Endovascular Recanalization Without Proximal Protection in people with Non-acute Carotid Artery Occlusion and Cognitive Impairment, run by Dapeng Mo at 1 site in China.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

This study is a multicenter, prospective, randomized, open-label, blinded-endpoint clinical trial designed to evaluate the safety and potential efficacy of endovascular recanalization strategies in patients with symptomatic non-acute carotid artery occlusion and cognitive impairment. Read more about this study

Who is it for?
Ages 18 to 80 years
What is being tested?
Guideline-Based Best Medical Treatment, Endovascular Recanalization With Proximal Balloon Protection and Endovascular Recanalization Without Proximal Protection
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
180 participants
Where
1 siteChina
Study dates
1 Sep 2026to 1 Dec 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • The age ranged from 18 to 80 years
  • Unilateral carotid artery occlusion confirmed by CTA or DSA (excluding anterior and middle cerebral artery occlusion)
  • Complete 3T-MRI within 1-3 days before operation
  • The time of carotid artery occlusion was more than 24h (confirmed by imaging or according to the patient's condition), and not more than 3 months
  • Ischemic stroke or TIA related to occluded vessels existed in the past 3 months, and the last ischemic event was > 2 weeks; and there was cognitive impairment, MoCA score ≤ 25 after education correction
  • Imaging confirmed that there was hypoperfusion in the ipsilateral cerebral hemisphere of carotid artery occlusion, which met at least any of the following requirements:
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  • ①Head CT perfusion imaging showed low perfusion in the lesion vascular area (CBF decreased by 30% compared with contralateral perfusion)
  • ②ASITN/SIR collateral circulation score based on DSA < 3 points
  • ③Cerebral infarction with hemodynamic abnormalities confirmed by head MRI (such as watershed infarction)
  • Sign the informed consent form

Who cannot join

  • There was severe neurological dysfunction (mRS ≥ 4) before enrollment
  • The ipsilateral common carotid artery was occluded, or the ipsilateral middle cerebral artery was severely stenosed or occluded
  • Non atherosclerotic occlusion (such as vasculitis, moyamoya disease, etc.)
  • Patients with massive cerebral infarction (infarction volume based on MRI-DWI/ADC is more than 70ml)
  • Untreated intracranial aneurysms, intracranial tumors (except meningiomas) or any intracranial vascular malformations
  • Evidence of cardiogenic embolism
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  • Allergic to heparin, aspirin, clopidogrel, statins, metals, anesthetics, contrast agents, or unable to tolerate general anesthesia surgery
  • Any history of intracranial hemorrhage within 30 days (including cerebral parenchyma, ventricle, subarachnoid hemorrhage, subdural or epidural)
  • History of primary cerebral parenchymal hemorrhage
  • There are contraindications to antiplatelet drugs
  • There are coagulation disorders and systemic bleeding
  • Thrombocytopenia (<100 × 10⁹/L)
  • Uncontrolled severe hypertension (systolic blood pressure>180mmHg or diastolic blood pressure>110mmHg)
  • Severe coronary heart disease, severe liver injury (AST or ALT more than 3 times the normal value), liver cirrhosis and severe renal insufficiency (creatinine>177 μmol/L) were observed
  • Major surgical operations within 30 days or in the next 90 days
  • It is known that patients with dementia, cognitive impairment caused by other reasons or mental diseases cannot complete the assessment of neurological and cognitive functions
  • There are cerebral infarction that clearly involves the key brain areas of cognition, or there are neurological deficits that affect the accuracy of cognitive function assessment, such as severe aphasia, neglect, and audiovisual impairment. According to the judgment of the researchers, the decline of cognitive function is mainly caused by irreversible brain tissue injury
  • The expected survival time of patients with other diseases was less than 2 years
  • Pregnancy or lactation
  • Patients have been included in other studies, which is in conflict with this study

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Dapeng Mo, MD contact

18811039300

bjttmodp@163.com

China1 site
  • Beijing Tiantan Hospital

    Beijing, Beijing Municipality, 100010

Other trials in China

About this study

Official title: Endovascular Treatment for Symptomatic Non-acute Carotid Occlusion - A Multicenter, Prospective, Blind Endpoint, Pilot, Randomized Controlled Trial

This study is a multicenter, prospective, randomized, open-label, blinded-endpoint clinical trial designed to evaluate the safety and potential efficacy of endovascular recanalization strategies in patients with symptomatic non-acute carotid artery occlusion and cognitive impairment. Eligible participants will be randomly assigned to best medical treatment alone, endovascular recanalization without proximal protection plus best medical treatment, or endovascular recanalization with proximal balloon protection plus best medical treatment. The study will assess whether endovascular recanalization improves cognitive function and whether proximal protection reduces procedure-related new ischemic lesions on diffusion-weighted magnetic resonance imaging.

Read the detailed description

Symptomatic non-acute carotid artery occlusion may lead to recurrent ischemic events, chronic cerebral hypoperfusion, and cognitive decline. Best medical treatment is the standard foundation of care, but selected patients with persistent hypoperfusion may remain at risk. Endovascular recanalization may improve cerebral perfusion, but procedure-related distal embolization and new ischemic lesions remain important safety concerns.

Eligible patients will have symptomatic non-acute carotid artery occlusion, ipsilateral cerebral hypoperfusion, and baseline cognitive impairment defined by an education-adjusted Montreal Cognitive Assessment score of 25 or lower. Participants will be randomized in a 1:1:1 ratio to best medical treatment alone, endovascular recanalization without proximal protection plus best medical treatment, or endovascular recanalization with proximal balloon protection plus best medical treatment.

In the proximal protection group, a balloon guide catheter will be used to achieve proximal flow arrest or flow control during key procedural steps. In the unprotected endovascular group, recanalization will be performed without routine proximal balloon flow control. The primary safety outcome is the number of new ischemic lesions on diffusion-weighted magnetic resonance imaging within 24 to 72 hours. The primary efficacy outcome is the change in Montreal Cognitive Assessment score from baseline to 6 months.

Being tested
Guideline-Based Best Medical Treatment, Endovascular Recanalization With Proximal Balloon Protection, Endovascular Recanalization Without Proximal Protection
Keywords
Non-acute Carotid Artery Occlusion, Chronic Carotid Artery Occlusion, Symptomatic Carotid Artery Occlusion, Endovascular Recanalization, Balloon Guide Catheter, Cognitive Impairment
Medical subject headings
Cognitive Dysfunction

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Guideline-Based Best Medical TreatmentOther

    Guideline-based best medical treatment includes antiplatelet therapy and management of vascular risk factors, such as blood pressure, lipid, glucose, and lifestyle management, according to current clinical practice.

  • Endovascular Recanalization With Proximal Balloon ProtectionProcedure or surgery

    Endovascular recanalization will be performed using neurointerventional techniques. A balloon guide catheter will be positioned proximally to achieve temporary flow arrest or flow control during key lesion-treatment steps, with the aim of reducing distal migration of thrombus or plaque debris.

  • Endovascular Recanalization Without Proximal ProtectionProcedure or surgery

    Endovascular recanalization will be performed using standard neurointerventional techniques without routine proximal balloon flow arrest or flow control.

Study groups in NCT07803419
Study groupRoleWhat they receive
Best Medical TreatmentActive comparatorParticipants in this arm will receive guideline-based best medical treatment, including antiplatelet therapy and management of vascular risk factors.
Receives: Other: Guideline-Based Best Medical Treatment
Endovascular Recanalization With Proximal Balloon Protection Plus Best Medical TreatmentExperimentalParticipants in this arm will undergo endovascular recanalization with proximal balloon protection in addition to guideline-based best medical treatment. Proximal balloon protection will be used to achieve temporary proximal flow arrest or flow control during key procedural steps.
Receives: Procedure: Endovascular Recanalization With Proximal Balloon Protection
Endovascular Recanalization Without Proximal Protection Plus Best Medical TreatmentExperimentalParticipants in this arm will undergo endovascular recanalization without routine proximal balloon flow control, in addition to guideline-based best medical treatment.
Receives: Procedure: Endovascular Recanalization Without Proximal Protection

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Changes of cognitive function (MoCA score) compared with baseline 6 months after randomization

    Changes of cognitive function (MoCA score) compared with baseline 6 months after randomization

    Measured: 6 months after randomization

  2. Total number of new infarcts on DWI-MRI within 24-72 hours after randomization

    Total number of new infarcts on DWI-MRI within 24-72 hours after randomization

    Measured: Within 24-72h after randomization

Secondary outcomes (15)
  1. The volume of new infarcts 24-72 hours after randomization

    The volume of new infarcts 24-72 hours after randomization

    Measured: 24-72 hours after randomization

  2. Incidence of new infarcts 24-72 hours after randomization

    Incidence of new infarcts 24-72 hours after randomization

    Measured: 24-72 hours after randomization

  3. Distribution characteristics of new infarcts 24-72 hours after randomization (within or beyond the scope of responsible vessels)

    Distribution characteristics of new infarcts 24-72 hours after randomization (within or beyond the scope of responsible vessels)

    Measured: 24-72 hours after randomization

  4. location of new infarcts 24-72 hours after randomization (only cortical area, only deep white matter area, cortex and white matter were involved)

    location of new infarcts 24-72 hours after randomization (only cortical area, only deep white matter area, cortex and white matter were involved)

    Measured: 24-72 hours after randomization

  5. The average number of new infarcts per enrolled patient 24-72 hours after randomization

    The average number of new infarcts per enrolled patient 24-72 hours after randomization

    Measured: 24-72 hours after randomization

  6. The average number of new infarcts in the responsible vessels of each enrolled patient 24-72 hours after randomization

    The average number of new infarcts in the responsible vessels of each enrolled patient 24-72 hours after randomization

    Measured: 24-72 hours after randomization

  7. The average number of new infarcts beyond the scope of responsible vessels per enrolled patient 24-72 hours after randomization

    The average number of new infarcts beyond the scope of responsible vessels per enrolled patient 24-72 hours after randomization

    Measured: 24-72 hours after randomization

  8. The rate of symptomatic intracranial hemorrhage (SICH) within 72 hours after randomization (Heidelberg bleeding classification)

    The rate of symptomatic intracranial hemorrhage (SICH) within 72 hours after randomization (Heidelberg bleeding classification)

    Measured: Within 72 hours after randomization

  9. Operation related complications within 72 hours after randomization (operation related complications, defined as arterial dissection, new area embolism, cavernous sinus fistula, arterial perforation, subarachnoid hemorrhage, etc.)

    Operation related complications within 72 hours after randomization (operation related complications, defined as arterial dissection, new area embolism, cavernous sinus fistula, arterial perforation, subarachnoid hemorrhage, etc.)

    Measured: Within 72 hours after randomization

  10. Any stroke (hemorrhagic or ischemic) or death within 30 days after randomization

    Any stroke (hemorrhagic or ischemic) or death within 30 days after randomization

    Measured: Within 30 days after randomization

  11. Occurrence of recurrent ischemic stroke (symptomatic ischemic cerebral infarction or TIA) of responsible vessels within 6 months after randomization

    Occurrence of recurrent ischemic stroke (symptomatic ischemic cerebral infarction or TIA) of responsible vessels within 6 months after randomization

    Measured: Within 6 months after randomization

  12. Restenosis or re-occlusion of target vessels confirmed by CTA/DSA 6 months after randomization

    Restenosis or re-occlusion of target vessels confirmed by CTA/DSA 6 months after randomization

    Measured: 6 months after randomization

  13. The changes of cognitive function (MMSE score) compared with baseline 6 months after randomization

    The changes of cognitive function (MMSE score) compared with baseline 6 months after randomization

    Measured: 6 months after randomization

  14. mRS score 6 months after randomization

    mRS score 6 months after randomization

    Measured: 6 months after randomization

  15. Changes in fundus blood vessels and fundus structures 6 months after randomization (average thickness of retinal nerve fiber layer around optic disc and average thickness of macular ganglion cell complex/ganglion cell-inner plexus layer

    Changes in fundus blood vessels and fundus structures 6 months after randomization (average thickness of retinal nerve fiber layer around optic disc and average thickness of macular ganglion cell complex/ganglion cell-inner plexus layer

    Measured: 6 months after randomization

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 Sep 2026
  2. Study start1 Sep 2026 (estimated)
  3. Primary completion1 Jun 2028 (estimated)
  4. Study completion1 Dec 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
180 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07803419
Sponsor's protocol ID
HX-A-2026054
Acronym
ASCENT
Status last verified
Aug 2026
First submitted
31 Aug 2026
Last updated
3 Sep 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Guideline-Based Best Medical Treatment, Endovascular Recanalization With Proximal Balloon Protection and Endovascular Recanalization Without Proximal Protection in people with Non-acute Carotid Artery Occlusion and Cognitive Impairment, run by Dapeng Mo at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 20 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 3 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Dapeng Mo, MD (18811039300, bjttmodp@163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Changes of cognitive function (MoCA score) compared with baseline 6 months after randomization (time frame: 6 months after randomization). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Sep 2026.

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