direct transfer to angiography suiteconventional CT/MRI triage strategy
direct transfer to angiography suite: Patients will bypass the emergency radiology imaging step and be directly transferred to the angiography suite. After screening for intracranial hemorrhage using flat-panel CT, intravenous tenecteplase will be administered according to current guidelines. DSA will be performed, and EVT will be provided for patients with confirmed LVO. EVT includes thrombectomy with stent retrievers, thromboaspiration, intra-arterial thrombolysis, balloon angioplasty, stenting, or a combination of these approaches at the discretion of the interventional team.
conventional CT/MRI triage strategy: Patients will undergo routine imaging, including non-contrast CT/CTA/CTP or MRI/MRA/PWI. For ischemic stroke patients, intravenous tenecteplase will be administered according to current guidelines. Patients with imaging-confirmed LVO will proceed to the angiography suite for further EVT following the standard procedure. EVT includes thrombectomy with stent retrievers, thromboaspiration, intra-arterial thrombolysis, balloon angioplasty, stenting, or a combination of these approaches at the discretion of the interventional team.
Study summary
The investigators initiated a multicenter, prospective, randomized, open-label, blinded-endpoint (PROBE) controlled trial to evaluate the efficacy and safety of the direct transfer to angiography suite (DTAS) triage strategy compared to the conventional triage strategy with CT/MRI in patients with suspected large artery occlusive (LVO) within 6 hours of symptom onset.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
* Age≥18 years old;
* Patients presenting with symptoms or signs suggestive of acute large vessel occlusion (LVO) stroke；
* Randomization within 6 hours of symptom onset；
* Baseline NIHSS score ≥10 points prior to randomization;
* Pre-stroke modified Rankin Scale (mRS) score ≤2;
* Written informed consent from patients or their legally authorized representatives.
Exclusion Criteria:
* Refusal of endovascular treatment；
* Allergy to contrast agents;
* Clinical symptoms or signs suggestive of intracranial hemorrhage (e.g., severe headache, seizures, or signs of increased intracranial pressure);
* Transferred patients (e.g., from centers without thrombectomy capability);
* Seizure at stroke onset, postictal paralysis, or inability or unwillingness to cooperate due to epilepsy or other neurological or psychiatric disorders;
* Clinically unstable conditions requiring urgent life-support treatment;
* Other standard contraindications to endovascular treatment;
* Any terminal illness such that the patient would not be expected to survive more than 1 year;
* Pregnant women, nursing mothers, or women with a positive pregnancy test at admission;
* Unlikely to adhere to the trial protocol or follow-up;
* Any condition that, in the judgment of the investigator could impose hazards to the patient if study therapy is initiated or affect the participation of the patient in the study;
* Participation in other interventional clinical trials within the previous 3 months.
Primary outcome measure(s)
The modified Rankin Scale (mRS) score 0-2 at 90 days — 90 days The proportion of patients with an mRS score of 0-2 at 90 days. The mRS score is a seven-point ordered categorical scale from 0 to 6 for functional neurological outcome, with 0 indicating no neurological symptoms and 6 indicating death.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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