ArticleStroke (Hoboken, N.J.)2025
PICASSO (Proximal Internal Carotid Artery Acute Stroke Secondary to Tandem Lesion or Local Occlusion) Thrombectomy Randomized Trial: Study Protocol and Rationale.
Article in Stroke (Hoboken, N.J.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05611242 (Proximal Internal Carotid Artery Acute Stroke Secondary to Tandem or Local Occlusion Thrombectomy Trial), which is not on this map. Cited by 4 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Proximal Internal Carotid Artery Acute Stroke Secondary to Tandem or Local Occlusion Thrombectomy Trial
Who cites it
4 citing papers in PubMed.
- Clinical and Angiographic Outcomes in Patients With Tandem Occlusion Thrombectomy: Analysis From the ASSIST International Registry.Stroke (Hoboken, N.J.) · 2026Article
- Revisiting Antiplatelet Therapy in Acute Carotid Tandem Lesions.Journal of clinical medicine · 2026Review
- Endovascular Acute Stroke Intervention-Tandem Occlusion (EASI-TOC) study: protocol and rationale.European stroke journal · 2026Article
- Treatment outcomes of antegrade versus retrograde approaches in tandem occlusion: a single-center retrospective study from Vietnam.Frontiers in neurologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
52 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The optimal treatment of acute large vessel occlusion with concomitant extracranial steno-occlusive disease of the internal carotid artery remains unclear. The PICASSO (Proximal Internal Carotid Artery Acute Stroke Secondary to Tandem or Local Occlusion Thrombectomy Trial) randomized clinical trial is designed to answer the question whether acute carotid stenting is superior to a nonacute stenting approach in the setting of a tandem lesion or tandem occlusion. Methods: PICASSO is a prospective, randomized, controlled, multicenter, open label, assessor-blinded acute ischemic stroke trial with pragmatic design enrolling up to 404 patients at up to 60 sites. Patients with anterior circulation large vessel occlusion with severe stenosis or complete occlusion (70%-100%) of the extracranial carotid artery who meet the imaging and clinical eligibility criteria will be randomized in a 1:1 ratio to undergo mechanical thrombectomy of the intracranial lesion plus emergent stenting of the extracranial lesion versus mechanical thrombectomy plus no stenting up to 16 hours from last known well. Results: The primary efficacy outcome is the ordinal shift of 90-day modified Rankin Scale (mRS) score. The primary analysis will be based on the intention-to-treat principle stratified by the Alberta Stroke Program Early CT [Computed Tomography] Score (7-8 versus 9-10), degree of proximal carotid stenosis (70%-90% versus 91%-100%), NIHSS (≤ 10 versus > 10), and use of intravenous thrombolysis. The primary safety outcome is symptomatic intracranial hemorrhage. Secondary outcomes include 1-year mRS (dichotomized and ordinal), successful reperfusion, and vessel patency at follow-up. Subgroup analyses will include comparison of intravenous versus oral antiplatelets in the stenting arm, and treatment of proximal intracranial occlusion first versus a simultaneous approach. Conclusion: PICASSO is a pragmatic randomized trial, designed to address the safety and efficacy of mechanical thrombectomy with acute carotid stenting versus nonacute stenting with or without delayed revascularization treatment in patients with anterior circulation large vessel occlusion and concomitant extracranial severe stenosis or complete occlusion. Clinical Trial Registration: NCT05611242.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.