Patients with symptomatic or asymptomatic carotid stenosis in whom carotid artery stenting is
planned are randomised between antiplatelet therapy with ticagrelor plus aspirin or
clopidogrel plus aspirin and examined with brain MRI before and after stent treatment. The
proportion of patients with new ischaemic lesions on MRI after treatment is compared between
the two groups.
Carotid artery stenting (CAS) is an emerging treatment for atherosclerotic carotid stenosis.
The main adverse event is embolic stroke during the procedure. Current medical management to
prevent peri-procedural embolisation consists of dual antiplatelet therapy with clopidogrel
and aspirin. Ticagrelor, a novel reversible inhibitor of the platelet adenosine diphosphate
receptor P2Y12, was superior to clopidogrel, as add-on therapy to aspirin, in preventing
stent thrombosis, cardiovascular outcome events, and death in patients undergoing coronary
artery stenting, without causing an increase in major bleeding events. This study aims to
test the hypothesis that ticagrelor is superior to clopidogrel as add-on to aspirin in
preventing cerebral embolism during the CAS procedure.
If you are confirmed eligible after full screening, you will be required to understand and sign the informed consent if you decide to enroll in the study. Once enrolled you may be asked to make scheduled visits over a period of time.
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