The Carotid and Middle Cerebral Artery Occlusion Surgery Study "CMOSS"


Phase 3 Results N/A

Eligibility Criteria

Inclusion Criteria

- Age ranging between 18 and 65 years;
- Digital subtraction angiography imaging studies demonstrating occlusion of unilateral ICA or MCA;
- Digital subtraction angiography imaging studies demonstrating less than 50% stenosis of any other vessels especially contralateral ICA and MCA;
- Modified Rankin Scales (mRS) 0-2;
- Qualifying TIA or ischemic stroke in the territory of the occluded ICA or MCA must have occurred within the past 12 months;
- The most recent stoke attacked more than 3 weeks ago;
- The neurological deficit must be stable for more than 1 month;
- No massive cerebral infarction (>50% of the MCA territory) in CT or MRI study;
- CT Perfusion demonstrates "misery perfusion" ;
- Competent to give informed consent;
- Legally an adult;
- Geographically accessible and reliable for follow-up;

Exclusion Criteria

- Other neurovascular disease (such as cerebral aneurysm or arteriovenous malformation) conditions likely to cause focal cerebral ischemia;
- Known unstable angina or myocardial infarction within recent 6 months;
- Pregnant or perinatal stage women;
- Blood coagulation dysfunction;
- Any diseases likely to death within 2 years;
- Past history of EC-IC bypass surgery;
- Any contraindications or allergy to aspirin or clopidogrel;
- Any heart disease likely to cause cerebral ischemia including prosthetic valves, infective endocarditis, atrial fibrillation, sick sinus syndrome, myxoma and cardiomyopathy with ejection fraction less than 25%;
- Allergy to iodine or radiographic contrast media;
- Serum creatinine > 3mg/dl;
- Uncontrolled diabetes mellitus (fasting blood glucose >16.7mmol/l);
- Uncontrolled hypertension (systolic BP >180 mmHg, diastolic BP>110 mmHg);
- Severe liver dysfunction [alanine transaminase (ALT) and/or aspartate aminotransferase (AST) > 3 times of normal level];
- Concurrent participation in any other experimental treatment trial;
- Any condition that in the surgeon's judgment suggests the patient an unsuitable surgical candidate;