One-stop approach for rapid start of endovascular clot removal
One-Stop manaGemEnT For A Swift Initiation of Endovascular Therapy - An International, Multicenter, Pragmatic Randomized Controlled Trial (GET-FAST
This trial will test whether taking eligible adults with suspected large- or medium-vessel ischemic stroke straight to the angiography suite for imaging and treatment gets clot-removal therapy started faster and improves outcomes.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 390 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Paracelsus Medical University Academic / other |
| Locations | 2 sites (Nuremberg and 1 other locations) |
| Trial ID | NCT07052045 on ClinicalTrials.gov |
What this trial studies
The trial compares a 'one-stop' workflow—direct transfer to the angiography suite for imaging and immediate endovascular therapy—against usual care where patients go to CT first. It enrolls adults with suspected large- or medium-vessel acute ischemic stroke (NIHSS ≥10) who arrive at a participating hospital within 4.5 hours and were independent before the stroke. The main focus is reducing door-to-groin time and measuring functional outcomes, discharge destination, and complications. Data will be collected at participating centers in Nuremberg and Basel to determine whether the one-stop pathway speeds treatment and improves recovery.
Who should consider this trial
Good fit: Adults (≥18) who were independent before the stroke (pre-stroke mRS 0–2), present directly to a participating hospital within 4.5 hours of last seen well, and have suspected large- or medium-vessel occlusion with NIHSS ≥10 are ideal candidates.
Not a fit: Patients with suspected intracranial hemorrhage, in-hospital stroke, severe comorbidities that limit recovery, presentation after 4.5 hours, or without a large-vessel occlusion are unlikely to benefit from this pathway.
Why it matters
Potential benefit: If successful, the one-stop pathway could shorten time to treatment and increase the number of patients who return home with less disability.
How similar studies have performed: Previous observational and some randomized efforts implementing 'direct-to-angio' or streamlined EVT pathways have shown reduced treatment times and signals of improved functional outcomes, though results vary by center.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Symptoms suggestive of an acute ischemic stroke caused by a large or medium vessel occlusion as defined by a National Institute of Health Stroke Scale (NIHSS) Score of ≥ 10 points * Patient presents directly to the treating hospital (mothership patient) within 4.5 hours of last seen well (LSW) * Age ≥ 18 years * Patient was independent in daily activities prior to the stroke (pre stroke modified Rankin Scale of 0 - 2) * Endovascular treatment team available (Neurologist, Interventionist, Anesthesiologist, Nursery, Technicians) * Informed Consent as documented by signature or fulfilling the criteria for emergency consent procedures Exclusion Criteria: * Severe comorbidities, which will likely prevent improvement or follow-up * In-hospital stroke * Clinical symptoms suggestive of intracranial hemorrhage (deterioration of patient during transport, vomiting or depressed consciousness) * Strong suspicion of functional neurological symptom disorder / conversion disorder * Hemodynamically unstable patients who require advanced vital support * Angiography room occupied by other procedure
Where this trial is running
Nuremberg and 1 other locations
- Klinik für Neurologie, Universitätsklinik der Paracelsus — Nuremberg, Germany (Recruiting)
- University Hospital Basel — Basel, Switzerland (Not_yet_recruiting)
Study contacts
- Principal investigator: Jan Liman, Dr — Klinkum Nuremberg
- Study coordinator: Alex Brehm, PhD
- Email: alex.brehm@usb.ch
- Phone: +41 61 328 79 48
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.