Abstract Number: Esoc2026ot162 Bilateral Carotid Filters for Prevention of Stroke Recurrence From Large Vessel Occlusion in Atrial Fibrillation Patients Treated With Oral Anticoagulation – The Intercept Trial

Abstract Background and aims Patients with atrial fibrillation (AF) and recent stroke are at increased risk of recurrent ischemic stroke, particularly those with stroke while on oral anticoagulation (OAC). Approximately 90% of strokes in this population occur in the anterior circulation. Permanent bilateral common carotid artery filters designed to capture proximal emboli ≥1.4 mm in length or diameter may reduce stroke (Figure). Methods To investigate whether permanent bilateral carotid filters used in addition to OAC reduce stroke compared to OAC alone. Results INTERCEPT (NCT05723926) is an ongoing, global, phase 3, prospective, open-label, randomized trial with blinded endpoint evaluation. Approximately 2,000 patients with AF and stroke in the preceding year will be randomized to receive or not receive permanent bilateral carotid filters (VineTM, Javelin Medical) deployed percutaneously under ultrasound guidance. All study participants will receive OAC, and those randomized to undergo bilateral carotid filter implantation will receive additional single antiplatelet therapy for 6 months following implantation. The trial is coordinated at World Health Research (Hamilton, Canada). Conclusions The primary efficacy endpoint is anterior circulation ischemic stroke due to large vessel occlusion (90% power to detect a 62% relative risk reduction). The secondary efficacy endpoint is total ischemic stroke (80% power to detect a 30% relative risk reduction). The primary safety endpoints are (1) serious device or procedure related complication and (2) ISTH major bleeding occurring during the first 6 months following randomization. Conflict of interest Figure 1 - belongs to Background and aims