Condition category
Circulatory System
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting

Plain English Summary

Not provided at time of registration

Trial website

Contact information



Primary contact

Prof Hugh Markus


Contact details

Centre for Clinical Neuroscience
St George's University of London
Cranmer Terrace
SW17 0RE
United Kingdom

Additional identifiers

EudraCT number number


Protocol/serial number

Protocol version 8.1 (19th Janurary 2010)

Study information

Scientific title

Cervical Artery Dissection In Stroke Study



Study hypothesis

Is therapy with anticoagulants better than treatment with antiplatelet agents for acute cervical artery dissection?

On 26/05/10 this record was updated to include changes in the protocol from v.3 (2007) to v.8.1 (2010). All updates can be found in the relevant field with the above update date. Please also note that the overall trial end date was changed from 01/01/10 to 31/12/11.

Ethics approval

South West London 3 Research Ethics Committee (formerly known as Wandsworth REC), 22/12/2004, ref: MREC 04/Q0803/215

Study design

Randomised multicentre open treatment trial

Primary study design


Secondary study design

Randomised controlled trial

Trial setting

Not specified

Trial type


Patient information sheet

Patient information can be found at:


Stroke, carotid artery dissection and vertebral artery dissection


This trial is currently recruiting in the United Kingdom as of 04/03/2007 - planning to extend internationally.

Patients will be randomised to either antiplatelet or anticoagulation therapy initially for at least 3 months, and thereafter at the discretion of the attending physician.

Arm 1: Antiplatelet therapy: Aspirin, dipyridamole or clopidogrel alone or in dual combination.
Arm 2: Anticoagulation with heparin (intravenous adminsitration, either unfractionated heparin or a therapeutic dose of low molecularweight heparin) followed by warfarin administered orally aiming for an coagulant response time (INR) in the range 2-3. Local protocols for heparin therapy can be used.

Treatment will be open-label. Low dose heparin prophylaxis for prevention of Deep Vein Thrombosis (DVT) is not a contra-indication, but its use should be recorded. Such prophylaxis may be continued after randomisation in the antiplatelet arm at the discretion of the local clinician. The doses of each drug used for antiplatelet therapy will be according to physician preference.

Intervention type



Not Applicable

Drug names

anticoagulants, antiplatelet agents

Primary outcome measures

Time to first ipsilateral stroke or death (any cause) within 3 months from randomisation

Secondary outcome measures

The following will be measured at the 3-month follow up:

1. Ipsilateral TIA, stroke or death (any cause) within 3 months from randomisation
2. Any TIA and stroke
3. Any stroke
4. Major bleeding
5. Presence of residual stenosis at 3 months (>50%)
6. Mortality

Overall trial start date


Overall trial end date


Reason abandoned


Participant inclusion criteria

1. Extra cranial carotid or vertebral artery dissection with symptom onset within the last 7 days. This includes:
1.1. Ipsilateral Transient Ischemic Attack (TIA) or stroke with known date of onset
1.2. Ipsilateral Horner's syndrome or neck pain with known date of onset
2. Imaging evidence of definite or probable dissection on Magnetic Resonance Imaging (MRI)/ Magnetic Resonance Angiography (MRA), Computed Tomographic Angiography (CTA) or ultrasound (patients can be initially randomised on ultrasound alone but subsequent MR or CTA confirmation is needed)

Participant type


Age group

Not Specified



Target number of participants

250 in feasibility phase

Participant exclusion criteria

1. Intracranial cerebral artery dissection
2. Symptom onset >7 days
3. Contraindications to either antiplatelet agents or anticoagulation therapy, including active peptic ulceration, bleeding peptic ulcer within 1 year
4. Patient refusal to consent
5. Patients already taking antiplatelets or anticoagulants for other reasons e.g. prosthetic heart valves in whom the treatment cannot be replaced by either antiplatelets or anticoagulants
6. Women who are pregnant

Added 26/05/10:
7. Iatrogenic induced dissection

Recruitment start date


Recruitment end date



Countries of recruitment

United Kingdom

Trial participating centre

Centre for Clinical Neuroscience
SW17 0RE
United Kingdom

Sponsor information


St George's University of London (UK)

Sponsor details

Research and Development Office
St George's University of London
Cranmer Terrace
SW17 0RE
United Kingdom

Sponsor type




Funder type


Funder name

Stroke association (UK)

Alternative name(s)

Funding Body Type

private sector organisation

Funding Body Subtype

professional associations and societies


United Kingdom

Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Results - basic reporting

Publication summary

2007 protocol in:
2012 non-randomised arm results in:
2015 results in:

Publication citations

  1. Protocol

    Antiplatelet therapy vs. anticoagulation in cervical artery dissection: rationale and design of the Cervical Artery Dissection in Stroke Study (CADISS)., Int J Stroke, 2007, 2, 4, 292-296, doi: 10.1111/j.1747-4949.2007.00165.x.

  2. Kennedy F, Lanfranconi S, Hicks C, Reid J, Gompertz P, Price C, Kerry S, Norris J, Markus HS, , Antiplatelets vs anticoagulation for dissection: CADISS nonrandomized arm and meta-analysis., Neurology, 2012, 79, 7, 686-689, doi: 10.1212/WNL.0b013e318264e36b.

  3. Results

    The CADISS trial investigators, Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): a randomised trial, Lancet Neurol, 2015, doi: 10.1016/S1474-4422(15)70018-9.

Additional files

Editorial Notes