The primary objective of this study is to demonstrate the superiority of endovascular therapy (EVT) associated with best medical therapy (BMT) compared to BMT alone to increase the functional independence at 3 months in patients with acute cervical isolated internal carotid artery occlusion (CICAO), mild to severe stroke (NIHSS score > 5), and core-perfusion or clinical-imaging mismatch.~Secondary objectives are,(i) to compare the safety of EVT + BMT vs. BMT alone; (ii) to demonstrate the superiority of EVT + BMT vs BMT alone on : the rate of excellent outcome at 3 months (modified Rankin Scale, mRS, score = 0-1), the rate of recanalization at 24 hours and at day 90 post-randomization, the cerebral infarct size at 24 hours post-randomization, the early neurological deterioration rate at 24 hours and at day 7 post-randomization, the ischemic recurrences rate at day 90 post-randomization, the cognitive impairment rate at day 90 post-randomization.~One of the secondary objective is also to describe in the experimental group (EVT + BMT), the procedure-related adverse events.
Our main hypothesis is that acute EVT associated with best medical treatment is superior to best medical treatment alone, for improving clinical outcomes at 90 days, in patient with mild or severe AIS and diffusion-perfusion or clinical-imaging mismatch, secondary to CICAO.