Acute Ischaemic Stroke Clinical Trial
Official title:
Endovascular Therapy in Acute Ischaemic Stroke Due to Large Vessel Occlusion
Aim of Study:
1. To develop a standardized patient selection criteria and imaging protocol for
endovascular therapy in acute ischaemic stroke (AIS)
2. To create a local efficacy and safety database for intra-arterial mechanical
thrombectomy devices use
3. To establish predictors for poor functional outcome despite successful recanalization
Study Design:
Prospective
Subject and Site:
100 acute ischaemic stroke patients with large vessel occlusion At Queen Mary and Ruttonjee
Hospital, Hong Kong
Duration of participation:
2 years
Entry Criteria:
Subject must meet all inclusion criteria and none of the exclusion criteria
Consent:
Both English and Chinese versions of Informed consent are available and will be obtained from
patient or his/her next of kin
Our study aim to set a standard patient selection and imaging protocol based on previous
positive trials for endovascular therapy in AIS patients. Local efficacy and safety data of
the FDA mechanical devices mainly Penumbra Aspiration System and Solitaire Flow Restoration
device will be collected to create a local database for future service development. Clinical
predictors for poor clinical outcomes despite successful recanalization will be looked for.
Intra-arterial treatment consisted of arterial catheterization with a micro-catheter and
micro-guide wire to the level of occlusion. Mechanical treatment could involve thrombus
aspiration technique or use of a retrievable stent. The method of intra-arterial treatment
will leave to the discretion of the involved interventionist. Only devices that have received
U.S. Food and Drug Administration (FDA) or Conformite Europeenne (CE) approval will be used
in the trial. One or more members of each intervention team have to have completed at least
five full procedures with a particular type of device.
Outcome and Safety Measures:
The primary outcome is 90 days modified Rankin scale. The modified Rankin scale is a 7-point
scale ranging from 0 (no symptoms) to 6 (death). A score of 2 or less indicates functional
independence.
Secondary outcomes include:
1. NIHSS score at 24 hours and at 7 day or discharge if earlier
2. Activities of daily living measured using Barthel index and NIHSS at 90 days
3. Percentage of successful recanalization, defined as modified Thrombolysis in Cerebral
Infarction (mTICI) of 2b (more that 50% of distal branches visible) or 3 (all distal
branches visible) assessed at the end of procedure
4. Efficacy of work flow with time measure on onset to CT, CT to groin puncture, puncture
to reperfusion and number of pass of device before successful recanalization
5. Final infarct volume measured by plain CT brain at 3 days after procedure
6. Death
;
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