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Endovascular Therapy for Low NIHSS Ischemic Strokes — ENDOLOW  

Cerebral Ischemia Clinical Trial

Official title:
Endovascular Therapy for Low NIHSS Ischemic Strokes

Clinical Trial Summary

This study will test the hypothesis that patients presenting within 8 hours of onset with cerebral ischemia in the setting of proximal large vessel occlusions (LVO) and low baseline NIHSS scores (0-5) will have better 90-day clinical outcomes (mRS distribution) with immediate mechanical thrombectomy (iMT) compared to initial medical management (iMM).

Clinical Trial Description

Currently, the vast majority of these patients do not receive immediate vessel imaging with either CT- or MR-angiography. However, acute ischemic stroke patients with low NIHSS who harbor a large vessel occlusion (LVO) later decline in 20-40% of cases, and/or have underappreciated impairments related to their relatively mild strokes. Similarly, LVO patients presenting with a transient ischemic attack (TIA) are under increased risk of clinical deterioration. Such patients with apparent good collateral circulation, and hence a substantial perfusion of the vascular territory of the occluded large artery, likely have the most to gain from endovascular revascularization. At the same time, this collateral perfusion may allow for more frequent recanalization, either spontaneously or by intravenous (IV) rtPA. Experience with immediate mechanical thrombectomy (iMT) in the LVO mild stroke target population is limited. This study will test the hypothesis that patients presenting within 8 hours of onset with cerebral ischemia in the setting of proximal large vessel occlusions (LVO) and low baseline NIHSS scores (0-5) will have better 90-day clinical outcomes (mRS distribution) with immediate mechanical thrombectomy (iMT) compared to initial medical management (iMM). ;

Study Design

Related Conditions & MeSH terms

Clinical Trial Details
NCT number NCT04167527
Study type Interventional
Source Emory University
Contact David Wright, MD
Phone 404-778-1709
Email dwwrigh@emory.edu; endolow@emory.edu
Status Recruiting
Phase Phase 2/Phase 3
Start date September 5, 2020
Completion date December 2024
View Details
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