Stroke Clinical Trial
Official title:
Diagnosis by Comprehensive Cardiovascular Imaging for Stroke and Transient Ischaemic Attacks
Stroke affects over 125,000 people each year in the UK and leaves at least 50% disabled.
After a first stroke, there is a significant risk of recurrence (around 5-10% over the first
year). While there are benefits from addressing general risk factors such as exercise, weight
and smoking, selecting the best treatments for preventing a further stroke depends on
understanding the underlying mechanism. Most strokes results from a blood clot causing a
blockage in a blood vessel in the brain ("ischaemic" strokes, about 85% of cases). The clot
may originate in the heart, the major blood vessels supplying the head, or result from
disease of the small blood vessels in the brain itself (around 25% of cases each), and in
around 25% of people a cause cannot be determined (sometimes because more than one exists).
Different treatments are given depending on cause (for example, anticoagulant medication for
clots from the heart, surgery for some arising from large arteries in the neck).
Current investigations involve multiple tests spread across different hospital departments,
and commonly take several weeks to be completed. This may contribute to a high rate of
strokes of uncertain cause, and may delay the start of the best treatment.
This trial will investigate the value of a single comprehensive scan to look at the heart and
major blood vessels (using CT scanning) in a pilot study, comparing the classification of
causes of stroke and the time to starting treatments with routine care, in a randomised study
of patients with recent stroke or transient ischaemic attack (TIA, a short-lived stroke
episode).
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