Ischemic Stroke Clinical Trial
Official title:
A Multicenter, Prospective, Control Study to Evaluate of Thrombectomy With Solitaire in Patients With Acute Ischemic Stroke
To evaluate the safety and efficacy of Solitaire thrombectomy in Chinese patients with acute stroke within 12 hours of symptom onset.
This study is a multicenter, prospective, control study. Patients with acute ischemic stroke
who meet inclusion criteria would be enrolled in the study. If the patient or patient's
legally authorized representative decides that the patient should receive the intervention
operation and signs the informed consent of intervention operation, the patient will be
assigned to the intervention group. If the patient participates in the EAST study but
refuses intervention after notified of all the benefits and risk of intervention and
conservative treatment, the patient will be assigned to the control group.There will be 150
patients enrolled in each group. Patients in the intervention group will be treated with
mechanical recanalization using Solitaire plus standard medical therapy. Patients in the
control group will receive standard medical therapy alone.
All patients were followed up for 90 days upon enrollment. During the trial, multiple
indicators will be assessed in all patients at baseline, 24hours,14days (or at discharge,
whichever occurs first) and 90 days. Primary efficacy endpoint will be functional
independence as defined by modified Rankin Scale (mRS) score ≤ 2 at 90 days or function
improvement by mRS shift analysis.Primary procedure efficacy endpoint will be arterial
recanalization of the occluded target vessel measured by Thrombolysis in Cerebral Infarction
(TICI) score equal or superior to 2b right following the use of the Study Device. Primary
safety endpoint is systematic ICH with 24 ±3hrs post procedure.The secondary endpoints
include: rate of device-related and procedure related Serious Adverse Events (SAEs) at 14
days or discharge; volume of cerebral infarction as measured by a CT scan at 24 ±3hrs post
procedure; arterial reperfusion measured by reperfusion ratio on CT scan 24 ±3hrs post
procedure; infarction in subjects who achieved TICI 2b‐3 reperfusion without intracranial
hemorrhage;death due to any cause at 14days or discharge and at 90 days; change in NIHSSat
24±3hrs post procedure;change in NIHSS at 14 days or discharge post procedure; change in
NIHSSat 90 ± 7days; quality of life at 90± 7days; the proportion of patients who suffer a
Safety Outcome : the proportion of patients with the composite of: (i) symptomatic
intracranial hemorrhage (ii) major bleeding due to femoral artery access complications
including groin hematoma, retroperitoneal hematoma (iii) contrast nephropathy;economic
(cost-effectiveness) analysis;evaluation of waiver/deferral of consent process; the total
radiation dose (CT, CTA, angiography) reported as a continuous measure;the proportion of
patients with malignant MCA infarction;the proportion of patients undergoing
hemicraniectomy.
Because a substantial number of patients are expected to have intracranial atherosclerosis,
subgroup analysis will also be carried out on this group of patient. The clinical outcomes,
the final TICI score after angioplasty and possible stenting, and symptomatic ICH (including
SAH) and immediate re-thrombosis rate will be included in the subgroup analysis.
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