MedPath

Thrombectomy in patients ineligible for iv tPA

Not Applicable
Conditions
I63
Cerebral infarction
Registration Number
DRKS00005792
Lead Sponsor
niversitätsKlinikum HeidelbergNeurologische KlinikAbteilung Neuroradiologie
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Recruiting stopped after recruiting started
Sex
All
Target Recruitment
4
Inclusion Criteria

Moderate to severe stroke (NIHSS>7 and <26)

Ineligibility for iv tPA and no prior iv tPA therapy

Premorbid mRS 0-1

Life expectancy > 6 Months

Treatment can be accomplished within 8 hours after stroke onset
Informed consent by the patient, legal guardian, or independent physician

Imaging criteria:
Occlusion of the M1 segment of the middle cerebral artery (MCA), and/or the intracranial segment of the distal internal carotid artery (ICA), determined by MRA or CTA
CT and CBV map on CTP or DWI with an ASPECT score of 7-10

Exclusion Criteria

Patient is eligible for and receives IV tPA according to licensing criteria
Patient with an INR of >3
Patient is an active participant in another drug or device treatment trial for any disease state,
or patient is expected to start participation in another drug or device treatment trial while
enrolled in this protocol, unless approved by Sponsor.
Patient has pre-existing neurological or psychiatric disease that could impede the study results or would confound the neurological or functional evaluations.
Patient has carotid dissection, high grade stenosis = 70% proximal to occlusion that requires stenting, or excessive tortuosity to gain access to occlusion, as determined by MRA/ CTA of neck and head.
Patient has vascular disease preventing endovascular treatment (e.g. aortic dissection or aneurysm, no arterial transfemoral access)
Patient has history of contraindication for contrast medium.
Patient is known to have infective endocarditis
CT scan or MRI with evidence of: Mass effect or intracranial tumor, or hypodensity on
unenhanced CT and CBV drop on CBV maps on CTP, or, alternatively as per institutional
standard, restricted diffusion on DWI with an ASPECT score of 6 or less
Female of childbearing potential who is known to be pregnant and/or lactating or who has a
positive pregnancy test on admission.
Patients anticipated life expectancy is less than 6 Months.

Study & Design

Study Type
interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Degree of disability after stroke assessed by modified Rankin Scale (mRS) outcome at 90 days poststroke
Secondary Outcome Measures
NameTimeMethod
Good neurological outcome with 90-day mRS=2 or 90-day NIHSS score improvement =10 from baseline<br>Excellent neurological outcomes with 90-day mRS=1<br>Infarct volume at 30 (-/+ 6) hours (CT or MRI).<br>Difference of infarct volume from infarct volume as predicted by pretreatment imaging<br>Functional health status and quality of life 90 (±14) days after stroke (EQ-5D)<br>For the endovascular treatment group successful recanalization will be defined as TICI 2b or 3.
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