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Prediction Model for the Recanalization OuTcome Evaluation of Ischemic Stroke Using Multimodal CT

Completed
Conditions
Stroke, Acute
Interventions
Other: CT
Registration Number
NCT03670862
Lead Sponsor
Chinese PLA General Hospital
Brief Summary

Prediction model for the Recanalization OuTcome Evaluation of ischemic stroke using multimodal CT (PROTECT) study was a multicenter prospective observational study that recruited patients from 13 centers located in 10 provinces across China. The study was to assess the effects of novel imaging biomarkers/ imaging patterns based on multimodel CT for patients selection and outcome prediction in acute ischemic stroke.

Detailed Description

Patients Patients with cerebral ischemia symptoms of anterior circulation or posterior circulation onset in 24 hours were included. A neurological evaluation (Modified Rankin Scale and NIHSS); physical examination, including measurement of weight (kg) and vital signs (supine systolic and diastolic blood pressure); time from symptom onset to enrollment were recorded.

Imaging protocols:

CT scan protocols: Non-contrast computed tomography(NCCT) , computed tomography angiography(CTA), computed tomography perfusion(CTP)

Contrast agent:

CTA: Omniscan 40-50ml, 5ml/s; saline solution 50ml, 5ml/s

CTP: Omniscan 50ml, 5ml/s; saline solution 50ml, 5ml/s

Imaging evaluation:

CTA was reviewed and stenosis or occlusive lesions were identified. Parameter maps including cerebral blood flow, cerebral blood volume, mean transit time, the time to the maximum of the residue function derived from CTP were processed by the software Rapid to quantitatively assess infarct core volume and mismatch.

Multiphase CTA was extracted from CTP to evaluate the collateral circulation.

Treatment:

Intravenous recombinant tissue plasminogen activator(rtPA), endovascular therapy, and conventional treatment including neuroprotection, anti-platelet, and statin according to the guideline.

Follow up:

Modified Rankin Scale(mRS) was obtained at 90 days after symptom onset. An imaging follow-up was also recommended within 30 days after symptom onset.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
862
Inclusion Criteria
  • Cerebral ischemic sympton with onset in 24 hours
  • All CT examination performed according to study protocol
  • Signed informed consent obtained from the patient or patient's legally authorized representative
Exclusion Criteria
  • Acute intracranial hemorrhage
  • Pre-existing medical, the neurological, or psychiatric disease that would confound the neurological, functional, or imaging evaluations
  • Pregnancy
  • Known allergy to iodine previously refractory to pretreatment medications
  • Renal Failure (serum creatinine > 2.0 or Glomerular Filtration Rate < 30)
  • History of severe kidney disease as an adult, including tumor or transplant surgery, or family history of kidney failure
  • Severe cardiac insufficiency

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
strokeCTIschemic stroke patients with sympton onset in 24 hours
Primary Outcome Measures
NameTimeMethod
90-day functional outcome90 days after symptom onset

Assessed by modified Rankin Scale with scores ranging from 0 (no symptoms) to 6 (death)

Secondary Outcome Measures
NameTimeMethod
Percentage of Hemorrhagic Transformationwithin 7 days after symptom onset

Symptomatic hemorrhagic transformation after acute ischemic stroke

Final infarction volumewithin 30 days after symptom onset

Finding the predictive value of novel imaging biomarkers/ imaging patterns on final infarction volume

Trial Locations

Locations (1)

Chinese PLA General Hospital

🇨🇳

Beijing, Beijing, China

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