Ji An Shi

Researchers are studying the safety and effectiveness of early use of tirofiban in patients who have acute ischemic stroke and are treated with tenecteplase. This study is exploring whether adding tirofiban soon after tenecteplase can reduce the risk of blood clot re-blockage in the brain, which happens in some patients after initial treatment. The study is a phase 3 trial aiming to improve stroke outcomes by preventing this reocclusion. Participants first receive tenecteplase intravenously for stroke treatment. Those who meet the study criteria are then randomly assigned to receive either tirofiban or a placebo. Tirofiban or placebo is given intravenously starting as soon as possible after randomization, initially as a higher dose for 30 minutes, followed by a continuous lower dose infusion for nearly 48 hours. After 24 hours, patients receive aspirin andor clopidogrel or their placebos, then after 44 hours, antiplatelet therapy with aspirin andor clopidogrel continues until the 90-day follow-up. During the study, participants undergo assessments including neurological exams and monitoring for bleeding or other adverse events. The main outcome measured is excellent functional recovery 90 days after randomization. Other outcomes include disability levels, neurological improvement, quality of life, bleeding events, and mortality. Safety and serious adverse events are tracked through the 90-day period to evaluate treatment effects and risks.

This observational, prospective, multi-center registry studies patients treated with Medtronic Neurovascular devices for intracranial aneurysms and acute ischemic stroke. It aims to continuously evaluate and report the safety and effectiveness of these market-approved products in real-world clinical practice. The registry includes patients who receive treatment using specific Medtronic devices under conditions MDT16056 and MDT17077. Participants undergo treatment with Medtronic devices designed either for embolization of intracranial aneurysms or for revascularization of blood vessels affected by acute ischemic stroke. The study involves a single-arm design without randomization, monitoring patients receiving standard device treatments as part of routine care. Data are collected during and after treatment to assess outcomes over time. During the study, participants will be followed up to assess clinical success, defined as complete occlusion of the aneurysm without retreatment or significant artery narrowing at one year, and functional independence measured by the modified Rankin Scale score at 90 days. The registry also collects safety and effectiveness data through periodic reporting. Participation may last up to several years, with follow-up visits scheduled according to the standard care and registry protocol to track outcomes and adverse events.

Researchers are evaluating normobaric hyperoxia NBO as a treatment for patients who have experienced an acute ischemic stroke and are transferred for endovascular thrombectomy EVT. The study aims to assess the effectiveness and safety of NBO in improving functional outcomes at 3 months after stroke. Stroke is a leading cause of death and disability, and although reperfusion treatments like thrombectomy improve blood flow, less than half of patients achieve favorable recovery. NBO is thought to protect the brain by rescuing hypoxic tissue and reducing damage processes, with advantages such as low cost and easy use. Participants will be randomly assigned to receive either NBO, which involves inhaling 100% oxygen alongside the best medical care, or best medical care alone. The study compares these two groups to see if NBO provides additional benefits. The treatment is given during the acute phase before or during transfer for EVT. The study includes a single-blind design and follows patients for outcomes over time. During the study, participants will have their disability level measured using the modified Rankin Scale at 90 days and one year after randomization. Other assessments include neurological function scores, imaging scans, infarct volume changes, and quality of life questionnaires at various time points. Safety and recovery progress are closely monitored throughout, with follow-up visits to track long-term effects. The total participation duration includes initial treatment and follow-up through one year.

Researchers are evaluating whether injecting nicardipine directly into the cerebrospinal fluid improves outcomes for patients with cerebral vasospasm caused by aneurysmal subarachnoid hemorrhage. This multi-center, prospective, double-blinded, randomized controlled trial compares two methods of delivering nicardipine through extraventricular drainage EVD or lumbar drainage LD. The study aims to determine which approach leads to a better prognosis for affected patients. Participants in the treatment group receive intrathecal nicardipine injections via EVD or LD catheters. The process involves withdrawing 6 ml of cerebrospinal fluid, injecting 4 ml 4 mg of nicardipine hydrochloride, followed by 2 ml of saline, then clamping the catheter for 2 hours. This dosing is done twice daily. The control group undergoes a simulated procedure without receiving the drug. The drainage tubes remain open as clinically needed between doses. During the study, participants are monitored for outcomes using multiple scales, including the Modified Rankin Scale at 90 and 365 days, Glasgow Outcome Score, MMSE, NIH Stroke Scale, and rates of complications like infections or hemorrhage. Safety is assessed through adverse event tracking. Follow-up visits occur up to one year after treatment. The entire study period spans from the start of treatment to long-term outcome evaluations.