Jing De Zhen Shi

Researchers are investigating the use of simple imaging methods compared to standard imaging to select stroke patients with anterior large vessel occlusion for thrombectomy treatment. The goal is to see if using simpler imaging techniques like NCCT and CTA is as effective as using more advanced imaging strategies that include CTP and MRI. This trial tests the hypothesis that simple imaging is not worse than the standard approach when it comes to achieving favorable outcomes after treatment. Participants will be randomly assigned to one of two groups one group will be screened using simple imaging methods NCCT and CTA, while the other group will be screened using standard imaging methods that include NCCT-ASPECTS, CTA, and CTP. Both groups will undergo endovascular treatment based on the imaging selection. The study compares these two imaging strategies to determine their impact on treatment decisions and patient outcomes. During the study, researchers will evaluate patients recovery by assessing favorable outcomes at 90 days after endovascular treatment. They will also monitor for safety concerns such as symptomatic intracranial hemorrhage within 48 hours and mortality at 90 days. Participants must be followed for at least 90 days post-treatment to gather these data. The study aims to provide clear information about the best imaging approach for selecting patients for thrombectomy.

Acute ischemic stroke is a leading cause of death worldwide, and intravenous thrombolysis with recombinant tissue plasminogen activator rt-PA within 4.5 hours of symptom onset is the most effective treatment currently available. However, some patients experience stroke progression and early reocclusion after thrombolysis, which can worsen neurological outcomes. This trial evaluates whether early antiplatelet therapy with oral aspirin, given soon after thrombolysis, can improve recovery without increasing bleeding risks. The study randomly assigns patients to receive either early oral aspirin within 3 hours of starting intravenous thrombolysis or a placebo, alongside the best medical care based on current guidelines. Aspirin is administered as a 300 mg dose, either chewed or given via nasogastric tube if swallowing is difficult. The trial includes a control group receiving placebo under similar conditions to compare outcomes. This is a Phase 3, multicenter, quadruple-blind, randomized clinical trial. During the study, participants will be closely monitored for neurological status and functional recovery using the modified Rankin scale at 30 and 90 days after stroke, as well as other assessments like NIH Stroke Scale scores within the first week. Researchers will track early neurological changes and safety outcomes such as intracranial hemorrhage. Follow-up will include evaluations at multiple time points up to 90 days post-stroke to determine the effects of early antiplatelet treatment on stroke recovery.