Jing De Zhen Shi

Researchers are studying stroke patients with large vessel blockage in the brain to see if a simpler imaging method can effectively select patients for a procedure called thrombectomy. This trial compares the usual detailed imaging approach using CT perfusion or MRI with a simpler method using only NCCT and CTA scans. The goal is to find out if this simpler imaging is as good as the standard method in helping patients achieve favorable outcomes after treatment. Participants will be randomly assigned to one of two groups. One group will be screened using the simplified imaging strategy involving NCCT and CTA scans, while the other group will undergo the standard screening that includes NCCT-ASPECTS, CTA, and CT perfusion imaging. Both approaches are used to decide eligibility for endovascular treatment to remove the blood clot. The study includes patients arriving within 24 hours of stroke onset and uses imaging to guide treatment decisions. During the study, patients will be assessed for clinical outcomes 90 days after the thrombectomy procedure to determine treatment success. Researchers will monitor stroke severity, functional recovery, and safety. Follow-up evaluations will ensure data on patient progress and any complications are collected. Participation involves initial imaging screening, treatment if eligible, and follow-up visits lasting at least 90 days post-treatment to measure results and recovery.

Stroke is the second leading cause of death worldwide, with ischemic stroke being the most common type. The current best treatment for acute ischemic stroke is intravenous thrombolysis using recombinant tissue plasminogen activator (rt-PA) given within 4.5 hours of symptom onset. However, some patients experience stroke progression or early blood vessel reocclusion after thrombolysis, which worsens neurological function and outcomes. This is believed to be caused by increased platelet activation after thrombolysis, which peaks within the first 2 hours. This clinical trial is testing whether starting oral aspirin early after intravenous thrombolysis can improve functional outcomes without causing more bleeding problems. Patients are randomly assigned to receive either 300 mg aspirin tablets or matching placebo tablets as soon as possible after enrollment. If swallowing is difficult, tablets can be crushed and given through a nasogastric tube. Both groups receive best medical management according to guidelines. The study is a Phase 3, multicenter, randomized, placebo-controlled trial. Participants will be followed for 90 days after stroke to measure their functional recovery using the modified Rankin scale (mRS). Researchers will check if patients have a good outcome defined as an mRS score of 0 or 1 at 90 days. During the study, patients undergo assessments including neurological exams and imaging to confirm eligibility and monitor safety. The trial aims to determine if early aspirin treatment after thrombolysis is safe and can help prevent neurological decline and improve recovery.