Actively Recruiting
Thrombectomy Versus Best Medical Management in Large Vessel Occlusion Stroke Patients Presenting Beyond 24 Hours and With Presence of Collateral Flow on CT Angiography
Led by Tianjin Huanhu Hospital · Updated on 2024-10-23
350
Participants Needed
1
Research Sites
183 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
The goal of this clinical trial is to investigate if endovascular treatment (EVT) can effectively treat patients with large vessel occlusion (LVO) who present beyond the typical 24-hour window after symptom onset. The main questions it aims to answer are: * Can EVT improve functional independence at 90 days for patients treated after 24 hours? * What is the safety profile of EVT in this delayed treatment group compared to best medical management (BMM)? Researchers will compare EVT outcomes in patients presenting after 24 hours to those receiving BMM to see if EVT offers significant benefits. Participants will: * Receive either EVT or BMM based on their eligibility. * Undergo CT angiography to assess collateral circulation and to confirm the presence of LVO. * Be followed for 90 days to evaluate functional outcomes and safety measures.
CONDITIONS
Official Title
Thrombectomy Versus Best Medical Management in Large Vessel Occlusion Stroke Patients Presenting Beyond 24 Hours and With Presence of Collateral Flow on CT Angiography
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Confirmed occlusion in the internal carotid artery or middle cerebral artery (M1 segment) by MRA or CTA.
- Moderate to good collateral blood flow shown by CT angiography.
- Age 18 years or older.
- National Institutes of Health Stroke Scale score of 2 or higher before randomization.
- Ability to start endovascular treatment between 24 and 72 hours after stroke onset.
- No significant disability before stroke (modified Rankin Scale score 0-2).
- Willing and able to attend follow-up visits.
- Signed informed consent by patient or legal representative.
You will not qualify if you...
- Serious, advanced, or terminal illness with life expectancy under six months.
- Medical, neurological, or psychiatric conditions interfering with evaluations or participation in another drug/device study.
- Pregnancy.
- Contraindications for MRI or CT contrast that prevent required imaging studies.
- Known allergy to iodine not responsive to pretreatment.
- Treatment with tPA more than 4.5 hours after last known well time.
- Known bleeding disorders or recent anticoagulant therapy with high INR.
- Stroke symptoms in multiple brain areas.
- Seizures at stroke onset making diagnosis uncertain.
- Extremely low or high blood glucose levels at baseline.
- Very low platelet count at baseline.
- Severe hypertension not treatable with medication.
- Participation in other investigational studies or registries.
- Suspected septic embolus, bacterial endocarditis, or cerebral vasculitis.
- Clot removal attempted within 24 hours of symptom onset.
AI-Screening
AI-Powered Screening
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Trial Site Locations
Total: 1 location
1
Tianjin Huanhu Hospital
Tianjin, Tianjin Municipality, China, 300070
Actively Recruiting
Research Team
M
Ming Wei, MD, PhD
CONTACT
Y
Yongbo Xu, MD
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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