Intracranial Rescue Stenting for Acute Ischemic Stroke, Predictors of Outcomes

NCT04987710 | Unknown DMC

• 1 other identifier: IRSFAIS-POO
• Study Type: interventional
• Target: 25
• Locations: 0 countries
• Sites: N/A

Brief Summary

The use of rescue intracranial stenting is thought to be associated with better outcomes than with patients received medical treatment only after failed thrombectomy as Reperfusion technique. This raised the questions about the factors that affect outcomes of rescue intracranial stenting angioplasty, so the best outcomes can be achieved.

Conditions

Ischemic Stroke; Thromboembolic Stroke

Outcome Measures

Primary Outcomes (1)

• number of participants with good re-perfusion after successful rescue stenting

  this may help in case selection for best outcomes of the procedure

  12 months

Secondary Outcomes (2)

• Compare the clinical outcomes of participants with rescue stenting with those who received medical treatment.

  12 months

• Compare the radio-logical outcomes of participants with rescue stenting with those who received medical treatment.

  12 months

Interventions

intracranial rescue stenting DEVICE

use of intracranial rescue stenting as re-perfusion technique after failed thrombectomy

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients with acute ischemic stroke due to large vessel occlusion as confirmed by CT angiography or Magnetic resonance (MR) angiography.
• Baseline NIHSS \>6.
• Presenting within the first 6 hours from onset of symptoms.
• First ever stroke or pre-stroke modified Rankin Score (mRS) ≤1.

You may not qualify if:

• Patients with intra cranial hemorrhage.
• Patients younger than 18 years.
• Patients with acute ischemic stroke due to small vessel disease or vasculitis.
• Patients with acute ischemic stroke due to occlusion of vessels of posterior circulation.
• Patients who refused to be included in the study.
• Patients with contraindications to intracranial stent placement (as total occlusion of artery).

Sponsors & Collaborators

• Assiut University: lead

Related Publications (12)

• Campbell BC, Mitchell PJ; EXTEND-IA Investigators. Endovascular therapy for ischemic stroke. N Engl J Med. 2015 Jun 11;372(24):2365-6. doi: 10.1056/NEJMc1504715. No abstract available.

  PMID: 26061843 BACKGROUND

• Behme D, Weber W, Mpotsaris A. Acute Basilar Artery Occlusion with Underlying High-Grade Basilar Artery Stenosis: Multimodal Endovascular Therapy in a Series of Seven Patients. Clin Neuroradiol. 2015 Sep;25(3):267-74. doi: 10.1007/s00062-014-0303-9. Epub 2014 Apr 12.

  PMID: 24727890 BACKGROUND

• Gao F, Lo WT, Sun X, Mo DP, Ma N, Miao ZR. Combined Use of Mechanical Thrombectomy with Angioplasty and Stenting for Acute Basilar Occlusions with Underlying Severe Intracranial Vertebrobasilar Stenosis: Preliminary Experience from a Single Chinese Center. AJNR Am J Neuroradiol. 2015 Oct;36(10):1947-52. doi: 10.3174/ajnr.A4364. Epub 2015 Jun 18.

  PMID: 26089317 BACKGROUND

• Stracke CP, Fiehler J, Meyer L, Thomalla G, Krause LU, Lowens S, Rothaupt J, Kim BM, Heo JH, Yeo LLL, Andersson T, Kabbasch C, Dorn F, Chapot R, Hanning U. Emergency Intracranial Stenting in Acute Stroke: Predictors for Poor Outcome and for Complications. J Am Heart Assoc. 2020 Mar 3;9(5):e012795. doi: 10.1161/JAHA.119.012795. Epub 2020 Mar 3.

  PMID: 32122218 BACKGROUND

• Kim GE, Yoon W, Kim SK, Kim BC, Heo TW, Baek BH, Lee YY, Yim NY. Incidence and Clinical Significance of Acute Reocclusion after Emergent Angioplasty or Stenting for Underlying Intracranial Stenosis in Patients with Acute Stroke. AJNR Am J Neuroradiol. 2016 Sep;37(9):1690-5. doi: 10.3174/ajnr.A4770. Epub 2016 Apr 14.

  PMID: 27079369 BACKGROUND

• Baracchini C, Farina F, Soso M, Viaro F, Favaretto S, Palmieri A, Kulyk C, Ballotta E, Nico L, Cester G, Causin F. Stentriever Thrombectomy Failure: A Challenge in Stroke Management. World Neurosurg. 2017 Jul;103:57-64. doi: 10.1016/j.wneu.2017.03.070. Epub 2017 Mar 24.

  PMID: 28347898 BACKGROUND

• Gruber P, Garcia-Esperon C, Berberat J, Kahles T, Hlavica M, Anon J, Diepers M, Nedeltchev K, Remonda L. Neuro Elutax SV drug-eluting balloon versus Wingspan stent system in symptomatic intracranial high-grade stenosis: a single-center experience. J Neurointerv Surg. 2018 Dec;10(12):e32. doi: 10.1136/neurintsurg-2017-013699. Epub 2018 Apr 7.

  PMID: 29627786 BACKGROUND

• Baek JH, Kim BM, Heo JH, Nam HS, Kim YD, Park H, Bang OY, Yoo J, Kim DJ, Jeon P, Baik SK, Suh SH, Lee KY, Kwak HS, Roh HG, Lee YJ, Kim SH, Ryu CW, Ihn YK, Kim B, Jeon HJ, Kim JW, Byun JS, Suh S, Park JJ, Lee WJ, Roh J, Shin BS. Number of Stent Retriever Passes Associated With Futile Recanalization in Acute Stroke. Stroke. 2018 Sep;49(9):2088-2095. doi: 10.1161/STROKEAHA.118.021320.

  PMID: 30354993 BACKGROUND

• Yoon W, Kim SK, Park MS, Kim BC, Kang HK. Endovascular treatment and the outcomes of atherosclerotic intracranial stenosis in patients with hyperacute stroke. Neurosurgery. 2015 Jun;76(6):680-6; discussion 686. doi: 10.1227/NEU.0000000000000694.

  PMID: 25988927 BACKGROUND

• Turan TN, Lynn MJ, Nizam A, Lane B, Egan BM, Le NA, Lopes-Virella MF, Hermayer KL, Benavente O, White CL, Brown WV, Caskey MF, Steiner MR, Vilardo N, Stufflebean A, Derdeyn CP, Fiorella D, Janis S, Chimowitz MI; SAMMPRIS Investigators. Rationale, design, and implementation of aggressive risk factor management in the Stenting and Aggressive Medical Management for Prevention of Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial. Circ Cardiovasc Qual Outcomes. 2012 Sep 1;5(5):e51-60. doi: 10.1161/CIRCOUTCOMES.112.966911. No abstract available.

  PMID: 22991350 BACKGROUND

• Terada T, Tsuura M, Matsumoto H, Masuo O, Yamaga H, Tsumoto T, Itakura T. Complications associated with stenting for cerebral arteries. Interv Neuroradiol. 2003 May 15;9(Suppl 1):165-9. doi: 10.1177/15910199030090S123. Epub 2004 Oct 22.

  PMID: 20591247 BACKGROUND

• Alexander MJ, Zauner A, Chaloupka JC, Baxter B, Callison RC, Gupta R, Song SS, Yu W; WEAVE Trial Sites and Interventionalists. WEAVE Trial: Final Results in 152 On-Label Patients. Stroke. 2019 Apr;50(4):889-894. doi: 10.1161/STROKEAHA.118.023996.

  PMID: 31125298 BACKGROUND

MeSH Terms

Conditions

Ischemic Stroke

Condition Hierarchy (Ancestors)

Stroke; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant lecturer

Study Record Dates

• First Submitted: July 17, 2021
• First Posted: August 3, 2021
• Study Start: January 1, 2022
• Primary Completion: December 31, 2022
• Study Completion: June 30, 2023
• Last Updated: August 3, 2021

Record last verified: 2021-07

Data Sharing

• IPD Sharing: Will not share