Stroke, Acute, Stroke, Ischemic
Conditions
Keywords
reperfusion, IVT
Brief summary
This is an observational prospective study about the reperfusion rate of intravenous thrombolysis on ischemic stroke patients with large vessel occlusions and predictor factors of successful recanalization.
Detailed description
Stroke is one the most common cause of mortality and disabilities in the world, with the highest incidence in East Asia. Current American Stroke Association (ASA) and European Stroke Organisation (ESO) guidelines recommend bridging therapy with IVT for all eligible patients before indicating endovascular thrombectomy (EVT) for those with large vessel occlusions (LVO). Nevertheless, the decision to use IVT on stroke patients with LVO is still debatable, with many arguments against and supporting combined therapy or direct mechanical thrombectomy. At present, guideline in our hospital advocates the use of IVT in all patients who meet eligibility criteria and present within the 4,5 hour window for anterior circulation stroke and within 24 hour window for posterior circulation stroke. Due to the overcrowded nature of our center as a high-end specialization establishment in Vietnam, it is noted that our door-to-groin time is sub-optimal. This fact inadvertently prolongs the time of action of intravenous tissue-type plasminogen activator before the re-assessment of occlusion site on interventional radiography. Therefore, it is possible for us to better estimate the reperfusion effectiveness of IVT as well as analyse other factors that might have an influence on this rate. The goal of our study is to determine the recanalization rate of IVT and related predictor factors in AIS patients.
Interventions
DRUGPlasminogen Activators
standard dosage of 0.9 mg/kg or reduced dosage of 0.6 mg/kg, divided into a 15% bolus and an 85% venous infusion
Sponsors
University of Medicine and Pharmacy at Ho Chi Minh City
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Age 18 and older with consent form signed. 2. Patients hospitalized in 115 People's Hospital for acute ischemic stroke. 3. Patients receiving full dose of IVT, with a confirmed LVO (including MCA M1, MCA M2, ICA, BA and VA) on angiography and repeat vascular imaging within 24 hours of hospitalization.
Exclusion criteria
1. Patients with evidence of chronic occlusion of large vessels. 2. Patients without source angiography data to assess the characteristics of thrombus
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| reperfusion rate | within 24 hours of hospitalization | the reperfusion rate of intravenous thrombolysis in acute ischemic stroke with large vessel occlusion first confirmed by angiography and assessed later by a vascular imaging modality. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| symptomatic intracerebral hemorrhage | 48 hours after initiation of IVT | incidence of symptomatic intracerebral hemorrhage 48 hours after initiation of IVT |
Countries
Vietnam
Contacts
Primary ContactTINH Dang Quang, MD
Outcome results
None listed