Ischemic Stroke
Conditions
Brief summary
Neurocardiology is an emerging specialty that addresses the interaction between the brain and the heart, i.e. the effects of cardiac injury on the brain, and the effects of brain injury on the heart. Accumulating clinical and experimental evidence suggests a causal relationship between brain damage and heart dysfunction.
Interventions
DEVICEMOSTCAREup Monitoring
The patients will be equipped with mini-invasive hemodynamic monitoring (the MOSTACAREup system). The MOSTCAREup obtains the hemodynamic data from either the same arterial femoral line used by the neuro-radiologist to perform the treatment or from a dedicated radial artery, as decided by the attending anesthetist to monitor and optimize arterial pressure (the decision to use the arterial line is at discretion of the attending anesthetist for clinical reasons and does not delay the procedure, which starts using always the femoral access).
DEVICEEcocardiography
Echocardiography will be performed 1) soon after the end of the treatment (whenever possible, avoiding delays, before od during the treatment in the angiography room); 2) at day 1 after the procedure; 3) at day 3 after the procedure.
Sponsors
Ospedale Policlinico San Martino
Humanitas Clinical and Research Center
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
1. Adult patients aged ≥ 18 years. 2. Acute supratentorial or carotid stroke.
Exclusion criteria
1\. Invasive arterial signal unsuitable to obtain hemodynamic data. 2. Emergency neurosurgery needed before intra-arterial treatment. 3. Once enrolled, the patient can be excluded from the study because of one of the following intraoperative conditions: 1. Intraoperative technical limitations limiting or impeding the arterial re-opening 2. Persistent low quality of the arterial signal. After positioning the patient and zeroing the arterial signal, the arterial waveform is checked for quality by means of a square-wave test and optimized in the case of the occurrence of under or over-damping.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cardiac output measurement | Up to 6 hours after clot removal | Changes of cardiac output of the enrolled patients before and after clot removal. |
| Arterial elastance measurement | Up to 6 hours after clot removal | Changes of arterial elastance of the enrolled patients before and after clot removal. |
| Arterial blood pressure measurement | Up to 6 hours after clot removal | Changes of arterial blood pressure of the enrolled patients before and after clot removal. |
| Heart rate variability measurement | Up to 6 hours after clot removal | Changes of heart rate variability of the enrolled patients before and after clot removal. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Transthoracic echocardiography | at the admission | Ejection Fraction measurement |
| Transthoracic Echocardiography | up to 3 weeks after clot removal | wave E assessment |
Countries
Italy
Outcome results
None listed