Brain Diseases, Brain Infarction, Central Nervous System Diseases, Cerebrovascular Disorders, Nervous System Diseases, Stroke, Acute, Vascular Diseases
Conditions
Keywords
stroke, Mechanical thrombectomy, Proximal intracranial arterial occlusions, Large vessel occlusion, acute neurological deterioration, Outcome
Brief summary
This multicenter registry study, which record the therapy strategy and follows up these acute ischemic stroke (AIS) patients with low NIHSS and large vessel occlusion (LVO), is intended to provide the important data for therapy evaluation and prognostic prediction of the LVO patients with low NIHSS.
Detailed description
It was reported that about two third of the stoke patients might present with minor or mild stroke symptoms. 20-40% of those minor stroke patients had large vessel occlusion (LVO). AIS patients with LVO and low NIHSS are common and has been associated with early neurological deterioration and worse outcomes. Until now, the best therapy strategy for the acute stoke patients with minor stroke and large vessel occlusion is unknown. Thus, we sought to (1) explore the potential predictors of acute neurological deterioration and 90-day clinical outcome; (2) and evaluate the best therapy strategy.
Interventions
OTHERImmediate endovascular therapy
The best medical therapy includes intravenous fibrinolysis, anticoagulants or antiplatelet, but NOT any immediate endovascular therapies.
Sponsors
Sir Run Run Shaw Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Aged 18 years or older 2. Acute ischemic stroke patients of NIHSS 0-5 with 24 hours after onset 3. Proximal intracranial artery occlusion on NCCT/CTA or MRI/MRA showing occlusion of the intracranial ICA, M1, or proximal M2 vessel 4. Baseline ASPECTS ≥6 or infarct Core Volume of \< 70 on NCCT/DWI/CTP 5. Pre-mRS≤1
Exclusion criteria
1. Any sign of intracranial hemorrhage on baseline CT/MR; 2. Seizures at stroke onset 3. Baseline blood glucose of \<2.78 mmol or \>22.20 mmol, or platelet count \< 100,000/uL or serum creatinine levels \> 3.0 mg/dL 4. Participation in any investigational study in the previous 30 days
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| modified Rankin Scale at 90 days | 90 days | modified Rankin Scale at 90 days |
| acute neurological deterioration | 24 hours | It is neurological deterioration of presumed ischemic origin with an NIHSS score increase of 4 points or more within the 24 hours after onset. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of symptomatic intracerebral hemorrhage | 2-3 days | Incidence of symptomatic intracerebral hemorrhage according to ECASS II criteria |
| patients with good outcome comparing the two treatment groups | 90 days | Good outcome is defined as a score of 0-2 on the 90-day mRS |
Countries
China
Outcome results
None listed