Improving Low ASPECTS Stroke Thrombectomy (I-LAST)

Universitätsklinikum Hamburg-Eppendorf

Status: Enrolling

Conditions: Acute Ischemic Stroke

Treatments: Other: Telephone call on day 90; Diagnostic Test: Quantification of lesion water uptake by CT densitometry

Study type: Observational

Funder types: Other

Identifiers

NCT04862507

I-LAST

Details and patient eligibility

About

Improving Low ASPECTS Stroke Thromectomy (I-LAST) is an academic, independent, prospective, multicenter, observational registry study. Consecutive patients treated with endovascular stroke treatment will be enrolled in German stroke centers. Patients receive regular care and data will be collected as part of clinical routine. Baseline clinical and procedural information as well clinical follow-up information during in-hospital stay, and up to 90 days of stroke onset are collected. Data collected include demographics, National Institute of Health Stroke Scale (NIHSS) on admission, pre-treatment ASPECTS, information on timing and success of interventional treatment, procedural complications, intracranial hemorrhage, and functional outcome. Advanced imaging biomarkers will be tested and validated aiming to improve treatment selection and outcome prediction of patients presenting with extensive baseline infarction.

Full description

This study aims to investigate the role of advanced imaging biomarkers in patients with large early infarct, in particular quantitative lesion water uptake (Minnerup et al. Annals of Neurology 2016), arterial and venous collateral circulation (Faizy et al. Radiology 2021), and multivariate CTP-derived parameters (Kemmling et al. JCBFM 2015). The goal is to use these imaging biomarkers as specific selection criterion to predict clinical benefit after reperfusion despite extensive baseline infarct lesions, also as a method of monitoring adjuvant neuroprotective agents after reperfusion therapy (for instance anti-edematous medication).

Enrollment: 500 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Clinical diagnosis of acute ischemic stroke
• ASPECTS of 0-5
• Confirmed diagnosis of persistent occlusion of terminal carotid artery, middle cerebral artery (M1 or M2), or basilar artery consistent with symptoms
• Age >18 years
• Ethic approval in process

Exclusion criteria

none

Trial design

500 participants in 2 patient groups

Stroke Patients with an ASPECTS of 0-5 on baseline neuroimaging undergoing thrombectomy

Description:

acute stroke patients treated with endovascular treatment combined with thrombolysis or without previous thrombolysis Intervention.

Treatment:

Diagnostic Test: Quantification of lesion water uptake by CT densitometry

Other: Telephone call on day 90

Stroke Patients with an ASPECTS of 0-5 on baseline neuroimaging not undergoing thrombectomy

Description:

acute stroke patients treated with or without thrombolysis

Treatment:

Diagnostic Test: Quantification of lesion water uptake by CT densitometry

Other: Telephone call on day 90