Predictive Multimodal MRI Factors in Subacute Cerebral Artery Occlusiontreated by Thrombectomy (PIMISUTT)

Poitiers University Hospital

Status: Enrolling

Conditions: Middle Cerebral Artery Acute Ischemic Stroke

Treatments: Other: Multimodal MRI

Study type: Interventional

Funder types: Other

Identifiers

NCT04651010

PIMISUTT

2020-A021118-31 (Registry Identifier)

Details and patient eligibility

About

Our study aims to measure metabolic and functional parameters of the infarcted territory by multimodal cerebral MRI in patients diagnosed with unilateral proximal occlusion of the middle cerebral artery and treated by thrombectomy in order to correlate those parameters to clinical outcome (evaluated by modified Rankin score) at 3 months.

We aim to find early radiologic predictive factors for favorable clinical outcome in this population of patients.

Full description

The treatment of acute ischemic stroke in the setting of intracranial large artery occlusion and especially middle cerebral artery occlusion (MCAO) with intravenous tissue plasminogen activator (IV-tPA) is associated with low rates of recanalization and high rates of neurological morbidity and functional dependence.

In the last few years, endovascular intervention (mechanical thrombectomy) has proven its safety and its efficacy on clinical outcome in patients diagnosed with MCAO and is now commonly recommended.

However, in this population of patients treated by thrombectomy, very few predictive factors, except for the post-procedural recanalization score (TICI), do exist to foresee the variability of clinical outcome.

Tissue viability of the infarcted territory can be approached by the measure of metabolic and morphological parameters (Na+, H+, phosphore, diffusion imaging) which can be non-invasively done by multimodal MRI, as suggest by recently published studies.

Our study plans to measure these parameters between 12 and 24 hours after acute ischemic stroke in patients with MCAO treated by thrombectomy in order to correlate those parameters to clinical outcome at 3 months (modifier Rankin Score).

Enrollment: 50 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients aged ≥ 18 years old
• Hospitalized at the Poitiers University Hospital
• Acute middle cerebral artery occlusion diagnosed by CT-scan or MRI
• NIHSS score ≥ 6 at admission
• To be treated by thrombectomy with or without fibrinolysis
• Written information delivered to the patient or his relatives concerning the study and its benefit and risk

Exclusion criteria

• Patients or relatives whom a loyal information about the study cannot be given
• Patient with cognitive impairments before MRI.
• Patients who cannot undergo MRI because of contraindications
• Patients too deteriorated to tolerate one hour long exam

Trial design

Primary purpose: Prevention

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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50 participants in 1 patient group

Multimodal MRI

Experimental group

Treatment:

Other: Multimodal MRI