Perfusion Imaging Evaluation for Ischemic Stroke on 6-24 Hours Undergoing Endovascular Thrombectomy (PESET)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study design is a prospective, single-center study of acute ischemic stroke patients with large artery occlusion in 6-24 hours of stroke onset. According to patients or their family members' willing, patients who meet the inclusion criteria will be assigned to endovascular thrombectomy group with approved devices (only the devices listed in this protocol are approved for us) plus standard medical therapy or control group (standard medical therapy alone) after undergoing either CT Perfusion or MR Perfusion studies. Patients who have evidence of an ICA or MCA M1 or M2 or BA occlusion and a Target Mismatch Profile will be enrolled.
The intent of this study is to support thrombectomy beyond the currently labeled 8 hour indicated time limit in wake up, unclear onset, and late presenting ischemic stroke subjects, who currently have no other option besides medical management of their symptoms, with careful selection.
The study will enroll up to 55 patients. The primary endpoint, the modified Rankin Score, will be assessed at 3 months.
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Zhejiang
-
Hangzhou, Zhejiang, China, 310009
- Recruiting
- Second Affiliated Hospital, School of Medicine, Zhejiang University
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Clinical Inclusion Criteria:
- Clinical signs and symptoms consistent with the diagnosis of an acute ischemic stroke
- Age ≥18 years
- NIHSS ≥ 6
- Endovascular thrombectomy can be initiated (femoral puncture) between 6 and 24 hours after time last know well
- No significant pre-stroke disability (pre-stroke mRS must be ≤ 3 )
- Patient/Legally Authorized Representative has signed the Informed Consent form
Imaging Inclusion Criteria:
- ICA or MCA-M1 or MCA-M2 or BA occlusion (carotid occlusions can be cervical or intracranial with or without tandem MCA lesions) as evidenced by MRA or 4D-CTA
- Target Mismatch Profile on CT perfusion or MR perfusion: ischemic core volume is ≤ 70 ml, mismatch ratio is >/= 1.2 )
Exclusion Criteria:
Clinical Exclusion Criteria:
- Other serious, advanced, or terminal illness (investigator judgment) or life expectancy is less than 90 days
- Subject with a co-morbid disease or condition that would confound the neurological and functional evaluations or compromise survival or ability to complete follow-up assessments
- Unable to undergo a contrast brain perfusion scan with either MRI or CT
- Pregnant
- Known serious sensitivity to radiographic contrast agents
- Treated with rtPA >6 hours after time last known well
- Known hereditary or acquired hemorrhagic diathesis, coagulation factor deficiency; recent oral anticoagulant therapy with INR > 3 (recent use of one of the new oral anticoagulants is not an exclusion if estimated GFR > 30 ml/min).
- Seizures at stroke onset if it precludes obtaining an accurate baseline NIHSS
- Current participation in another investigational drug or device treatment study
- Known hereditary or acquired hemorrhagic diathesis, coagulation factor deficiency
- Any other condition that, in the opinion of the investigator, precludes an endovascular procedure or poses a significant hazard to the subject if an endovascular procedure was performed.
Neuroimaging Exclusion Criteria:
- ASPECTS score <6 on non-contrast CT (if patient is enrolled based on CT perfusion criteria)
- Evidence of intracranial tumor (except small meningioma), acute intracranial hemorrhage, neoplasm, subarachnoid hemorrhage, or arteriovenous malformation
- Significant mass effect with midline shift
- Evidence of internal carotid artery dissection
- Intracranial stent implanted in the same vascular territory, known history of arterial tortuosity, and/or other arterial disease that precludes the safe deployment/removal of the thrombectomy device
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Endovascular Thrombectomy
Procedure: Endovascular Thrombectomy Device: Trepo trevor Retriever Device: Solitaire™ FR Revascularization Device
|
Procedure: Endovascular Thrombectomy Device: Trepo trevor Retriever Device: Solitaire™ FR Revascularization Device
Procedure:Endovascular Thrombectomy Device: Solitaire™ FR Revascularization Device
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Good Functional Independence
Time Frame: 90 days
|
This outcome will look at the proportion of patients with mRS 0-2 at day 90.
|
90 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Death
Time Frame: 90 days
|
Death
|
90 days
|
|
Symptomatic Intracranial Hemorrhage
Time Frame: 24 hours
|
Defined as NIHSS worsening of 4 or more points associated with ICH within 24 hours of randomization
|
24 hours
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: MIN LOU, Ph.D., Second Affiliated Hospital, School of Medicine, Zhejiang University
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- yan2017-150
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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