Assessing Local Hypothermia and Endovascular Recanalization for Acute Stroke With a Large Core Infarction (RESCUE-LCI)
Assessing Local Hypothermia and Endovascular Recanalization for Acute Stroke With a Large Core Infarction-A Multicenter, Prospective, Open-label, Blinded-Endpoint, Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Zhiming Zhou, PhD
- Phone Number: (++)86-(+)-553-5739543
- Email: neuro_depar@hotmail.com
Study Contact Backup
- Name: Xianjun Huang, PhD
- Phone Number: (++)86-(+)-553-5739543
- Email: doctorhuangxj@hotmail.com
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
General Inclusion Criteria:
- Age ≥18 years old.
- The National Institutes of Health Stroke Scale (NIHSS) score was ≥6 points before randomization.
- Time from symptom onset to randomization ≤24h.
- Patients or their guardians can understand the purpose of the trial, voluntarily participate and sign a written informed consent, and are capable of receiving clinical follow-up.
Specific Neuroimaging Inclusion Criteria
- Prior to randomization, CTA, MRA, or DSA confirmed the presence of anterior circulatory large vessel occlusion (internal carotid artery or M1segment).
- NCCT ASPECTS value of 3 to 5 based on findings from non-contrast CT within 24 hours after stroke onset (defined as the time the patient was last known to be well), with no limitation with respect to infarct-core volume;
- NCCT ASPECTS value of 0 to 2 based on findings from non-contrast CT within 24 hours after stroke onset and an infarct-core volume between 70 ml and 100 ml;
- NCCT ASPECTS value greater than 5 based on findings from non-contrast CT after stroke onset and an infarct-core volume of 70 to 100 ml.
Exclusion Criteria:
- Pre stroke mRS>1 score.
- Multivessel Occlusion
- Concomitant untreated intracranial aneurysms, intracranial tumors (with the exception of small meningiomas), or intracranial vascular malformations.
- History of intracranial hemorrhage within 6 months, including parenchymal hemorrhage, intraventricular hemorrhage, or subarachnoid hemorrhage.
- History of gastrointestinal hemorrhage, genitourinary bleeding, acute myocardial infarction (AMI), cranial trauma, or having undergone major surgical procedures within the past month.
- The presence of active bleeding, severe anemia, coagulation dysfunction, or an uncorrected bleeding tendency (platelet count < 40,000 /μl, uncorrected INR>2.0).
- Patients with heart function of grade 1 or above, or with a clear history of acute or chronic heart dysfunction, are at greater risk of acute heart failure or fluid perfusion intolerance as determined by clinicians.
- Severe heart, liver, kidney disease.
- Known allergy to contrast media or related medications.
- Refractory hypertension uncontrolled by medication (defined as persistent systolic blood pressure >185 mmHg or diastolic blood pressure >110 mmHg).
- glucose <2.8 mmol/L or >22.2 mmol/L;
- Pregnancy or lactation;
- the expected survival time is less than 12 months.
- Participating in other clinical trials, in the investigational phase or in the follow-up phase.
- Other conditions deemed by investigators to pose significant risks or render participation unsuitable (e.g. inability to comply due to psychiatric/cognitive/emotional disorders).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Normothermial group
In the contral group, after crossing the occluded vessel segment with a microcatheter and confirming its location in the true lumen, roomtemperature saline will be extracted from the refrigerator.
50ml will be drawn within 2 minutes and then continuously infused at a rate of 10ml/min using an infusion pump.
After infusion, standard thrombectomy procedures will be performed.
After completion of the thrombectomy procedure (regardless of achieving 2b/3-grade reperfusion), another roomtemperature 300ml of saline will be extracted within 2 minutes and infused at a rate of 30ml/min for 10 minutes through the intermediate catheter or guiding catheter placed in the internal carotid artery.
|
In the contral group, after crossing the occluded vessel segment with a microcatheter and confirming its location in the true lumen, roomtemperature saline will be extracted from the refrigerator.
50ml will be drawn within 2 minutes and then continuously infused at a rate of 10ml/min using an infusion pump.
After infusion, standard thrombectomy procedures will be performed.
After completion of the thrombectomy procedure (regardless of achieving 2b/3-grade reperfusion), another roomtemperature 300ml of saline will be extracted within 2 minutes and infused at a rate of 30ml/min for 10 minutes through the intermediate catheter or guiding catheter placed in the internal carotid artery.
|
|
Experimental: Hypothermia group
In the treatment group, after crossing the occluded vessel segment with a microcatheter and confirming its location in the true lumen, 4℃-saline will be extracted from the refrigerator.
50ml will be drawn within 2 minutes and then continuously infused at a rate of 10ml/min using an infusion pump.
After infusion, standard thrombectomy procedures will be performed.
After completion of the thrombectomy procedure (regardless of achieving 2b/3-grade reperfusion), another 300ml of saline will be extracted within 2 minutes and infused at a rate of 30ml/min for 10 minutes through the intermediate catheter or guiding catheter placed in the internal carotid artery.
Post-infusion, contrast-enhanced cerebral angiography using room temperature contrast agent is generally not recommended to dilute the local temperature.
|
In the treatment group, after crossing the occluded vessel segment with a microcatheter and confirming its location in the true lumen, 4℃-saline will be extracted from the refrigerator.
50ml will be drawn within 2 minutes and then continuously infused at a rate of 10ml/min using an infusion pump.
After infusion, standard thrombectomy procedures will be performed.
After completion of the thrombectomy procedure (regardless of achieving 2b/3-grade reperfusion), another 300ml of saline will be extracted within 2 minutes and infused at a rate of 30ml/min for 10 minutes through the intermediate catheter or guiding catheter placed in the internal carotid artery.
Post-infusion, contrast-enhanced cerebral angiography using room temperature contrast agent is generally not recommended to dilute the local temperature.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Proportion of patients with modified Rankin Score 0-2 at 90 days.
Time Frame: 90±7 days after randomization
|
The modified Rankin Score is an ordinal hierarchical scale ranging from 0 to 6, with higher scores indicating more severe disability.
|
90±7 days after randomization
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Neurofunctional deficit defined as modified Rankin Scale (mRS)
Time Frame: 90±7 days after randomization
|
The modified Rankin Scale (mRS) is a commonly used scale for measuring the degree of disability or dependence in the daily activities of people who have suffered a stroke or other causes of neurological disability.
The scale runs from 0-6 with "0" being perfect health without symptoms to "6" being death.
|
90±7 days after randomization
|
|
Proportion of patients with modified Rankin Score 0-1 at 90 days
Time Frame: 90±7 days after randomization
|
The modified Rankin Score is an ordinal hierarchical scale ranging from 0 to 6, with higher scores indicating more severe disability.
|
90±7 days after randomization
|
|
Proportion of patients with modified Rankin Score 0-3 at 90 days.
Time Frame: 90±7 days after randomization
|
The modified Rankin Score is an ordinal hierarchical scale ranging from 0 to 6, with higher scores indicating more severe disability.
|
90±7 days after randomization
|
|
Rate of symptomatic intracranial hemorrhage within 48 hours (Heidelberg Bleeding Classification)
Time Frame: within 48±12 hours after randomization
|
Intracranial hemorrhage (ICH) was assessed with the Heidelberg Bleeding Classification within 48 hours of endovascular treatment.
Intracranial hemorrhage was classified as hemorrhagic infarction or parenchymal hematoma.
The sICH was defined as ICH associated with a worsening of 4 or more points on the NIHSS or resulting in death, and cerebral herniation, which were not present at baseline.
|
within 48±12 hours after randomization
|
|
All-Cause Mortality within 90 (±7) Days Post-Randomization
Time Frame: 90±7 days after randomization
|
The modified Rankin Scale is a graded ordinal scale that ranges between 0 and 6, where a score of 6 is assigned to indicate mortality.
|
90±7 days after randomization
|
|
Any type of intracranial hemorrhage according to Heidelberg Classification.
Time Frame: within 48±12 hours after randomization
|
Any type of intracranial hemorrhage according to Heidelberg Classification.
|
within 48±12 hours after randomization
|
|
Incidence rate of malignant cerebral edema within 72 (±48) hours post-randomization
Time Frame: 72 (±48) hours post-randomization
|
Patients with MCE were defined as those with: (1) infarct lesions with obvious space-occupying mass effect with more than 50% of the MCA territory and signs of local brain swelling such as sulcal effacement and compression of the lateral ventricle and (2) midline shift of ≥5 mm at the septum pellucidum or pineal gland with obliteration of the basal cisterns
|
72 (±48) hours post-randomization
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
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
Keywords
Additional Relevant MeSH Terms
- Cerebrovascular Disorders
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Vascular Diseases
- Cardiovascular Diseases
- Body Temperature Changes
- Pathological Conditions, Signs and Symptoms
- Signs and Symptoms
- Stroke
- Hypothermia
- Pharmaceutical Preparations
- Crystalloid Solutions
- Isotonic Solutions
- Solutions
- Saline Solution
Other Study ID Numbers
Other Study ID Numbers
- 20250913
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
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