- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03869567
Cone Beam Computed Tomography Following Thrombectomy (Hemathromb)
Cone Beam Computed Tomography Following Thrombectomy : Identification of Hemorrhage and Distinction From Contrast Accumulation Due to Blood-Brain Barrier Disruption
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Until December 2014, intravenous thrombolysis was the only reperfusion therapy proven to be effective within 4 hours of a cerebral infarction and several studies showed a clear functional benefit of thrombectomy in combination with thrombolysis in the first six hours of proximal arterial occlusion. Cerebral haemorrhages following reperfusion treatments involve not only rupture of the blood-brain barrier, but also direct damage to vessels related to the equipment used and secondary toxicity to thrombolytics. The rupture of the blood-brain barrier which results from ischemia / reperfusion is responsible for stagnation of the contrast product on the exams performed after thrombectomy, but it is difficult to distinguish hyperdensities related to the stagnation of contrast product and Hemorrhage on a conventional scanner. Several techniques are available to evaluate the hyperdensities post endovascular cerebral reperfusion including: the dual energy ct, the flat panel CT performed in the angiography room and the conventional scanner. The Cone beam CT is a relevant exam because it is performed in the angiography room and does not require transporting the patient who can be agitated or intubated until the scanner. The reference imaging is the double energy scanner performed at the thrombectomy outlet. Some studies have shown an excellent negative predictive value of the flat panel CT to eliminate haemorrhage in post-thrombectomy but no study directly compared the results of the flat panel with the CT performed in immediate post-thrombectomy and even less with the double energy scanner, it is therefore difficult to assert the sensitivity and exact specificity of this exam to detect and distinguish haemorrhage from contrast stagnation. The investigators propose a direct comparison of the cone beam CT with the dual energy CT performed at the exit of thrombectomy.
Method: consecutive patients presenting acute ischemic stroke candidates to thrombectomy will be enrolled in one hospital center. A cone beam Ct will be performed at the end of the procedure as well as a dual energy CT and finally a CT 24 h after the thrombectomy. Predictive factors of hemorrhage transformation such blood barrier disruption will be studied secondarily.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Cyril Chivot, Dr
- Phone Number: (33)32208757538
- Email: chivot.cyril@chu-amiens.fr
Study Locations
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Amiens, France, 80054
- CHU Amiens-Picardie
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- all patients with cerebral thrombectomy
- Adults
- Patients able to express consent
- Signed written informed consent form
- Covered by national health insurance
Exclusion Criteria:
- minors
- pregnancy or beast feeding
- patient deprived of liberty by administrative or judicial decision or placed under judicial protection (guardianship or supervision)
- obstruction to participate
- non covered by national health insurance
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Cone beam CT
A cone beam CT wll be performed just after thrombectomy on patients with acute ischemic stroke
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Just after thrombectomy, a cone beam CT will be done, while patient is on angiography table, in order to determine if hemorrhage image is due to contrast accumulation or blood-brain barrier disruption.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Hemorrhage presence
Time Frame: up to two days
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hemorrhage presence or not is determined with cone beam and scanner images
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up to two days
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of patients with hemorrhagic transformation
Time Frame: 24 hours from symptom onset
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Any type of parenchyma hemorrhage according to ECASS II criteria (European Cooperative Acute Stroke Study 2).
Scores are HI1, HI2, PH1 or PH2.
HI1 = small petechia around stroke area.
HI2 = confluent petechia in the stroke area.
PH1 = Hematoma with less than 30% stroke weight.
PH2 = Hematoma with more than 30% stroke weight.
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24 hours from symptom onset
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Health deterioration
Time Frame: 24 hours from symptom onset
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Any deterioration in NIHSS score (NIHSS : National Institute of Heath Stroke ) or death combined with intracerebral hemorrhage.
Scale of NIHSS score : 1 to 42.
Minimum score : 1. Maximum score : 42.
1-4 : minor stroke.
5-15 : mild stroke.
15-20 : acute stroke.
More than 20 : major stroke.
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24 hours from symptom onset
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Collaborators and Investigators
Investigators
- Principal Investigator: Cyril Chivot, Dr, CHU Amiens
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- PI2018_843_0027
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
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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