- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04201964
Improving Neuroprotective Strategy for Ischemic Stroke With Poor Recanalization After Thrombectomy by Intra-arterial TNK (INSIST-TNK)
May 23, 2023 updated by: Hui-Sheng Chen
Improving Neuroprotective Strategy for Ischemic Stroke With Poor Recanalization After Thrombectomy by Intra-arterial TNK (INSIST-TNK): a Prospective, Single Arm, Pilot Study
In 2015, five randomized trials showed efficacy of endovascular thrombectomy over standard medical care in patients with acute ischemic stroke caused by occlusion of arteries of the proximal anterior circulation.
However, sufficient recanalization (mTICI2b-3) can 't be acquired in all patients under thrombectomy.
There is a lack of evidence that whether salvage intra-arterial thrombolysis is beneficial for patients with insufficient recanalization after endovascular thrombectomy.
The EXTEND-IA TNK study indicated that tenecteplase before thrombectomy was associated with a higher incidence of reperfusion and better functional outcome than alteplase among patients with ischemic stroke treated within 4.5 hours after symptom onset.
This study intends to explore the proportion of sufficient recanalization (2b/3) after intra-arterial tenecteplase administration in patients undergoing thrombectomy with insufficient recanalization (1/2a).
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Estimated)
30
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Zi-Ai Zhao, Doctor
- Phone Number: +86 17790998175
- Email: zhaoziai@hotmail.com
Study Contact Backup
- Name: Lin Tao, Master
- Phone Number: +86 18802401698
- Email: 1939908868@qq.com
Study Locations
-
-
-
ShenYang, China, 110840
- Recruiting
- General Hospital of Northern Theater Command
-
Contact:
- Zi-Ai Zhao
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Age ≥18 years;
- Patients who presented with acute ischemic stroke and a large vessel occlusion in the anterior circulation and met the criteria of mechanical thrombectomy;
- insufficient perfusion (mTICI 1/2a) after endovascular treatment;
- The availability of informed consent.
Exclusion Criteria:
- Sufficient recanalization (TICI 2b-3);
- More than 3 times of thrombectomy device passes
- Hemorrhagic stroke: cerebral hemorrhage, subarachnoid hemorrhage
- Coagulation disorders, systematic hemorrhagic tendency, thrombocytopenia ( <100000/mm3)
- Severe hepatic or renal dysfunction, increase in ALT or AST (more than 2 times of upper limit of normal value), increase in serum creatinine (more than 1.5 times of upper limit of normal value) or requiring dialysis
- Severe uncontrolled hypertension (systolic blood pressure over 200mmHg or diastolic blood pressure over 110 mmHg)
- Patients allergic to any ingredient of drugs in our study
- Unsuitable for this clinical studies assessed by researcher
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Intra-arterial administration of tenecteplase
Intra-arterial administration of tenecteplase (0.2-0.4 mg/min) immediately after thrombectomy device pass for 30-40 minutes.
|
Intra-arterial administration of tenecteplase (0.2-0.4 mg/min) immediately after thrombectomy device pass for 30-40 minutes.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Proportion of sufficient recanalization
Time Frame: immediately after local TNK treatment
|
sufficient recanalization is defined as TICI 2b-3
|
immediately after local TNK treatment
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Proportion of favorable outcome
Time Frame: 90 days
|
favorable outcome is defined as mRS 0-2
|
90 days
|
proportion of early neurological improvement
Time Frame: 48 hours
|
early neurological improvement is defined as more than 4 decrease in NIHSS
|
48 hours
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
incidence of symptomatic intracranial haemorrhage
Time Frame: 48 hours
|
intracranial haemorrhage is defined as more than 4 increase in NIHSS caused by intracranial bleeding
|
48 hours
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
December 15, 2019
Primary Completion (Estimated)
December 30, 2023
Study Completion (Estimated)
December 30, 2023
Study Registration Dates
First Submitted
December 15, 2019
First Submitted That Met QC Criteria
December 15, 2019
First Posted (Actual)
December 17, 2019
Study Record Updates
Last Update Posted (Actual)
May 25, 2023
Last Update Submitted That Met QC Criteria
May 23, 2023
Last Verified
May 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Necrosis
- Cardiovascular Diseases
- Vascular Diseases
- Cerebrovascular Disorders
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Brain Ischemia
- Infarction
- Brain Infarction
- Stroke
- Ischemic Stroke
- Ischemia
- Cerebral Infarction
- Molecular Mechanisms of Pharmacological Action
- Fibrinolytic Agents
- Fibrin Modulating Agents
- Tenecteplase
Other Study ID Numbers
- k(2019)30
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
No
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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