- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05299034
Optimizing the Radiological Selection and Transfer Model in Stroke Patients Presenting 6-24h After Onset (VESTA Study) (VESTA)
Treatment of Stroke in the Extended Window: Optimization of the Radiological Selection and Transfer Model in Patients With a Stroke Presenting 6-24h After Symptoms Onset (VESTA Study)
We aim to optimize the radiological selection and the transfer model in patients with a 6-24h stroke for a fairer and broader access to a reperfusion treatment. The specific objectives are:
- To confirm that the selection of patients for reperfusion therapies in the late window is safe by applying the same clinical and imaging criteria recommended by clinical guidelines for the early window treatment selection.
- To evaluate the performance of non-contrast CT by applying immediate post-processing software for the selection of patients for reperfusion treatment in the late window.
- To analyze the prehospital and arrival variables at the primary stroke center to generate decision trees that optimize the transfer decision in patients with activation of the stroke code in >6h from the onset of symptoms.
METHODOLOGY: Study based on a mandatory, prospective, multicenter registry (CICAT registry) consisting of two phases
- retrospective analysis with a detailed evaluation of the images of the included patients and generation of "machine learning" models that accurately predict the probability of receiving reperfusion treatment in the late window.
- validation of the models in a prospective study. Clinical, radiological and transport variables will be studied.
Response variables: rate of patients receiving reperfusion treatment in the late window, functional prognosis at 90 days, hemorrhagic transformation, and mortality.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
-
-
Barcelona
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Badalona, Barcelona, Spain, 08916
- Germans Trias i Pujol Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
SUBSTUDY 1. OPTIMIZATION OF IMAGING SELECTION METHODS FOR SELECTING STROKE PATIENTS FOR REPERFUSION TREATMENT IN THE EXTENDED WINDOW.
- Inclusion criteria: Consecutive patients registered in the CICAT registry between the years 2019 and 2021 with a stroke who meet the following criteria
- Age older than 18 years,
- Diagnosis of acute cerebral infarction,
- More than six hours of evolution or uncertain chronology of symptoms,
- Absence of disability prior to stroke (modified Rankin score 0-2),
- NIHSS score>5,
- Neuroimaging study including at least one non-contrast cranial CT scan within 60 minutes of arrival at the hospital center.
SUBSTUDY 2. OPTIMIZATION OF CIRCUITS AND TRANSFER MODEL IN PATIENTS WITH STROKE IN THE EXTENDED WINDOW OF TREATMENT.
Inclusion criteria: Selection of consecutive, prospective patients to be included in the CICAT registry between January 2023 and March 2024 with stroke meeting the following criteria:
- Age over 18 years,
- Suspicion of acute cerebral infarction,
- More than six hours of evolution or uncertain chronology of symptoms,
- absence of pre-stroke disability (modified Rankin score 0-2),
- NIHSS score greater than 5.
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Stroke patients 6-24h receiving non-contrast CT + CTA
Stroke patients 6-24h undergoing non-contrast CT + CTA to decide stroke therapy
|
NCCT+CTA
|
Stroke patients 6-24h receiving multimodal imaging
Stroke patients 6-24h undergoing NCCT+CTA+CTP or MRI with DWI and PWI imaging to decide stroke therapy
|
MR perfusion or multiparametric CT including NCCT, CTA and CTP
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
mRS at 90 days
Time Frame: 90 days after stroke
|
Percentage of patients with functional independence, defined as mRS < or =2 on day 90 as assessed centrally by blinded evaluators of the Catalan Stroke Master Plan.
|
90 days after stroke
|
Rate of patients treated with mechanical thrombectomy
Time Frame: less than 24 hours after the diagnostic test
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less than 24 hours after the diagnostic test
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Mortality at discharge and at day 90
Time Frame: 90 days after stroke
|
90 days after stroke
|
Symptomatic intracerebral hemorrhage, defined as PH2 or SAH on imaging test at 24-72 hours associated with a worsening in NIHSS ≥ 4 points
Time Frame: From 24 to 72 hours after stroke
|
From 24 to 72 hours after stroke
|
Collaborators and Investigators
Sponsor
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
- PI21/01548
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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