Ultra-early Identification of Futile Recanalization After Reperfusion Therapy in Acute Ischemic Stroke Based on Cerebral Autoregulation Monitoring (FACTOR)
Ultra-early Identification of Futile Recanalization After Reperfusion Therapy in Acute Ischemic Stroke Based on Cerebral Autoregulation Monitoring: a Multicenter, Prospective, Interventional Study
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
Studietype
Studietype
Inschrijving (Geschat)
Inschrijving
Fase
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
Studiecontact
- Naam: Shen Li
- Telefoonnummer: 010-63925616
- E-mail: lishen@mail.ccmu.edu.cn
Studie Contact Back-up
- Naam: Simeng Wang
- Telefoonnummer: 010-63925615
- E-mail: wsm990419@163.com
Studie Locaties
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Beijing, China
- Werving
- Beijing Shijitan Hospital, Capital Medical University
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Hoofdonderzoeker:
- Shen Li
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Contact:
- Shen Li
- Telefoonnummer: 010-63925616
- E-mail: lishen@mail.ccmu.edu.cn
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Dalian, China
- Nog niet aan het werven
- Central Hospital of Dalian University of Technology (Dalian Municipal Central Hospital)
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Contact:
- Xiaoyan Lan
- Telefoonnummer: +86 15840985380
- E-mail: jinnerlan@hotmail.com
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Hoofdonderzoeker:
- Xiaoyan Lan
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Heilongjiang, China
- Nog niet aan het werven
- The First Affiliated Hospital of Harbin Medical University
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Hoofdonderzoeker:
- Guang Zhang
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Contact:
- Guang Zhang
- Telefoonnummer: +86 13945085063
- E-mail: Zhangguang@hrbmu.edu.cn
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Shandong, China
- Werving
- Weifang People's Hospital Affiliated to Weifang Medical University
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Hoofdonderzoeker:
- Weili Li
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Contact:
- Weili Li
- Telefoonnummer: +86 15169697295
- E-mail: liweili0536@163.com
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Deelname Criteria
Geschiktheidscriteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Age ≥ 18
- Diagnosis of acute ischemic stroke caused by anterior circulation large vessel occlusion (intracranial internal carotid artery or M1 segment of the middle cerebral artery).
- National Institutes of Health Stroke Scale (NIHSS) score ≥ 6 at presentation.
- Pre-stroke modified Rankin Scale (mRS) score ≤ 1.
- Symptom onset ≤ 24 hours.
- For patients with symptom onset within 6 hours: ASPECTS ≥ 6; for patients with symptom onset between 6 and 24 hours: age ≤ 80 years and ASPECTS ≥ 3.
- Underwent mechanical thrombectomy and achieved successful recanalization (mTICI 2b-3).
- Patient or legally authorized representative provides written informed consent.
Exclusion Criteria:
- Pre-procedural baseline imaging showing significant intracranial hemorrhagic transformation, intracranial arterial dissection, large chronic cerebral infarction, or intracranial metastasis from malignant tumors.
- Any degree of stenosis, plaque, dissection, severe tortuosity, or imaging evidence of unstable/vulnerable plaque in the target-side or bilateral common carotid artery or the origin of the internal carotid artery.
- Known history of carotid sinus hypersensitivity syndrome, severe autonomic dysfunction, sick sinus syndrome, high-grade atrioventricular conduction block, or other malignant arrhythmias.
- Refractory malignant hypertensive crisis (systolic blood pressure persistently ≥ 200 mmHg despite standardized intravenous antihypertensive therapy, or hemodynamic instability with shock).
- Known severe allergy to contrast agents or anesthetic drugs, or contraindications to antiplatelet/anticoagulation therapy.
- Severe systemic active infection, multiple organ failure, or expected survival < 6 months.
- Severe hepatic or renal dysfunction (ALT/AST > 3× upper limit of normal; estimated glomerular filtration rate < 30 mL/min) or severe coagulation disorders (platelet count < 40 × 10⁹/L, APTT > 50 s, INR > 3.0).
- Blood glucose < 2.7 mmol/L or > 22.2 mmol/L.
- Heart failure with NYHA class > II, or persistent systolic blood pressure < 100 mmHg.
- Central nervous system infection or intracranial tumor.
- Unstable vital signs.
- Severe alcohol dependence or drug dependence.
- Cognitive impairment or psychiatric disorders that may affect follow-up assessments.
- Pregnant or breastfeeding women.
- Participation in another clinical drug or device study within the past 30 days.
- Local skin damage or other conditions preventing proper placement of monitoring electrodes.
- Severe agitation or other conditions that interfere with data acquisition.
- Any other condition judged by investigators to potentially affect study results.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Diagnostisch
- Toewijzing: NVT
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Geen (open label)
Aantal wapens
Wapens en interventies
Deelnemersgroep / ArmDeelnemersgroep / Arm |
Interventie / BehandelingInterventie / Behandeling |
|---|---|
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Experimenteel: Cerebral Autoregulation Monitoring After Mechanical Thrombectomy
Participants with acute intracranial large vessel occlusion in the anterior circulation who achieve successful recanalization (mTICI 2b-3) after mechanical thrombectomy will undergo bedside cerebral autoregulation monitoring.
Monitoring includes continuous near-infrared spectroscopy (NIRS) to record cerebral oxygen saturation and continuous noninvasive or invasive blood pressure measurement for 25-30 minutes immediately after recanalization.
A carotid compression test is performed to dynamically assess cerebral autoregulation.
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Bedside multimodal cerebral autoregulation monitoring performed immediately after successful mechanical thrombectomy (mTICI 2b-3).
Monitoring includes continuous near-infrared spectroscopy (NIRS) to record cerebral oxygen saturation and continuous noninvasive or invasive arterial blood pressure measurement for 25-30 minutes.
Cerebral oxygenation index (COx) is calculated as a moving Pearson correlation coefficient between mean arterial pressure and cerebral oxygen saturation over 30 consecutive 10-second epochs (300 seconds).
COx ≥ 0.3 indicates impaired cerebral autoregulation, while COx < 0.3 indicates preserved autoregulation.
Changes in cerebral oxygen saturation before and after carotid compression are also used to assess autoregulatory.
A carotid compression test is performed by compressing the common carotid artery at the lower one-third of the neck (avoiding the carotid sinus) against the transverse process of C6 until pulsation disappears for 5-10 seconds, followed by release.
If the brain oxygen saturation has increased compared to before the test, it indicates that the brain's automatic blood flow regulation function is intact; conversely, if it has decreased, it is regarded as a damaged automatic blood flow regulation function of the brain.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Distribution of Modified Rankin scale
Tijdsspanne: 90±7days
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the distribution of Modified Rankin scale (mRS) [ranging from 0 (normal) to 6 (death)]
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90±7days
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Secundaire uitkomstmaten
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Early neurological improvement
Tijdsspanne: 24±12 hours
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Early neurological improvement is defined as a reduction of ≥8 on the National Institutes of Health Stroke Scale [ranging from 0 to 42 points, with higher numbers indicating greater severity] or National nstitutes of Health Stroke Scale zero to one 24 hours after thrombectomy.
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24±12 hours
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Medewerkers en onderzoekers
Sponsor
Sponsor
Onderzoekers
Onderzoekers
- Hoofdonderzoeker: Shen Li, Beijing Shijitan Hospital, Capital Medical University
Studie record data
Bestudeer belangrijke data
Studie start (Geschat)
Studie start
Primaire voltooiing (Geschat)
Primaire voltooiing
Studie voltooiing (Geschat)
Studie voltooiing
Studieregistratiedata
Eerst ingediend
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Eerst geplaatst
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update geplaatst
Laatste update ingediend die voldeed aan QC-criteria
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
Andere studie-ID-nummers
- FACTOR
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Beschrijving IPD-plan
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
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