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Ultra-early Identification of Futile Recanalization After Reperfusion Therapy in Acute Ischemic Stroke Based on Cerebral Autoregulation Monitoring (FACTOR)

14. august 2026 oppdatert av: Shen Li, Beijing Shijitan Hospital, Capital Medical University

Ultra-early Identification of Futile Recanalization After Reperfusion Therapy in Acute Ischemic Stroke Based on Cerebral Autoregulation Monitoring: a Multicenter, Prospective, Interventional Study

This multicenter, prospective, and interventional diagnostic accuracy study enrolls patients undergoing thrombectomy with intraoperative cerebral autoregulation monitoring and follows them up at predefined time points up to 90 days post-enrollment.This study aims to evaluate a monitoring system based on cerebral autoregulation function and explore its predictive value for adverse neurological outcomes at the ultra-early stage following mechanical thrombectomy.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Antatt)

227

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studer Kontakt Backup

Studiesteder

  • Kina
      • Beijing, Kina
        • Rekruttering
        • Beijing Shijitan Hospital, Capital Medical University
        • Hovedetterforsker:
          • Shen Li
        • Ta kontakt med:
      • Dalian, Kina
        • Har ikke rekruttert ennå
        • Central Hospital of Dalian University of Technology (Dalian Municipal Central Hospital)
        • Ta kontakt med:
        • Hovedetterforsker:
          • Xiaoyan Lan
      • Heilongjiang, Kina
        • Har ikke rekruttert ennå
        • The First Affiliated Hospital of Harbin Medical University
        • Hovedetterforsker:
          • Guang Zhang
        • Ta kontakt med:
      • Shandong, Kina
        • Rekruttering
        • Weifang People's Hospital Affiliated to Weifang Medical University
        • Hovedetterforsker:
          • Weili Li
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inclusion Criteria:

  1. Age ≥ 18
  2. Diagnosis of acute ischemic stroke caused by anterior circulation large vessel occlusion (intracranial internal carotid artery or M1 segment of the middle cerebral artery).
  3. National Institutes of Health Stroke Scale (NIHSS) score ≥ 6 at presentation.
  4. Pre-stroke modified Rankin Scale (mRS) score ≤ 1.
  5. Symptom onset ≤ 24 hours.
  6. 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.
  7. Underwent mechanical thrombectomy and achieved successful recanalization (mTICI 2b-3).
  8. Patient or legally authorized representative provides written informed consent.

Exclusion Criteria:

  1. Pre-procedural baseline imaging showing significant intracranial hemorrhagic transformation, intracranial arterial dissection, large chronic cerebral infarction, or intracranial metastasis from malignant tumors.
  2. 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.
  3. Known history of carotid sinus hypersensitivity syndrome, severe autonomic dysfunction, sick sinus syndrome, high-grade atrioventricular conduction block, or other malignant arrhythmias.
  4. Refractory malignant hypertensive crisis (systolic blood pressure persistently ≥ 200 mmHg despite standardized intravenous antihypertensive therapy, or hemodynamic instability with shock).
  5. Known severe allergy to contrast agents or anesthetic drugs, or contraindications to antiplatelet/anticoagulation therapy.
  6. Severe systemic active infection, multiple organ failure, or expected survival < 6 months.
  7. 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).
  8. Blood glucose < 2.7 mmol/L or > 22.2 mmol/L.
  9. Heart failure with NYHA class > II, or persistent systolic blood pressure < 100 mmHg.
  10. Central nervous system infection or intracranial tumor.
  11. Unstable vital signs.
  12. Severe alcohol dependence or drug dependence.
  13. Cognitive impairment or psychiatric disorders that may affect follow-up assessments.
  14. Pregnant or breastfeeding women.
  15. Participation in another clinical drug or device study within the past 30 days.
  16. Local skin damage or other conditions preventing proper placement of monitoring electrodes.
  17. Severe agitation or other conditions that interfere with data acquisition.
  18. Any other condition judged by investigators to potentially affect study results.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Diagnostisk
  • Tildeling: N/A
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: 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.
Enhet: NIRS-based cerebral oxygenation and blood pressure monitoring
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.
Fremgangsmåte: Carotid compression test
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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Distribution of Modified Rankin scale
Tidsramme: 90±7days
the distribution of Modified Rankin scale (mRS) [ranging from 0 (normal) to 6 (death)]
90±7days

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Early neurological improvement
Tidsramme: 24±12 hours
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.
24±12 hours

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Beijing Shijitan Hospital, Capital Medical University

Etterforskere

  • Hovedetterforsker: Shen Li, Beijing Shijitan Hospital, Capital Medical University

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

31. juli 2026

Primær fullføring (Antatt)

31. januar 2027

Studiet fullført (Antatt)

5. februar 2027

Datoer for studieregistrering

Først innsendt

31. juli 2026

Først innsendt som oppfylte QC-kriteriene

31. juli 2026

Først lagt ut (Faktiske)

5. august 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

17. august 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

14. august 2026

Sist bekreftet

1. august 2026

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • FACTOR

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

IPD-planbeskrivelse

The deidentified individual participant data underlying this article will not be publicly available. However, the data may be made available to researchers upon reasonable request to the corresponding author, subject to approval by the institutional review board and execution of a data access agreement.

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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