Hemodynamic Optimization of Cerebral Perfusion After Endovascular Therapy in Patients With Acute Ischemic Stroke

  • STATUS
    Recruiting
  • End date
    Sep 30, 2024
  • participants needed
    814
  • sponsor
    Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau
Updated on 1 October 2021

Summary

Mechanical thrombectomy is a very effective treatment in patients who have suffered an acute ischemic stroke associated with intracranial large vessel occlusion. However, less than half of the patients achieve functional independence despite treatment. The optimization of blood pressure after mechanical thrombectomy based on the degree of recanalization achieved at the end of the procedure could improve the perfusion of the ischemic brain tissue thanks to the improvement of blood circulation provided by collateral circulation. For this, authorized hypotensive or hypertensive drugs will be used. Moreover, this individualized treatment would allow to decrease reperfusion injury and therefore decrease the risk of intracerebral bleeding complications and cerebral edema. Therefore, we designed a clinical trial in which the standard management of blood pressure after mechanical thrombectomy will be compared with a specific protocol in which blood pressure targets are applied according to the degree of recanalization obtained during the thrombectomy procedure. The beneficial effect and risk reduction of this treatment will translate into a better short and long-term outcome

Details
Condition Acute Ischemic Stroke
Treatment Adjusted medication
Clinical Study IdentifierNCT04892511
SponsorFundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau
Last Modified on1 October 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Patients with acute ischemic stroke and large intracranial vessel occlusion within 24 hours after the onset of symptoms in whom mechanical thrombectomy has been performed
Successful recanalization, defined as a TICI score of 2b, 2c, or 3
Previous score on the modified Rankin scale (mRS) of 0, 1, or 2
The patient or her legal representative gives informed written or verbal consent

Exclusion Criteria

ASPECTS score <6
Vertebral, basilar, A2, P2 and M3-4 occlusion
History of intracerebral hemorrhage
Pregnant or breastfeeding patient
Patient with congestive heart failure or recent/unstable coronary artery disease (<3 months)
Dissection of aorta, cervical or cerebral or unruptured aortic / cerebral aneurysm or known arteriovenous malformation
Any bleeding visible on baseline CT
History of ventricular arrhythmias
Use of MAO inhibitors
Inclusion in other clinical trials
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