Imaging Collaterals in Acute Stroke (iCAS)

Not Recruiting

Trial ID: NCT02225730

Age - 18 Years-N/A Condition - Stroke, Vascular Diease Gender - All Accepting Healthy Volunteers - No

Purpose

Stroke is caused by a sudden blockage of a blood vessel that delivers blood to the brain. Unblocking the blood vessel with a blood clot removal device restores blood flow and if done quickly may prevent the disability that can be caused by a stroke. However, not all stroke patients benefit from having their blood vessel unblocked. The aim of this study is to determine if special brain imaging, called MRI, can be used to identify which stroke patients are most likely to benefit from attempts to unblock their blood vessel with a special blood clot removal device. In particular, we will assess in this trial whether a noncontrast MR imaging sequence, arterial spin labeling (ASL), can demonstrate the presence of collateral blood flow (compared with a gold standard of the angiogram) and whether it is useful to predict who will benefit from treatment.

Official Title

Imaging Collaterals in Acute Stroke

Stanford Investigator(s)

Paul George, MD, PhD
Paul George, MD, PhD

Assistant Professor of Neurology and, by courtesy, of Neurosurgery

Nirali Vora
Nirali Vora

Clinical Professor, Neurology & Neurological Sciences

Neil Schwartz, MD, PhD
Neil Schwartz, MD, PhD

Clinical Professor, Neurology & Neurological Sciences Clinical Professor (By courtesy), Neurosurgery

Greg Zaharchuk

Professor of Radiology (Neuroimaging and Neurointervention)

Gregory W. Albers, MD
Gregory W. Albers, MD

Coyote Foundation Professor and Professor, by courtesy, of Neurosurgery

Maarten Lansberg, MD, PhD
Maarten Lansberg, MD, PhD

Professor of Neurology and, by courtesy, of Neurosurgery

Marion S. Buckwalter, MD, PhD
Marion S. Buckwalter, MD, PhD

Professor of Neurology and of Neurosurgery

Chitra Venkatasubramanian, MBBS, MD
Chitra Venkatasubramanian, MBBS, MD

Clinical Professor, Neurology & Neurological Sciences Clinical Professor (By courtesy), Neurosurgery

Eligibility


Inclusion Criteria

   1. Age 18 and older

   2. Clinical diagnosis of ischemic stroke and an associated score on the NIHSS of 5 or
   more points

   3. Planned to undergo (or has undergone) intra-arterial (IA) thrombectomy and/or
   thrombolysis for acute hemispheric stroke. (Either as primary therapy or as adjuvant
   therapy following intravenous tPA treatment)

   4. Planned to undergo or has undergone an MR brain scan including MR perfusion imaging
   (ASL & bolus PWI) and MR angiography of the circle of Willis prior to IA therapy

   5. Intra-arterial thrombectomy can be started within 90 minutes of completion of the MR
   perfusion scan and within 24 hours of symptom onset (Start of IA therapy is defined as
   the time of insertion of the femoral artery sheath; Time of brain scan is defined as
   the time that the scan is completed)

   6. Able to obtain informed consent

Exclusion Criteria

   1. Any pre-existing illness resulting in a modified Rankin Scale Score of 2 or higher
   prior to the qualifying stroke

   2. Creatinine clearance < 40 ml/min based on the NIDDK four-variable MDRD method
   (non-weight based)

   3. Documented allergy to MR contrast agent

   4. MRI contraindications (pacemaker, etc.)

   5. Pregnancy

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Not Recruiting

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305
Gregory Zaharchuk, MD
650-723-4448

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