Rescue Intracranial Stenting in Acute Ischemic Stroke

Study Overview
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Brief Summary
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In acute ischemic stroke caused by intracranial large vessel occlusion, rescue intracranial stenting has been recently a treatment option to achieve recanalization in patients with the failure of mechanical thrombectomy. Nevertheless, there are few studies supporting this beneficial treatment in two cerebral circulations. We aimed to analyse whether the use of rescue intracranial stenting would improve prognosis of patients at 3 months.

Detailed Description
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In Asia population, large intracranial arterial stenosis lesion accounts for more than 30% in common causes of ischemic stroke, compares with about 10% in Caucasian population every year. Normally, in human brain, there are about 130 billion neurons but they are lost equivalent to their losses in approximately 3.6 years of normal aging in case of a large vessel ischemic stroke untreated each hour. Consequently, after the success of 5 randomized controlled trials about the mechanical thrombectomy, which have been done from December 2010 to December 2014, all of guidelines recommended this technique as the first-line treatment in acute ischemic stroke. However, the HERMES meta-analysis showed that revascularisation failure ratio 28.9% in patients older than 80 years. Recently, in case of mechanical thrombectomy failure, many studies suggested the rescue intracranial stenting could be alternative urgently needed treatment to achieve permanent recanalization which is one of the most important factors impacting on clinical outcomes after acute ischemic stroke. Hence, the aims of our study were to assess both the non-poor outcome at 3 months and the symptomatic intracerebral hemorrhage relating to procedure in patients receiving rescue intracranial stenting.

Official Title
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Rescue Intracranial Stenting in Acute Ischemic Stroke

Conditions
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Acute Stroke, Ischemic Stroke, Intracranial Atherosclerosis, Stent Stenosis, Cerebral Ischemia, Stent Occlusion, Stroke, Ischemic, Intracranial Hemorrhages, Thrombotic Stroke, Acute

Intervention / Treatment
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* Procedure: Rescue intracranial stenting


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Evidence of intracranial large vessel occlusion. Absence of intracranial hemorrhage. Severe stenosis or reocclusion after mechanical thrombectomy. Exclusion Criteria: Tandem lesion. Loss to follow-up after discharge. A severe or fatal combined illness before acute ischemic stroke.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 105 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Rescue Intracranial Stenting (RIS)<br>RIS in Acute Ischemic Stroke caused by intracranial large vessel occlusion | Procedure: Rescue intracranial stenting<br>* Rescue Intracranial Stenting in Acute Ischemic Stroke caused by intracranial large vessel occlusion<br>* Other names: RIS;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The non-poor 3-month outcome rate. | The non-poor 3-month outcome rate was accessed by modified Rankin Score (mRS), which comprised of included good (mRS 0 - ≤ 2) and fair (mRS 3). | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The symptomatic intracerebral hemorrhage rate. | The symptomatic intracerebral hemorrhage was defined as patient's intracerebral hemorrhage with postprocedural mRS ≥ 5 and there were no other evident causes for the increased mRS. | 24 hours after rescue intracranial stenting. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Acute ischemic stroke, Rescue intracranial stenting, Symptomatic intracerebral hemorrhage, MRI 3 Tesla, Rehabilitation