REperfusion With Cooling in CerebraL Acute IscheMia II (RECCLAIM-II)
Ischemic Stroke, Hypothermia
About this trial
This is an interventional prevention trial for Ischemic Stroke focused on measuring Acute ischemic stroke, Mild hypothermia, Stroke, Hypothermia, Cerebral infarction, Ischemia, Cerebrovascular disorder, Brain disease, Central nervous system disease, Nervous system disease, Vascular disease, Cardiovascular disease, Brain infarction, Brain ischemia, Pathologic process, Body temperature change, Signs and symptoms
Eligibility Criteria
Inclusion Criteria:
- Male or female subjects of any ethnicity and age >/=18 but </= 79 years;
- Symptom onset </=8 hours;
- Symptoms consistent with an ischemic stroke with a large vessel occlusion (Middle Cerebral Artery (MCA), Internal Carotid Artery (ICA) terminus) as determined by CT imaging of the brain;
- Alberta Stroke Program Early CT Score (ASPECTS) of 5-10 on non-contrast CT of the brain;
- Ability to undergo endovascular reperfusion therapy;
- No contraindications to general anesthesia, conscious sedation, or allergies to any components associated with the anticipated diagnostic or treatment procedures that cannot be treated;
- A pre-treatment modified Rankin Scale (mRS) of 0 or 1;
- Baseline CT scan shows no hemorrhage;
- National Institutes of Health Stroke Scale (NIHSS) 14-29;
- Subject has either 1) failed iv tissue plasminogen activator (tPA) therapy or 2) contradicted for iv tPA therapy;
- Subject is capable of complying with study procedures and agrees to complete all required study procedures, study visits and associated activities.
- Subject or legally authorized representative must be able to understand and give written informed consent.
Exclusion Criteria:
- Females of childbearing potential who are pregnant or not using adequate contraception;
- Bleeding diathesis with a platelet count < 50,000 or International Normalized Ratio (INR) >1.7 or any active or recent (within 10 to 30 days) hemorrhage;
- History of genetically confirmed hypercoagulable syndrome;
- Any condition that excludes MRI imaging;
- History of dementia, currently on Aricept or Namenda, or other Alzheimer's-like symptoms;
- End stage renal disease on hemodialysis;
- History of cardiac arrest;
- Presence of an inferior vena cava (IVC) filter;
- Contrast dye allergy with history of anaphylaxis, known serious sensitivity to contrast agents or any condition in which angiography is contraindicated;
- Known allergy to meperidine or buspar;
- Prior neurologic event that would obscure interpretation of the signal and current presenting neurologic deficits;
- Sustained hypertension (systolic blood pressure (SBP) > 185 or diastolic blood pressure (DBP) > 110 refractory to treatment);
- Baseline CT/MRI of head showing evidence of mass effect with mid-line shift, hemorrhage, intracranial tumor, arterial vasculitis or dissection, or bilateral stroke;
- Presence of any other serious comorbidity that would be likely to impact life expectancy to less than 6 months or limit subject cooperation or study compliance;
- Concurrent participation in an investigational clinical study that has not completed the follow-up period or planned participation in another study within the next 3 months;
- Any other condition or personal circumstance that, in the judgment of the investigator, might interfere with the collection of complete, good quality data or the completion of the research study.
Sites / Locations
- WellStar Kennestone Regional Medical Center
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Normothermia
Mild hypothermia
As part of standard of care, an interventional reperfusion procedure will be performed on all subjects using the Trevo Pro Retriever (Stryker), after which normothermia will attempt to keep core body temp between 38 and 36.5 degrees centigrade.
As part of standard of care, an interventional reperfusion procedure will be performed on all subjects using the Trevo Pro Retriever (Stryker). Subjects will also have a catheter placed in the femoral vein (Zoll Thermogard XP technology with the Quattro catheter) and temperature brought to 33 degrees centigrade as quickly as possible. They will stay in mild hypothermia for 12 hours, and then be rewarmed very slowly.