Effect of DIRECT Transfer to ANGIOsuite on Functional Outcome in Severe Acute Stroke (DIRECTANGIO)
Acute Ischemic Stroke
About this trial
This is an interventional treatment trial for Acute Ischemic Stroke focused on measuring large-vessel occlusion, reperfusion therapy
Eligibility Criteria
Inclusion Criteria:
- Aged from 18 to 85 years,
- Rapid neurological examination by the neurologist of the participating centre before randomization,
Suffered from acute severe neurological deficit at hospital admission confirmed by neurologist defined as:
Unilateral motor deficit with a total score ≥ 5
- Facial palsy: item 4 of NIHSS (score 0 to 2)
- Arm: item 5 of NIHSS (score 0 to 4)
- Leg: item 6 of NIHSS (score 0 to 2) AND
Cortical symptom with a total score ≥ 1
- Language: item 9 of NIHSS (score 0 to 3)
- Extinction: item 11 of NIHSS (score 0 to 2)
- Patients who admitted to hospital within 5 hours after symptom onset
- Known onset time of symptom
- Only mothership admissions
- Fully autonomous patient (pre-stroke mRS ≤2)
- Availability of the angio-suite and endovascular treatment team at the randomization
- Person affiliated to or beneficiary of a social security plan
Exclusion Criteria:
- Severe allergy to iodinated contrast agents,
- Ongoing pregnancy,
- Breastfeeding,
- Consent refusal or opposition of the relatives,
- Individuals under mandatory legal guardianship or unable to consent and whose relatives oppose the research,
- Any conditions that could hamper the 3-month outcome recording
Sites / Locations
- Centre Hospitalier Régional UniversitaireRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Direct angio-suite admission
Standard management
Upon arrival in angio-suite and after neurological examination with scoring NIHSS and pre stroke mRS, and performing the blood sample, patient undergoes rotational CBCT in order to exclude intracerebral hemorrhage and cerebral angiography to confirm proximal arterial occlusion. Mechanical thrombectomy is then performed as well as intravenous thrombolysis in the absence of contraindications.
Arrival is in the MRI/CT-scan room or in the emergency department. Directly after neurological examination and blood sample, patient undergoes imaging and then bridging therapy, mechanical thrombectomy or intravenous thrombolysis alone when indicated.