Tenecteplase Reperfusion Therapy in Acute Ischemic Cerebrovascular Events(TRACE)
Acute Ischemic Stroke
About this trial
This is an interventional treatment trial for Acute Ischemic Stroke focused on measuring rhTNK-tPA, acute, stroke, phaseII, Acute Ischemic Stroke, rt-PA
Eligibility Criteria
Inclusion Criteria:
- Age over 18 years.
- Time from onset to treatment < 3 hours; the time symptoms start is defined as "the last moment they appear normal".
- Diagnosis of ischemic stroke according to "2014 China Guideline for Diagnosis and Treatment of Acute Ischemic Stroke" with assessable neurological impairment e.g., language, motor function, cognitive impairment, gaze impairment, visual field deficit and/or visual neglect. Ischemic stroke is defined as sudden acute focal neurological impairment with suspected cerebral ischemia, hemorrhage ruled out by CT scan.
- mRS > 2 at the first onset or prior onset.
- Baseline NIHSS score is > 4 and < 26.
- Signed informed consent.
Exclusion Criteria:
Absolute contraindications:
1.1 History of severe head trauma or stroke within 3 months; 1.2 Suspected subarachnoid hemorrhage; 1.3 Arterial puncture at a non-compressible site within the previous 1week; 1.4 History of intracranial hemorrhage; 1.5 Intracranial tumor, vascular malformation, or arterial aneurysm; 1.6 Recent intracranial or intraspinal surgery; 1.7 Systolic blood pressure ≧ 180 mm Hg, or diastolic blood pressure ≧ 100 mm Hg; Increased blood pressure; 1.8 Active internal bleeding ; 1.9 Acute bleeding tendency, including platelet count below 100×109/L or otherwise; 1.10 Heparin treatment was performed within 48 h ( APTT exceeded the upper limit of normal range ) ; 1.11 Warfarin has been taken orally , and the international standardized ratio is INR > 1.7 or PT > 15 s ; 1.12 Anticoagulant drugs such as thrombin inhibitor or Xa factor inhibitor , argatroban ( including new anticoagulants with unclear mechanism ) are currently being used , and various sensitive laboratory tests are abnormal ( such as live ) APTT , INR , Platelet count , Serpentine ECT of pulse enzyme setting time ; thrombin time TT or appropriate determination of Xa factor activity ) ; 1.13 Blood glucose < 2.7 mmol/L; 1.14 CT showed multilobular infarction ( low density > 1 / 3 cerebral hemisphere )
Relative contraindications : The risks and benefits of thrombolysis should be carefully considered and weighed in the following cases ( that is , although there is one or more relative contraindications , it is not absolutely impossible to thrombolysis ).
2.1 Mild stroke or stroke with rapid improvement of symptoms; 2.2 Women in pregnancy ; 2.3 Symptoms of neurological impairment after seizures ; 2.4 There have been major surgical operations or serious injuries in the last 2 weeks; 2.5 There were gastrointestinal or urinary system bleeding in recent 3 weeks ; 2.6 History of myocardial infarction within 3 months.
- Have been enrolled in rhTNK-tPA in pre-study or participated in other clinical trials within 3 months prior to screening.
- Lactating women, or childbearing women who do not use effective contraception.
- Known allergy to rhTNK-tPA and/or rt-PA or relevant excipients.
- The researchers judged that not suitable to participate in this study or participate in this study may lead to greater risk for patients ;
- Can not comply with the test program or follow-up requirements .
Sites / Locations
- Beijing Tiantan Hospital, Capital Medical University
- The Ninth People's Hospital of Chongqing
- First Affiliated Hospital of Jinan University
- ShenZhen Hospital ,Beijing University
- Affiliated Hosptial to GuiZhou Medical University
- HaiNan Provincial People's Hospital
- Hebei Medical University Third Hospital
- Tangshan Workers' Hospital
- The First Hospital Of Qiqihar
- Luoyang First People's Hosptical
- 1st Hospital Affiliated to Zhengzhou University
- ChangSha 1st Municipal Hospital
- Baotou Central Hospital
- Inner Mongolia BaoGang Hospital
- Huai'an Second People's Hospital
- First Hospital of Jilin University
- Meihekou Central Hospital
- First People 's Hospital Of Shenyang
- General Hospital of Northern War Zone , PLA
- Linyi People's Hospital
- Yantai Yuhuangding Hospital
- HuaShan Hospital Affiliated to FuDan University
- ZhongShan Hospital ,FuDan University
- SiChuan University HuaXi Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Experimental
Experimental
Active Comparator
Group 1 (rhTNK-tPA 0.10 mg/kg)
Group 2 (rhTNK-tPA 0.25 mg/kg)
Group 3 (rhTNK-tPA 0.32 mg/kg)
Group 4 (rt-PA 0.9 mg/kg)
Dissolve one vial of rhTNK-tPA in 3 ml sterile water for injection to prepare a solution of 5.33 mg/ml. Calculate the required volume according to the body weight of the subject, then measure the required volume. Administer as a single 0.10 mg/kg IV bolus over 5-10 seconds.
Dissolve one vial of rhTNK-tPA in 3 ml sterile water for injection to prepare a solution of 5.33 mg/ml. Calculate the required volume according to the body weight of the subject, then measure the required volume. Administer as a single 0.25 mg/kg IV bolus over 5-10 seconds.
Dissolve one vial of rhTNK-tPA in 3 ml sterile water for injection to prepare a solution of 5.33 mg/ml. Calculate the required volume according to the body weight of the subject, then measure the required volume. Administer as a single 0.32 mg/kg IV bolus over 5-10 seconds.
10% of rt-PA 0.9 mg/kg administered as an initial IV bolus followed by the remaining 90% as an IV infusion over the next 1 hour.