Hypothermia With Intrajugular Cooling in Acute Ischemic Stroke Thrombectomy (PICNIC)
Primary Purpose
Acute Ischemic Stroke
Status
Not yet recruiting
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Hypothermia with intrajugular cooling
Sponsored by
About this trial
This is an interventional treatment trial for Acute Ischemic Stroke focused on measuring acute ischemic stroke, hypothermia, thrombectomy, intrajugular cooling
Eligibility Criteria
Inclusion Criteria:
- Age 18-80 years;
- Acute ischemic stroke caused by unilateral internal carotid artery terminal segment/middle cerebral artery M1 segment occlusion;
- In line with the indications for mechanical thrombectomy without contraindications;
- Successful recanalization (mTICI 2b/3) after mechanical thrombectomy that confirmed by digital subtraction angiography;
- Written informed consent provided by the patients or their legal relatives.
Exclusion Criteria:
- Suffering from cerebral venous system diseases such as cerebral venous thrombosis/stenosis/dysplasia;
- Suffering from heart diseases such as ventricular arrhythmia/myocardial infarction/congestive heart failure;
- Imaging examination after mechanical thrombectomy shows intracranial hemorrhage/contrast extravasation;
- Difficulty in reaching the designated position of the device used for intrajugular cooling;
- Difficulty in complying with intrajugular cooling or other conditions that the investigator considered inappropriate for inclusion.
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Intrajugular cooling group
Arm Description
The safety and tolerability of hypothermia with intrajugular cooling will be investigated using 3+3 dose-escalation trial design.
Outcomes
Primary Outcome Measures
Number of participants with major response
Major response is any of the following:
Cerebral venous system damage;
Cerebral venous thrombosis;
Huge hematoma at the puncture site requiring surgical intervention;
Malignant arrhythmia within 24 hours;
Cardiac arrest within 24 hours;
Myocardial infarction within 24 hours;
Congestive heart failure within 24 hours.
In the 3 + 3 design, 3 subjects are recruited for a given intrajugular cooling dose level. The trial is stopped if ≥ 2 of 3 subjects at a given dose level show major response. If only 1 of 3 subjects shows major response, 3 more subjects are recruited at a given dose level and a major response in any of them will stop the trial. Otherwise, same procedure is followed for the next dose level. Maximum tolerable dose will be the dose at the level before stopping of the trial. The schedule of advancing duration is 10 min, 15 min, 20 min, 25 min, and 30 min.
Secondary Outcome Measures
Full Information
NCT ID
NCT05488392
First Posted
August 3, 2022
Last Updated
August 3, 2022
Sponsor
Capital Medical University
1. Study Identification
Unique Protocol Identification Number
NCT05488392
Brief Title
Hypothermia With Intrajugular Cooling in Acute Ischemic Stroke Thrombectomy
Acronym
PICNIC
Official Title
Safety and Tolerability of Intrajugular Cooling in Patients With Acute Ischemic Stroke After Mechanical Thrombectomy
Study Type
Interventional
2. Study Status
Record Verification Date
August 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
November 1, 2022 (Anticipated)
Primary Completion Date
November 1, 2023 (Anticipated)
Study Completion Date
February 1, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Capital Medical University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Hypothermia with intrajugular cooling is a neuroprotective strategy that has been proven to minimize brain damage and maximize functional preservation in animal models of stroke. The purpose of this proof-of-concept study is to determine the safety and tolerability of intrajugular cooling in patients with acute ischemic stroke who are treated with mechanical thrombectomy.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Ischemic Stroke
Keywords
acute ischemic stroke, hypothermia, thrombectomy, intrajugular cooling
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
15 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Intrajugular cooling group
Arm Type
Experimental
Arm Description
The safety and tolerability of hypothermia with intrajugular cooling will be investigated using 3+3 dose-escalation trial design.
Intervention Type
Procedure
Intervention Name(s)
Hypothermia with intrajugular cooling
Intervention Description
Hypothermia with intrajugular cooling will be applied after successful recanalization of the culprit internal carotid artery/middle cerebral artery. The perfusion rate will be set at 30 ml/min. Low temperature saline will be infused into the internal jugular vein for 10 min, 15 min, 20 min, 25 min, and 30 min successively.
Primary Outcome Measure Information:
Title
Number of participants with major response
Description
Major response is any of the following:
Cerebral venous system damage;
Cerebral venous thrombosis;
Huge hematoma at the puncture site requiring surgical intervention;
Malignant arrhythmia within 24 hours;
Cardiac arrest within 24 hours;
Myocardial infarction within 24 hours;
Congestive heart failure within 24 hours.
In the 3 + 3 design, 3 subjects are recruited for a given intrajugular cooling dose level. The trial is stopped if ≥ 2 of 3 subjects at a given dose level show major response. If only 1 of 3 subjects shows major response, 3 more subjects are recruited at a given dose level and a major response in any of them will stop the trial. Otherwise, same procedure is followed for the next dose level. Maximum tolerable dose will be the dose at the level before stopping of the trial. The schedule of advancing duration is 10 min, 15 min, 20 min, 25 min, and 30 min.
Time Frame
Within 24 hours after hypothermia with intrajugular cooling
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age 18-80 years;
Acute ischemic stroke caused by unilateral internal carotid artery terminal segment/middle cerebral artery M1 segment occlusion;
In line with the indications for mechanical thrombectomy without contraindications;
Successful recanalization (mTICI 2b/3) after mechanical thrombectomy that confirmed by digital subtraction angiography;
Written informed consent provided by the patients or their legal relatives.
Exclusion Criteria:
Suffering from cerebral venous system diseases such as cerebral venous thrombosis/stenosis/dysplasia;
Suffering from heart diseases such as ventricular arrhythmia/myocardial infarction/congestive heart failure;
Imaging examination after mechanical thrombectomy shows intracranial hemorrhage/contrast extravasation;
Difficulty in reaching the designated position of the device used for intrajugular cooling;
Difficulty in complying with intrajugular cooling or other conditions that the investigator considered inappropriate for inclusion.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xunming Ji, M.D.
Phone
010-83198952
Email
jixm@ccmu.edu.cn
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
Related data will be shared if full study protocol and statistical analysis plan are provided with reasonable design.
Learn more about this trial
Hypothermia With Intrajugular Cooling in Acute Ischemic Stroke Thrombectomy
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