Direct Mechanical Thrombectomy Versus Bridging Therapy
Primary Purpose
Thrombectomy, Ischemic Stroke, Large-Artery Atherosclerosis (Embolus/Thrombosis)
Status
Completed
Phase
Phase 4
Locations
Egypt
Study Type
Interventional
Intervention
Trevo and or Merci devices for stent retreival
Penumbra system for stent aspiration
recombinant tissue plasminogen activator
Sponsored by
About this trial
This is an interventional treatment trial for Thrombectomy focused on measuring ischemic stroke, Direct mechanical thrombectomy, Bridging therapy
Eligibility Criteria
Inclusion Criteria:
- Patients with anterior ischemic stroke due to large vessel occlusion.
- A previous autonomous modified Rankin Scale (mRS) of less than 2.
- A National Institutes of Health Stroke Scale (NIHSS)≥4
- A groin puncture within 4.5 hours of the neurological deficit onset.
Exclusion Criteria:
- Imaging documentation of intracranial haemorrhage
- A premorbid mRS score of 2 or more
- Absence of diffusion perfusion mismatch in CT perfusion.
Sites / Locations
- Alexandria University Faculty of Medicine
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Active Comparator
Arm Label
Direct mechanical thrombectomy
Bridging therapy
Arm Description
Direct mechanical thrombectomy performed within 4.5 of stroke onset without giving intravenous recombinant tissue plasminogen activator.
Mechanical thrombectomy performed within 4.5 of stroke onset after giving intravenous recombinant tissue plasminogen activator at a dose of 0.9 mg/Kg
Outcomes
Primary Outcome Measures
Modified Rankin Scale score
A measurement of functional independence following ischemic stroke
Complication rate
The rate and type of complications occuring postoperatively
Secondary Outcome Measures
The National Institutes of Health Stroke Scale (NIHSS) score
A validated scale for assessment of neurological dysfunction associated with stroke
Full Information
NCT ID
NCT05155540
First Posted
December 3, 2021
Last Updated
December 11, 2021
Sponsor
Alexandria University
1. Study Identification
Unique Protocol Identification Number
NCT05155540
Brief Title
Direct Mechanical Thrombectomy Versus Bridging Therapy
Official Title
A Comparative Study of The Efficacy and Safety of Direct Mechanical Thrombectomy Versus Bridging Therapy in Large Vessel Occlusion: An Egyptian Single-Center Experience
Study Type
Interventional
2. Study Status
Record Verification Date
December 2021
Overall Recruitment Status
Completed
Study Start Date
July 1, 2019 (Actual)
Primary Completion Date
July 1, 2020 (Actual)
Study Completion Date
September 1, 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Alexandria University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No
5. Study Description
Brief Summary
This study compares the efficacy and safety of direct mechanical thrombectomy versus bridging therapy in patients with anterior circulation large vessel occlusion in a cohort of patients treated at the stroke unit of a single centre at Alexandria University in Egypt.
Detailed Description
This study compares the efficacy and safety of direct mechanical thrombectomy versus bridging therapy in patients with anterior circulation large vessel occlusion in a cohort of patients treated at the stroke unit of a single centre at Alexandria University in Egypt. In the first arm, 17 patients were recruited and underwent direct mechanical thrombectomy without receiving recombinant tissue plasminogen activator. In the bridging therapy arm, 34 patients received first tissue plasminogen activator then underwent direct mechanical thrombectomy. The efficacy was evaluated by the NIHSS improvement 24 hours following stroke onset and the modified Rankin scale 3 months following stroke. Safety was assessed by the procedural complications rate especially the hemorhagic transformation.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Thrombectomy, Ischemic Stroke, Large-Artery Atherosclerosis (Embolus/Thrombosis)
Keywords
ischemic stroke, Direct mechanical thrombectomy, Bridging therapy
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Model Description
Open-label, non-randomized, prospective, double-arm clinical trial
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
51 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Direct mechanical thrombectomy
Arm Type
Active Comparator
Arm Description
Direct mechanical thrombectomy performed within 4.5 of stroke onset without giving intravenous recombinant tissue plasminogen activator.
Arm Title
Bridging therapy
Arm Type
Active Comparator
Arm Description
Mechanical thrombectomy performed within 4.5 of stroke onset after giving intravenous recombinant tissue plasminogen activator at a dose of 0.9 mg/Kg
Intervention Type
Device
Intervention Name(s)
Trevo and or Merci devices for stent retreival
Other Intervention Name(s)
No other names
Intervention Description
FDA approved devices for stent retrieval during mechanical thrombectomy
Intervention Type
Device
Intervention Name(s)
Penumbra system for stent aspiration
Intervention Description
FDA approved devices for stent aspiration during mechanical thrombectomy
Intervention Type
Drug
Intervention Name(s)
recombinant tissue plasminogen activator
Intervention Description
FDA approved drug for treatment of acute ischemic stroke within 4.5 hours of strokeonset
Primary Outcome Measure Information:
Title
Modified Rankin Scale score
Description
A measurement of functional independence following ischemic stroke
Time Frame
3 months
Title
Complication rate
Description
The rate and type of complications occuring postoperatively
Time Frame
within one week postoperatively
Secondary Outcome Measure Information:
Title
The National Institutes of Health Stroke Scale (NIHSS) score
Description
A validated scale for assessment of neurological dysfunction associated with stroke
Time Frame
at 24 hours postoperatively
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients with anterior ischemic stroke due to large vessel occlusion.
A previous autonomous modified Rankin Scale (mRS) of less than 2.
A National Institutes of Health Stroke Scale (NIHSS)≥4
A groin puncture within 4.5 hours of the neurological deficit onset.
Exclusion Criteria:
Imaging documentation of intracranial haemorrhage
A premorbid mRS score of 2 or more
Absence of diffusion perfusion mismatch in CT perfusion.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mohamed A Abdel Ghani, Master's
Organizational Affiliation
Alexandria University Faculty of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Alexandria University Faculty of Medicine
City
Alexandria
ZIP/Postal Code
11523
Country
Egypt
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
The data will be available upon request
IPD Sharing Time Frame
30 days
IPD Sharing Access Criteria
The data will be available upon request
Learn more about this trial
Direct Mechanical Thrombectomy Versus Bridging Therapy
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