Imaging Collaterals in Acute Stroke (iCAS)

Completed

Conditions studied: Stroke, Acute

In brief

Stroke is caused by a sudden blockage of a blood vessel that delivers blood to the brain. Unblocking the blood vessel with a blood clot removal device restores blood flow and if done quickly may prevent the disability that can be caused by a stroke. However, not all stroke patients benefit from having their blood vessel unblocked. The aim of this study is to determine if special brain imaging, called MRI, can be used to identify which stroke patients are most likely to benefit from attempts to unblock their blood vessel with a special blood clot removal device. In particular, we will assess in this trial whether a noncontrast MR imaging sequence, arterial spin labeling (ASL), can demonstrate the presence of collateral blood flow (compared with a gold standard of the angiogram) and whether it is useful to predict who will benefit from treatment.

Key facts

Study ID

NCT02225730

Run by

Stanford University

People needed

187

Starts

2013-09-01

Expected to finish

2019-10-31

Last updated by the study team

2020-03-19

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Age 18 and older
• Clinical diagnosis of ischemic stroke and an associated score on the NIHSS of 5 or more points
• Planned to undergo (or has undergone) intra-arterial (IA) thrombectomy and/or thrombolysis for acute hemispheric stroke. (Either as primary therapy or as adjuvant therapy following intravenous tPA treatment)
• Planned to undergo or has undergone an MR brain scan including MR perfusion imaging (ASL \& bolus PWI) and MR angiography of the circle of Willis prior to IA therapy
• Intra-arterial thrombectomy can be started within 90 minutes of completion of the MR perfusion scan and within 24 hours of symptom onset (Start of IA therapy is defined as the time of insertion of the femoral artery sheath; Time of brain scan is defined as the time that the scan is completed)
• Able to obtain informed consent

You may not qualify if…

• Any pre-existing illness resulting in a modified Rankin Scale Score of 2 or higher prior to the qualifying stroke
• Creatinine clearance < 40 ml/min based on the NIDDK four-variable MDRD method (non-weight based)
• Documented allergy to MR contrast agent
• MRI contraindications (pacemaker, etc.)
• Pregnancy

Where it is running

• Eden Medical Center — Castro Valley, California, United States
• Stanford University Medical Center — Stanford, California, United States
• University of Pittsburgh — Pittsburgh, Pennsylvania, United States
• Swedish Hospital — Seattle, Washington, United States

Full record on ClinicalTrials.gov

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