PRECISE (PeRfusion imaging to identify postErior CIrculation candidateS for thrombectomy)

PRECISE（灌注成像以识别血栓切除术的后循环候选者）

基本信息

批准号：
10186074
负责人：
GREGORY W ALBERS
金额：
$ 150.99万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-01 至 2026-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10186074
关键词：
Acute Address Adult Aftercare Angiography Anterior Area Blood Circulation Blood flow Brain region Cause of Death Cell Nucleus Cerebrum Cervical Cessation of life Clinical Cohort Studies Data Death Rate Disease Emergency Situation Enrollment Evaluation Exhibits Future Goals Hour Image Image Analysis Infarction Injury Ischemic Stroke Knowledge Lead Magnetic Resonance Imaging Medical Modernization Morphologic artifacts Multicenter Studies Outcome Patient Selection Patients Perfusion Population Prospective cohort study Protocols documentation Randomized Reperfusion Therapy Reporting Retrospective Studies Severities Site Specificity Stroke Structure Symptoms Thrombectomy Time Tissues United States Validation X-Ray Computed Tomography anterior cerebral artery artery occlusion base basilar artery brain tissue brain volume cerebral artery clinical care design disability effective therapy endovascular thrombectomy improved insight neuroimaging novel patient subsets perfusion imaging primary endpoint prognostic prognostic value prospective randomized trial response stroke patient stroke symptom treatment trial trial comparing vertebral artery

Acute Address Adult Aftercare Angiography Anterior Area Blood Circulation Blood flow Brain region Cause of Death Cell Nucleus Cerebrum Cervical Cessation of life Clinical Cohort Studies Data Death Rate Disease Emergency Situation Enrollment Evaluation Exhibits Future Goals Hour Image Image Analysis Infarction Injury Ischemic Stroke Knowledge Lead Magnetic Resonance Imaging Medical Modernization Morphologic artifacts Multicenter Studies Outcome Patient Selection Patients Perfusion Population Prospective cohort study Protocols documentation Randomized Reperfusion Therapy Reporting Retrospective Studies Severities Site Specificity Stroke Structure Symptoms Thrombectomy Time Tissues United States Validation X-Ray Computed Tomography anterior cerebral artery artery occlusion base basilar artery brain tissue brain volume cerebral artery clinical care design disability effective therapy endovascular thrombectomy improved insight neuroimaging novel patient subsets perfusion imaging primary endpoint prognostic prognostic value prospective randomized trial response stroke patient stroke symptom treatment trial trial comparing vertebral artery

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项目摘要

PROJECT SUMMARY . Acute ischemic stroke is the leading cause of disability in the United States and the second-leading cause of death worldwide. AIS that involves a major cervical or cerebral artery is termed a large vessel occlusion, and recent landmark randomized studies found that endovascular thrombectomy is an effective treatment for ischemic stroke caused by large vessel occlusion of the internal carotid, middle, or anterior cerebral arteries (anterior circulation). However, up to 15% of large vessel occlusions occur in the vertebral or basilar arteries, and these posterior circulation stroke patients were largely excluded from modern endovascular thrombectomy trials. Clinical outcomes in patients with vertebral or basilar artery occlusions are often poor with severe disability or death occurring in 30-54% and 36-86% of patients, respectively. There are no prospective or randomized data designed to determine which imaging strategies should be used to guide thrombectomy treatment decisions in this understudied population. PRECISE (PeRfusion imaging to identify postErior CIrculation candidateS for thrombEctomy) is a prospective cohort study of patients with acute ischemic stroke due to occlusion of the vertebral or basilar artery within 24- hours of symptom onset. Patients will undergo CT or MRI cerebral perfusion imaging prior to endovascular thrombectomy treatment. The results of this study will determine if cerebral perfusion imaging can identify a subset of patients who are most likely to have a favorable outcome after thrombectomy treatment. PRECISE has the potential to improve the imaging evaluation of patients with acute ischemic stroke of the posterior circulation, to provide valuable prognostic information regarding thrombectomy efficacy in these patients, and to define sub-groups of patients who might benefit from future neuroprotective strategies.

项目摘要。急性缺血性中风是美国残疾的主要原因，是第二个领导的原因全球死亡。涉及主要宫颈或脑动脉的AI被称为大血管阻塞，并且最近的地标随机研究发现，血管内血栓切除术是一种有效的治疗方法由颈内，中部或前脑动脉的大血管阻塞引起的缺血性中风（前循环）。但是，多达15％的大血管闭塞发生在椎骨或基底动脉中，这些后循环中风患者在很大程度上被排除在现代血管内血栓切除术中试验。椎骨或基底动脉闭塞患者的临床结局通常很差在30-54％和36-86％的患者中，残疾或死亡发生。没有前瞻性或随机数据旨在确定应使用哪些成像策略来指导血栓切除术在这个研究的人群中的治疗决定。精确（灌注成像以识别血栓切除术后循环候选者）是一种前瞻性由于椎骨或基底动脉阻塞24-- 症状发作时间。患者将在血管内进行CT或MRI脑灌注成像血栓切除术治疗。这项研究的结果将确定脑灌注成像是否可以识别血栓切除治疗后最有可能有良好结果的患者子集。精确的有可能改善后部急性缺血性中风患者的成像评估循环，提供有关这些患者血栓切除术功效的有价值的预后信息，以及定义可能从未来的神经保护策略中受益的患者的子组。