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）

• 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
• 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

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致残的主要原因，也是导致残疾的第二大原因 全世界的死亡。涉及主要颈动脉或脑动脉的 AIS 称为大血管闭塞，并且 最近具有里程碑意义的随机研究发现，血管内血栓切除术是一种有效的治疗方法 由颈内动脉、大脑中动脉或大脑前动脉大血管闭塞引起的缺血性中风 （前循环）。然而，高达 15% 的大血管闭塞发生在椎动脉或基底动脉， 这些后循环卒中患者很大程度上被排除在现代血管内血栓切除术之外 试验。椎动脉或基底动脉闭塞患者的临床结果通常很差，严重程度 分别有 30-54% 和 36-86% 的患者发生残疾或死亡。没有预期或 旨在确定应使用哪些成像策略来指导血栓切除术的随机数据 该研究人群的治疗决策。 PRECISE（灌注成像以识别血栓切除术后循环候选者）是一项前瞻性研究 24 天内因椎动脉或基底动脉闭塞而导致急性缺血性中风患者的队列研究 症状出现的小时数。患者在血管内治疗前将接受 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获得良好结果的患者子集。精确的 有潜力改善急性后部缺血性脑卒中患者的影像学评估 循环，提供有关这些患者血栓切除术疗效的有价值的预后信息，以及 定义可能受益于未来神经保护策略的患者亚组。