Image Detection Of Impaired Microcirculatory Reperfusion (Id Imr)
Posted Date: Jun 17, 2024
- Investigator: Yasmin Aziz
- Specialties:
- Type of Study: Observational/Survey
Maximal tissue reperfusion, which is the restoration of blood flow to cerebral tissue, following large vessel occlusion (LVO) stroke is not achieved with current standard of care therapies. A validated radiographic surrogate for cerebral tissue with impaired microcirculatory reperfusion (IMR), or suboptimal blood flow leading to tissue death, is needed. Our long-term objective is to identify regions of impaired microcirculatory blood flow associated with infarct expansion despite restoration of macrocirculatory flow via technically successful mechanical thrombectomy (MT), an emergency endovascular procedure for thrombus retrieval. Identification of such regions will allow development of a mechanistic target for early phase clinical trials seeking to maximize tissue reperfusion to improve patient outcomes. As a critical first step, we are conducting a prospective observational study that will enroll 40 patients at the University of Cincinnati Medical Center to demonstrate the feasibility of a future definitive study to identify/validate a radiographic biomarker of IMR associated with infarct expansion despite complete angiographic reperfusion, which is maximal visualized filling of the previously occluded vessel. We will perform study-specific CT Perfusion (CTP) imaging within 90 minutes after complete angiographic reperfusion is achieved. The CTP will be used to measure post-procedure volume, rate, and intensity of blood flow to the affected cerebral tissue. A clinical MRI performed at 48-96 hours from angiographic reperfusion will be used to determine the follow up infarct volume. The primary outcome of this study is feasibility determined by >80% of the planned sample size with technically adequate and usable 90-minute CTP and 48-96-hour MRI key parameters.
Criteria:
Adult Patients Presenting Within 24 Hours Of Last Known Normal Time With Ischemic Stroke Due To Large Vessel Anterior Circulation Occlusion And Successfully Treated To Obtain Complete Angiographic Reperfusion
Keywords:
Ischemic Stroke, Thrombectomy, No Reflow
For More Information:
Christina Mihova
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mihovaca@ucmail.uc.edu