IV thrombolysis for branch atheromatous stroke in deep brain arteries

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This observational study focuses on acute ischemic stroke due to branch atheromatous disease affecting deep perforating arteries such as the lenticulostriate, paramedian pontine, and anterior choroidal arteries. It aims to compare the safety and efficacy of intravenous thrombolysis with single antiplatelet therapy and dual antiplatelet therapy in this specific stroke subtype. Eligibility requires adults with acute onset within 24 hours, MRI-confirmed BAD involvement, and specific lesion patterns on diffusion-weighted imaging. Outcomes will consider early neurological changes and subsequent functional status, while monitoring bleeding and other treatment-related risks. This study seeks to clarify whether IV thrombolysis offers benefits in BAD beyond what is seen in other stroke etiologies.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* aged over 18 years, with acute ischemic stroke and symptom onset no more than 24 hours before admission, who were treated in one of the stroke units of the participating institutions.
* All enrolled patients must have undergone a cerebral MRI for inclusion:

  1. DWI lesion: single isolated deep subcortical stroke AND
  2. The affected vessel involves the LSA, PPA, or ACHA, and the infarct lesion on DWI conforms to one of the following characteristics (A, B, OR C):

A. LSA: "Comma-like" infarct lesions with "fan-shaped" extension from bottom to top in the coronary position OR ≥ 3 layers (layer thickness 5 mm) on axial DWI.

B. PPA: Infarct lesion extending from the deep pons to the ventral pons on axial DWI.

C. ACHA: Infarct within the anterior choroidal artery territory.

Exclusion Criteria:

* Typical recent small subcortical infarction (RSSI) (oval, \<20mm in all axes)
* ≥ 50% stenosis on the parent artery (i.e., BA, MCA, or ICA)
* Stroke due to other clearly identified causes or possible cardioembolic etiology.

Where it's running

• Clinic Favoriten
  Vienna, State of Vienna, Austria Recruiting
• Clinic Hietzing
  Vienna, State of Vienna, Austria Recruiting
• Department of Neurology, St. John's Hospital, Vienna, Austria
  Vienna, Austria Recruiting
• Department of Neurology, Medical University of Vienna
  Vienna, Austria Recruiting
• Department of Neurology, Heidelberg University Hospital
  Heidelberg, Germany Recruiting
• Department of Neurology & Stroke, University of Tübingen
  Tübingen, Germany Recruiting

Study contacts

• Principal investigator: Julian Frederic Hotz, DDr. — 1. Department of Neurology, St. John's Hospital, Vienna, Austria, 2. Department of Neurology, University Hospital, Bern, Switzerland, 3. Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna
• Study coordinator: Julian Frederic Hotz, DDr.
• Email: julian.hotz@meduniwien.ac.at
• Phone: +43 1 211210

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.