Simple non-contrast CT versus advanced imaging to choose thrombectomy for acute large-vessel stroke

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 randomized trial enrolls adults with anterior large-vessel occlusion stroke who arrive within 24 hours and randomizes them to a simplified imaging selection strategy (non-contrast CT/ASPECTS) or a standard imaging strategy (CT perfusion or MRI) to determine eligibility for endovascular thrombectomy. The primary aim is to see if outcomes after thrombectomy selected by simple imaging are non-inferior to those selected by advanced imaging. Key inclusion criteria include age ≥18, FAST-ED ≥4, and arrival within 24 hours of last known well, while key exclusions include multiple vessel occlusion, arterial tortuosity preventing device access, certain intracranial vascular lesions, pregnancy, and contrast allergy. The trial is being conducted at several hospitals in China and compares clinical and imaging endpoints between the two selection pathways.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Aged 18 years or older;
2. The interval time from last known well to hospital arrival is within 24 hours;
3. Acute stroke confirmed by clinical symptoms or imaging examination;
4. Field Assessment Stroke Triage for Emergency Destination (FAST ED) ≥4;
5. Written informed consent is obtained from patients and/or their legal representatives.

Exclusion Criteria:

1. Allergy to radiographic contrast agents, or nitinol devices;
2. Currently pregnant or lactating (women patients);
3. Arterial tortuosity and/or other arterial disease that would prevent the device from reaching the target vessel;
4. Preexisting neurological or psychiatric disease that would confound the neurological functional evaluations;
5. Multiple vessel occlusion (e.g., bilateral anterior circulation, or occlusion of both anterior and posterior circulation);
6. Brain tumors with mass effect (except meningiomas) that are radiographically pleasant;
7. Intracranial aneurysm, arteriovenous malformation;
8. Any terminal illness with life expectancy less than 6 months;
9. Unlikely to be available for 90-day follow-up.

Where it's running

• Yijishan Hospital of Wannan Medical College
  Wuhu, Anhui, China Recruiting
• The First Affiliated Hospital of Hainan Medical University
  Haikou, Hainan, China Recruiting
• Huai'an First People's Hospital
  Huai'an, Jiangsu, China Recruiting
• Jingdezhen First People's Hospital
  Jingdezhen, Jiangxi, China Recruiting
• Dalian Central Hospital
  Dalian, Liaoning, China Recruiting
• Xinqiao Hospital of Army Medical University
  Chongqing, Chongqing Municipality, China Not yet recruiting

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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.