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| Name | Class |
|---|---|
| Asan Medical Center | OTHER |
| St John of God Hospital, Vienna | OTHER |
| Medical University Innsbruck | OTHER |
| Hospital Vall d'Hebron |
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Isolated vertebral artery occlusions (VAO) account for approximately one third of posterior circulation occlusions, but have been given the least attention among posterior circulation strokes. If the two recent ATTENTION and BAOCHE randomized clinical trials have proven the superiority of endovascular thrombectomy (EVT) in basilar artery occlusions, data on the effectiveness and harm of acute revascularization treatment on isolated VAO is scarce. We aim to investigate the impact of acute recanalisation treatments in acute ischemic stroke patients with isolated VAO.
In the absence of RCT, observational data with appropriate statistical methods may give indications on benefits and harms of treating neglected stroke situations like acute vertebral occlusion. Results may also lay the basis for prospective studies, such as randomized clinical trials.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AIS and isolated VAO | Patients with acute ischemic stroke (AIS) and concomitant isolated intracranial and/or extracranial vertebral artery occlusion (VAO) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Conservative treatment (CT) | Other | Best medical treatment without intravenous thrombolysis nor endovascular thrombectomy |
|
| Measure | Description | Time Frame |
|---|---|---|
| 3-month modified Rankin scale | 3-month functional outcome, [range: 0-6, 0= no symptoms, 6=death] | 90 days |
| Measure | Description | Time Frame |
|---|---|---|
| Symptomatic intracerebral haemorrhage (sICH) | Any hemorrhagic transformation temporally related to any worsening in neurological condition. [yes/no] | 7 days |
| EVT procedural complications | Any complication attributed to the procedure (vessel perforation, vasospasm, dissection, Subarachnoid haemorrhage (SAH)/Intracerebral haemorrhage (ICH), device detachment/misplacement, embolization to new territory, access-site complications, early reocclusion, other) |
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Inclusion criteria:
Exclusion criteria
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Patients with acute ischemic stroke and concomitant isolated vertebral artery occlusion accounting for stroke symptoms
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| Name | Affiliation | Role |
|---|---|---|
| Dr. med. Alexander Salerno, MD | CHUV | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre Hospitalier Universitaire Vaudois | Lausanne | Canton of Vaud | 1011 | Switzerland |
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| OTHER |
| University Hospital, Basel, Switzerland | OTHER |
| Clinical Centre of Serbia | OTHER |
| Charite University, Berlin, Germany | OTHER |
| Insel Gruppe AG, University Hospital Bern | OTHER |
| Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico | OTHER |
| Boston Medical Center | OTHER |
| Università degli Studi di Brescia | OTHER |
| The Cooper Health System | OTHER |
| University Hospital Carl Gustav Carus | OTHER |
| Duke University | OTHER |
| University Hospital, Geneva | OTHER |
| Hadassah Medical Organization | OTHER |
| Sahlgrenska University Hospital | OTHER |
| Universitätsklinikum Hamburg-Eppendorf | OTHER |
| Helsinki University Central Hospital | OTHER |
| The University of Texas Health Science Center, Houston | OTHER |
| University Hospital, Lille | OTHER |
| Hospital de Egas Moniz | OTHER |
| Neurocenter of Southern Switzerland | OTHER |
| Corewell Health West | OTHER |
| Azienda Ospedaliero-Universitaria di Modena | OTHER |
| Ludwig-Maximilians - University of Munich | OTHER |
| Azienda USL Reggio Emilia - IRCCS | OTHER_GOV |
| University of Zurich | OTHER |
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| Intravenous thrombolysis (IVT) | Other | Best medical treatment with intravenous thrombolysis but without endovascular thrombectomy |
|
| Endovascular thrombectomy (EVT) ± intravenous thrombolysis (IVT) | Other | Best medical treatment with endovascular thrombectomy with or without intravenous thrombolysis |
|
| During EVT procedure or peri-procedural |
| 24-hour NIHSS | NIH Stroke Scale/Score (NIHSS). Quantifies stroke severity based on weighted clinical evaluation findings at 24h. [0-42, 0= no deficit, 42=maximum stroke severity] | 24 hours |
| Early neurological deterioration (ENDi) | Early neurological deterioration of ischemic origin (ENDi) is defined as an increase in National Institute of Health Stroke (NIHSS) score ≥ 4 points or death within 24 hours. [yes/no] | 24 hours |
| Cerebrovascular ischemic recurrences | Any ischemic stroke or transient ischemic attack recurrence [yes/no] | 90 days |
| 24h and 3month mortality | Mortality at 24h and 3 months | 24h and 90 days |
| Vessel recanalisation on follow up-imaging | Vessel recanalisation at follow-up imaging (0= no recanalisation, 1= partial recanalisation 50-99%, 2=full recanalisation, 3= initially not occluded) | 48 hours |
| ID | Term |
|---|---|
| D000083242 | Ischemic Stroke |
| D014715 | Vertebrobasilar Insufficiency |
| D001157 | Arterial Occlusive Diseases |
| ID | Term |
|---|---|
| D020521 | Stroke |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D002545 | Brain Ischemia |
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| ID | Term |
|---|---|
| D000072700 | Conservative Treatment |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
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