EndovaSCular TreAtment to imProve outcomEs for Medium Vessel Occlusions (ESCAPE-MeVO trial)

Summary

Patients who present to the Foothills hospital with acute stroke symptoms receive a CT scan of their brain. If there is a blockage in one of the arteries, supplying blood to the brain and there is no hemorrhage, and if they are eligible, they receive standard stroke treatment, which is administration of a clot dissolving agent and repeat imaging of the brain to check if the clot is dissolved. Depending on the location of the clot, sometimes thrombectomy is also performed. During thrombectomy, the doctor makes a small cut and places a thin hollow tube (catheter) into a blood vessel in the patient's groin. The tube is advanced into the blood vessels in the neck and head. Dye is be injected into the tube several times and x-rays are taken to help view the blockage. The doctor try to remove the clot by putting a Health Canada approved device (eg. a stent retriever or other device) into the artery with the clot and removing the clot into the tube and pulling it out of the patient's body. Thrombectomy is a standard of care to the patients who have occlusion in the large vessel. However, we do not have data to help decide the doctors, if the same technique will work for certain medium vessel blockage or not. Currently there are smaller devices available, which are useful in accessing the medium size vessels and current study will gather information as to whether the thrombectomy treatment results in better outcome for the patients or not.

Eligibility

Currently recruiting participants: Yes

Eligible ages: 18 to 90

Inclusion criteria:

18 year or older adults with occlusion in the medium vessel Acute ischemic stroke clinically eligible for immediate thrombectomy
Time from onset (or last-seen-well) to randomization <12 hours
Disabling stroke with confirmed medium vessel occlusion which will be treatable using endovascular thrombectomy approach

Signed informed consent, two-physician consent, or deferral of consent where approved.

Exclusion criteria:

Any evidence of bleeding in the brain on qualifying imaging
Patients living in a nursing home or requiring daily nursing care or assistance with activities of daily living.
Patient has a major co-morbid illness, such as severe dementia, advanced cancer, advanced heart failure etc. such that they are unlikely to be able to complete follow-up or they are unlikely to achieve the primary outcome due to the underlying illness (rather than the stroke or its treatment).
Pregnancy: female with positive urine or serum beta human chorionic gonadotropin (β-hCG) test
Participation in another clinical therapeutic intervention trial

Participate

This study is not currently accepting expressions of interest via the website. Please see contact information below.

Additional information

Contact information

The recruitment is through hospital admission only.

Principal investigator:

Andrew Demchuk

Clinical trial:

Yes

REB-ID:

REB21-1528