To study safety and feasibility of mild therapeutic hypothermia after successful recanalization by mechanical endovascular treatment in patients with acute ischemic stroke and proximal arterial occlusion.
The current clinical trial is an investigator-initiated one, and it is conducted under the multi-center, randomized, open-label, prospective design. The subjects meeting inclusion/exclusion criteria will be assigned to the treatment group or the control group. The randomization ratio is 1:1. The subjects of the treatment group will receive a 2-day hypothermia therapy followed by the process of recovery of temperature within 30 hours (the recovery phase). After 3 months of the onset of symptoms, mRS scores are measured. This is followed by the closure of the clinical trial.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
40
1. Induction phase: At a temperature of 4℃, a saline 500 mL or 1 L is intravenously administered. Arctic sun (surface freezing equipment) Target temperature: 35±0.5℃ Within 12 hours of the onset of symptoms, the therapeutic hypothermia is performed 2. Maintenance phase:The use of bedside shivering assessment scale (BSAS) The use of Columbia anti-shivering protocol,Maintenance period: 48 hours 3. Recovery phase:Rewarming velocity: 0.05\~0.1℃ (within 30 hours)
1. All the patients receive standard treatment modalities for stroke, which are applicable to the international treatment guidelines. 2. In all the patients, neurological assessments and NIHSS scoring are performed on a daily basis for 4 days with the help of board-certified nurses or specialists in stroke. 3. Blood pressure, respiratory rate and heart rate are measured at least once at a 4-hour interval for 4 days. 4. Using an esophageal thermometer, the central temperature is measured at a 2-hour interval for 5 days.
Seoul National University Bundang
Seongnam, Gyeoinggido, South Korea
RECRUITINGFavorable outcome
modified Rankin Scale of 0-2 points at 3 months
Time frame: 3 months after symptom onset
mortality at 3 months
mortality at 3 months
Time frame: 3 months after symptom onset
Improvements in neurological functions
Changes in the cerebral infarction lesions at 5\~7 days
Time frame: Volume change on diffusion lesion at 5~7 days
Symptomatic cerebral hemorrhage
deterioration in the National Institute of Health Stroke Scale score of ≥4 points with parenchymal hematoma type 2 documented by CT or MR image
Time frame: within 5~7 days of symptom onset
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