MRI Biomarkers of Effective Tissue Reperfusion After Thrombectomy of an Acute Proximal Occlusion of the Anterior Circulation

N/AUnknownNCT04952077

Central Hospital, Nancy, France40 enrolled

Overview

Cerebral infarction by proximal occlusion of the anterior circulation is common with major personal and societal consequences. MRI is the gold standard for exploring stroke, especially ischemic, and a number of biomarkers on initial MRI (before reperfusion) are predictive of neurological prognosis. However, their spatiotemporal evolution in the suites of reperfusion is unclear. Close monitoring by MRI would make it possible to precisely know the tissue, vascular and microvascular evolution of the infarct area and the penumbra after reperfusion, and thus to characterize MRI biomarkers associated with efficient tissue reperfusion. The aim of the MR-Reperfusion study is to characterize new MRI biomarkers of efficient tissue reperfusion.

Study Type

INTERVENTIONAL

Allocation

Purpose

DIAGNOSTIC

Masking

NONE

Enrollment

Conditions

Ischemic Stroke, Acute

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * To be over 18 year-old * Perfusion MRI assessment on admission; * Admission for an acute infarction of the anterior circulation with proximal occlusion (tandem, distal internal carotid, or M1 segment of the middle cerebral artery); * Initial mTICI = 0-1 on the initial angiography before treatment; * Patient in complete autonomy (mRS ≤ 2) before the onset of symptoms; * Mechanical thrombectomy (in combination or not with intravenous thrombolysis), within the first 6 hours of the onset of symptoms, or within 24 hours in case of clinical-radiological or radiological mismatch; * Success of reperfusion estimated by an mTICI = 3 at the end of the procedure; * Availability of MRI within 3 hours of angiographic reperfusion; * To be able to understand the instructions given; * Written consent given by the patient or a trusted person; * To be enrolled in a social security plan; Exclusion Criteria: * Posterieur circulation obstruction; * 3 months follow-up impossible with the completion of the MRI; * Subject under a measure of legal protection

Outcomes

Primary Outcomes

Description of MRI biomarkers (volume, location of the infarction and penumbra; collateral circulation; location, length of the thrombus; trans-cerebral, cortical venous changes) in patients with ischemic stroke successfully treated by thrombectomy

Time frame: Admission to hospital, 3 hours, 24 hours, 7 days and 3 months after thrombectomy

Secondary Outcomes

Kinetic evolution of MRI biomarkers (volume, location of the infarction and penumbra; collateral circulation; location, length of the thrombus; trans-cerebral, cortical venous changes) and its correlation with the functional prognosis (mRS score)

Time frame: Admission to hospital, 3 hours, 24 hours, 7 days and 3 months after thrombectomy

Kinetic evolution of the NIHSS score and its correlation with the functional prognosis at 3 months evaluated by the mRS score.

Time frame: Admission to hospital, 3 hours, 24 hours, 7 days and 3 months after thrombectomy

Description of MRI biomarkers (volume, location of the infarction and penumbra; collateral circulation; location, length of the thrombus; trans-cerebral, cortical venous changes) and its correlation with the hemorrhagic transformation (SWAN sequence)

Time frame: 24 hours after thrombectomy

Radioclinical concordance evaluated by measuring MRI biomarkers (volume, location of the infarction and penumbra; collateral circulation; location, length of the thrombus; trans-cerebral, cortical venous changes), the mRS score and the NIHSS score

Time frame: 3 months after thrombectomy

MRI Biomarkers of Effective Tissue Reperfusion After Thrombectomy of an Acute Proximal Occlusion of the Anterior Circulation

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts