To examine the revascularization efficacy and safety of T-02 and its associated performance characteristics in treatment of appropriately selected subjects experiencing an acute ischemic stroke when the treatment is initiated within 24 hours after last seen well under the current guideline, and to generate hypotheses to be confirmed in subsequent confirmatory clinical investigations
Stroke is the second leading cause of death and the third leading cause of disability worldwide, with a 16 million incidence. The Global prevalence of stroke was 104.2 million people, whereas that of ischemic stroke was 82.4 million in 2017. Countries in Eastern Europe and Central and East Asia have the highest prevalence rates of ischemic stroke, and countries in Eastern Europe, North Africa and Central Asia have among the highest mortality rates attributable to ischemic stroke. Each year, there are about 800 000 new or recurrent cases of stroke in the United State. With all the advancements, 13.6% is still die. The incidence of large vessel occlusion (LVO) compromise 24% to 38% of acute ischemic stroke. The proportion increases to 46% on including A2 and P2 segments. Two-thirds of LVO occur in the anterior circulation, mainly in the Internal Carotid Artery (ICA) and Middle Cerebral Artery (MCA), and the remaining occur in the posterior circulation. Intravenous tissue plasminogen activator (IV-tPA) was found to have some benefits to treat an acute ischemic stroke (AIS). However, IV-tPA has many limitations, including a short therapeutic window with administration being restricted to 4.5 hours post known symptom onset, and a strong time dependency. Another limitation is the high pharmacological resistance for more proximal occlusion (4%-8% for ICA vs 31%-44% distal recanalization). T-02 which is the study device is indicated for use to restore blood flow in the neurovasculature by removing thrombus for the treatment of acute ischemic stroke to reduce disability in patients with a persistent, proximal anterior circulation, large vessel occlusion (LVO) such as internal carotid artery (ICA) and middle cerebral artery (MCA) segments as well as Medium-vessel occlusions (MeVOs) including M2 and M3 with smaller core infarcts. Endovascular therapy with the device should start up to 24 hours of time last seen well in patients who are ineligible for intravenous tissue plasminogen activator (IV t-PA) or who fail IV t-PA therapy. This study will be conducted: * To confirm that T-02 has similar efficacy and safety for treating European patients presenting acute ischemic stroke including distal vessel region such as M3 within 6 hours after time last seen well (TLSW) according to European Guidelines in comparison with the ones of stent retrievers available on the market; * To generate hypotheses for subsequent confirmatory clinical investigations to evaluate the efficacy and safety of T-02 and its associated performance characteristics in treatment of appropriately selected patients presenting AIS within 24 hours after TLSW while following the eligible criteria recommended by the current European guideline.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Stent retriever
eTICI 2b-3
Successful revascularization measured using eTICI score ≥2b in the target vessel following 3 or less passes of T-02 device(s).
Time frame: immediately after the intervention
sICH
Incidence of symptomatic intracranial hemorrhage (SICH), by ECASS III definition, within 24 (-8/+12) hours post procedure
Time frame: within 24 hours
modified Rankin scale (mRS)
90-day disability assessed by the modified Rankin scale (mRS) defined between 1 to 6 wherein higher scores mean a worse outcome.
Time frame: 90 days
mRS 0-2 rate
The proportion of subjects with a good functional outcome at 90 days defined as mRS 0-2 with and without adjunction treatment, respectively.
Time frame: 90 days
NIHSS score
The proportion of subjects with "early response", defined as a NIHSS drop of ≥10 from baseline of or NIHSS score 0 or 1 ( NIHSS score is defined between 1 and 42 wherein higher scores mean a worst outcome.)
Time frame: Day 5-12 / Discharge (whichever is earlier)
Stroke-rerated mortality
Incidence of stroke-rerated mortality at 90 days
Time frame: 90 days
All-cause mortality
Incidence of all-cause mortality at 90 days
Time frame: 90 days
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