Acute ischemic stroke (AIS) caused by intracranial large vessel occlusion (LVO) in the anterior circulation significantly contributes to stroke-related disability and mortality. Recent randomized controlled trials have demonstrated substantial benefits of endovascular thrombectomy (EVT) when patients are appropriately triaged beforehand. However, accurately orienting the 'missed segment' during EVT remains challenging. Guide-wires often fail to navigate through the occlusion or are mistakenly directed into the small tranches or even cause vessel rupture. To address this clinical need, the investigators developed an artificial intelligence (AI) algorithm to automate the reconstruction of CT angiography (CTA), focusing on the occluded LVO segment. To evaluate the clinical utility of this AI algorithm, the investigators propose a prospective, stepped-wedge cluster-randomized study to determine whether integrating our AI algorithm into AIS care flow can reduce the time for first pass of the thrombus by improving the visualization of the occluded segment on CTA. Physicians will assess patient eligibility for thrombectomy, and all selected patients will receive standard care according to current guidelines. This approach is expected to enhance patient treatment outcomes for endovascular thrombectomy by leveraging readily available data.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
174
Artificial intelligence algorithms in the automated reconstruction of intracranial large vessel occlusion (LVO)
Shanghai Sixth People's Hospital
Shanghai, Shanghai Municipality, China
ACTIVE_NOT_RECRUITINGShanghai Sixth People's Hospital
Shanghai, China
RECRUITINGAFAT
The time from target angiography to the initiation of first thrombectomy attempt (angiography-to-first-attempt time \[AFAT\])
Time frame: Immediately after EVT
PRT
The time from groin puncture to final arterial recanalization (puncture-to-recanalization time \[PRT\])
Time frame: Immediately after EVT
IPT
The time from the completion of imaging to the initiation of EVT (imaging-to-puncture time \[IPT\])
Time frame: Immediately after EVT
IRT
The time from imaging completion to final arterial recanalization (imaging-to-recanalization time \[IRT\])
Time frame: Immediately after EVT
The rate of successful flow restoration immediately after EVT
The rate of successful flow restoration immediately after EVT
Time frame: Immediately after EVT
The rate of symptomatic intracerebral hemorrhage within 24 hours post-EVT
The rate of symptomatic intracerebral hemorrhage within 24 hours post-EVT
Time frame: 24 hours post-EVT
The rate of procedure-related complications
The rate of procedure-related complications
Time frame: Immediately after EVT
The rate of functional independence at 90 days post-EVT
The rate of functional independence at 90 days post-EVT
Time frame: 90 days post-EVT
The mortality rate within 90 days post-EVT
The mortality rate within 90 days post-EVT
Time frame: 90 days post-EVT
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