The purpose of this study is to determine the efficacy and safety of plasma adsorption for patients of acute ischemic stroke who underwent endovascular thrombectomy due to large vessel occlusion of anterior circulation.
Large vessel occlusive (LVO) stroke has a higher mortality and disability rate than other types of acute ischemic stroke (AIS). Endovascular thrombectomy (EVT) is recommended as a standard treatment for AIS-LVO. However, even if the blood vessels are successfully recanalization, nearly one-third of the patients still die and nearly half remain disabled at 3 months. Inflammation plays a crucial role in the pathophysiological cascade of ischemic stroke and related forms of brain injury. Evidence from experimental stroke indicates that targeting cytokines may reduce infarct volume and promote functional recovery. Plasma adsorption (PA) has been applied in the treatment of severe inflammatory diseases, including pancreatitis and sepsis, as well as in the neurological autoimmune diseases, such as myasthenia gravis, multiple sclerosis, and autoimmune encephalitis. We hypothesize that PA can improve functional outcome of AIS-LVO who underwent EVT. In this study, the experimental group receive EVT and PA, 1 time per day for 3 consecutive days. The control group receive EVT . Two groups will be followed up for 90 days to evaluate the efficacy and safety of PA for patients of AIS-LVO of anterior circulation, who achieve successful recanalization through EVT.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
100
Plasma adsorption was initiated after endovascular thrombectomy once daily for 3 days.
The patients will be treated with endovascular thrombectomy.
The First Hospital of Jilin University
Changchun, Jilin, China
Proportion of patients with Modified Rankin Scale (mRS) Score 0-2 at 90 days
Modified Rankin Scale (mRS) ranged from 0 to 6, a low value represents a better outcome.
Time frame: 90±7 days
Proportion of patients with Modified Rankin Scale (mRS) Score 0-1 at 90 days
Modified Rankin Scale (mRS) ranged from 0 to 6, a low value represents an excellent outcome.
Time frame: 90±7 days
Ordinal distribution of Modified Rankin Scale (mRS)
Modified Rankin scale (range, 0 to 6, with a score of 0 indicating no disability, 1 no clinically significant disability, 2 slight disability, 3 moderate disability but remaining able to walk unassisted, 4 moderately severe disability, 5 severe disability, and 6 death).
Time frame: 90±7 days
Proportion of patients with a reduction of NIHSS score(≥4 points)
The NIHSS is an ordinal hierarchical scale to evaluate the severity of stroke by assessing a patient's performance. Scores range from 0 to 42, with higher scores indicating a more severe deficit.
Time frame: 7 days(or discharge)
Blood lipid in peripheral blood
Blood lipid in peripheral blood,including total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglycerides. are assessed at 72 hours and 7 days from randomization.
Time frame: 72 hours, 7 days
Cytokine levels in peripheral blood
Cytokines such as pro-inflammatory factors including interleukins are assessed at 72 hours and 7 days from randomization.
Time frame: 72 hours, 7 days
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Final infarct volume
Final infarct volume measured with diffusion weighted imaging (DWI) MRI.
Time frame: 7 days (or discharge)