Selective Intra-Arterial Cooling Infusion with Endovascular Thrombectomy for Acute Ischemic Stroke: A Multicenter,...

Area of Science:

• Neurology
• Cardiovascular Medicine
• Interventional Radiology

Background:

• Acute ischemic stroke (AIS) from large-vessel occlusion (LVO) requires timely intervention.
• Endovascular thrombectomy (EVT) is a standard treatment for LVO-AIS.
• Cerebroprotective strategies, like hypothermia, are being investigated to improve EVT outcomes.

Purpose of the Study:

• To determine the efficacy and safety of selective intra-arterial cooling infusion (SI-AC) as an adjunct to EVT in patients with anterior circulation LVO-AIS.
• To assess if SI-AC improves functional recovery compared to EVT alone.

Main Methods:

• A multicenter, randomized, controlled, blinded superiority trial involving 12 hospitals in China.
• Patients with anterior circulation LVO-AIS within 24 hours of symptom onset were randomized 1:1 to receive SI-AC plus EVT or EVT alone.
• Follow-up was conducted for 90 days, with functional recovery assessed using the modified Rankin Scale (mRS).

Main Results:

• The primary outcome is the distribution of mRS scores at 90 days.
• Secondary outcomes include functional independence (mRS 0-2), good outcome (mRS 0-1), Barthel index, infarct volume, and early neurological improvement.
• Safety outcomes include intracranial hemorrhage and all-cause mortality.

Conclusions:

• This trial is designed to evaluate the efficacy and safety of SI-AC as a novel cerebroprotective strategy.
• The results will inform the potential use of SI-AC in clinical practice for LVO-AIS patients undergoing EVT.