Computed Tomography Perfusion (CTP) to Predict Response to Recanalization in Ischemic Stroke Project (CRISP)
| Status: | Completed |
|---|---|
| Conditions: | Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/2/2016 |
| Start Date: | September 2011 |
| End Date: | February 2016 |
Computed Tomography Perfusion (CTP) to Predict Response to Recanalization in Ischemic Stroke Project
The overall goal of the CTP to predict Response to recanalization in Ischemic Stroke Project
(CRISP) is to develop a practical tool to identify acute stroke patients who are likely to
benefit from endovascular therapy.
The project has two main parts. During the first part, the investigators propose to develop
a fully automated system (RAPID) for processing of CT Perfusion (CTP) images that will
generate brain maps of the ischemic core and penumbra. There will be no patient enrollment
in part one of this project.
During the second part, the investigators aim to demonstrate that physicians in the
emergency setting, with the aid of a fully automated CTP analysis program (RAPID), can
accurately predict response to recanalization in stroke patients undergoing
revascularization. To achieve this aim the investigators will conduct a prospective cohort
study of 240 consecutive stroke patients who will undergo a CTP scan prior to endovascular
therapy. The study will be conducted at four sites (Stanford University, St Luke's Hospital,
University of Pittsburgh Medical Center, and Emory University/Grady Hospital). Patients will
have an early follow-up MRI scan within 12+/-6 hours to assess reperfusion and a late
follow-up MRI scan at day 5 to determine the final infarct.
(CRISP) is to develop a practical tool to identify acute stroke patients who are likely to
benefit from endovascular therapy.
The project has two main parts. During the first part, the investigators propose to develop
a fully automated system (RAPID) for processing of CT Perfusion (CTP) images that will
generate brain maps of the ischemic core and penumbra. There will be no patient enrollment
in part one of this project.
During the second part, the investigators aim to demonstrate that physicians in the
emergency setting, with the aid of a fully automated CTP analysis program (RAPID), can
accurately predict response to recanalization in stroke patients undergoing
revascularization. To achieve this aim the investigators will conduct a prospective cohort
study of 240 consecutive stroke patients who will undergo a CTP scan prior to endovascular
therapy. The study will be conducted at four sites (Stanford University, St Luke's Hospital,
University of Pittsburgh Medical Center, and Emory University/Grady Hospital). Patients will
have an early follow-up MRI scan within 12+/-6 hours to assess reperfusion and a late
follow-up MRI scan at day 5 to determine the final infarct.
Inclusion Criteria:
1. be 18 or older;
2. have a clinical diagnosis of ischemic stroke and a score of 5 or more points on the
NIHSSS;
3. be scheduled to undergo intraarterial (IA) therapy for acute hemispheric stroke
(either as primary therapy or as adjuvant therapy following intravenous tPA
treatment);
4. be scheduled to have a standard CT including perfusion imaging and CT angiography of
the circle of Willis (CTA) prior to IA therapy;
5. begin intra-arterial thrombectomy within 90 minutes of completion of the CT scan and
within 18 hours of symptom onset. (Start of IA therapy is defined as the time of
insertion of the femoral artery sheath; Time of brain scan is defined as the time
that the scan is completed); and
6. have provided informed consent.
Exclusion Criteria:
1. have any pre-existing illness resulting in a modified Rankin Scale Score of 3 or
higher prior to the qualifying stroke;
2. are pregnant.
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