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A Randomized Trial of Imaging Selection Modalities for Stroke Thrombectomy (NO-SELECT)

RecruitingNAAges 18 Years - anyAllXinqiao Hospital of Chongqing
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In plain words

What the trial is, and whether it could suit you

Several studies suggest that advanced multi-modal imaging with CTP should be used to screen late time window stroke patients for thrombectomy. However, NCCT is more accessible when comparing with CTP. It is unclear whether the NCCT-based ASPECTS can be used as an imaging criterion to screen patients for thrombectomy. The newly published MR CLEAN-LATE and TENSION trials used NCCT or CTA, but still relied on ASPECTS scores to evaluate and select patients for endovascular therapy. However, different trials have different time windows. The aim of this trial was to assess the clinical outcomes of stroke patients with anterior large vessel occlusion who selected by simple imaging (NCCT) comparing via standard imaging screening strategy (CTP/MRI). The hypothesis is that simple imaging is non-inferior to standard imaging selection strategy in terms of achieving favorable outcomes.

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๐Ÿ“‹ Eligibility rules (as published)
Inclusion Criteria: 1. Aged 18 years or older; 2. The interval time from last known well to hospital arrival is within 24 hours; 3. Acute stroke confirmed by clinical symptoms or imaging examination; 4. Field Assessment Stroke Triage for Emergency Destination (FAST ED) โ‰ฅ4; 5. Written informed consent is obtained from patients and/or their legal representatives. Exclusion Criteria: 1. Allergy to radiographic contrast agents, or nitinol devices; 2. Currently pregnant or lactating (women patients); 3. Arterial tortuosity and/or other arterial disease that would prevent the device from reaching the target vessel; 4. Preexisting neurological or psychiatric disease that would confound the neurological functional evaluations; 5. Multiple vessel occlusion (e.g., bilateral anterior circulation, or occlusion of both anterior and posterior circulation); 6. Brain tumors with mass effect (except meningiomas) that are radiographically pleasant; 7. Intracranial aneurysm, arteriovenous malformation; 8. Any terminal illness with life expectancy less than 6 months; 9. Unlikely to be available for 90-day follow-up.
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What it tests

  • Simplified imaging strategy
  • Standard imaging strategy
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Where

8 sites
Yijishan Hospital of Wannan Medical College
Wuhu, China
Xinqiao Hospital of Army Medical University
Chongqing, China
Wuyi Traditional Chinese Medicine Hospital
Jiangmen, China
The First Affiliated Hospital of Hainan Medical University
Haikou, China
Huai'an First People's Hospital
Huai'an, China
The 904th Hospital of CPLA
Wuxi, China
Jingdezhen First People's Hospital
Jingdezhen, China
Dalian Central Hospital
Dalian, China
๐Ÿค Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible โ€” always decide together with your own doctor.
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