Allgemeine Informationen
  • Krankheitskategorie Arterielle und venöse Erkrankungen, inkl. tiefe Venenthrombose und Lungenembolie (BASEC)
  • Studienphase N/A (ICTRP)
  • Rekrutierungsstatus Rekrutierung läuft (BASEC/ICTRP)
  • Studienstandort
    Basel
    (BASEC)
  • Studienverantwortliche Alex Brehm alex.brehm@usb.ch (BASEC)
  • Datenquelle(n) BASEC: Import vom 14.05.2025 ICTRP: Import vom 12.04.2025
  • Letzte Aktualisierung 14.05.2025 17:46
HumRes62943 | SNCTP000005574 | BASEC2023-01086 | DRKS00023679

Anesthetic care during thrombectomy for stroke A randomized clinical study

  • Krankheitskategorie Arterielle und venöse Erkrankungen, inkl. tiefe Venenthrombose und Lungenembolie (BASEC)
  • Studienphase N/A (ICTRP)
  • Rekrutierungsstatus Rekrutierung läuft (BASEC/ICTRP)
  • Studienstandort
    Basel
    (BASEC)
  • Studienverantwortliche Alex Brehm alex.brehm@usb.ch (BASEC)
  • Datenquelle(n) BASEC: Import vom 14.05.2025 ICTRP: Import vom 12.04.2025
  • Letzte Aktualisierung 14.05.2025 17:46

Zusammenfassung der Studie

Endovascular thrombectomy - a minimally invasive procedure to reopen cerebral vessels - is the standard treatment for stroke due to a vascular occlusion in the brain. According to current knowledge, sedation and anesthesia are equivalent regarding treatment outcomes during endovascular thrombectomy. Both sedation and anesthesia are routinely employed by the physicians caring for you. Anesthesia eliminates consciousness and pain perception and usually also respiration. For patients to be ventilated, either a ventilation tube (endotracheal tube) is inserted into their trachea or a laryngeal mask (laryngeal mask, which is a tube with an inflatable cuff at the end) is placed in front of the laryngeal opening. During sedation, calming or pain-relieving medications are given to make patients calm and drowsy or to sleep through the procedure. Breathing may be slightly affected, but ventilation is not required. If sedation is insufficient or breathing becomes too weak, a switch to anesthesia may also be made. Patients are randomly assigned to one of the two study groups. Depending on the assignment, anesthesia or sedation was used for performing the endovascular thrombectomy. A description of this study can also be found at http://www.actinstroke.de.

(BASEC)

Untersuchte Intervention

Anesthesia and sedation

(BASEC)

Untersuchte Krankheit(en)

Acute ischemic stroke

(BASEC)

Kriterien zur Teilnahme
- Acute ischemic stroke due to arterial occlusion - Decision for endovascular thrombectomy (BASEC)

Ausschlusskriterien
- Suspected technical difficulties - Onset of stroke in the hospital or worsening of a stroke in the hospital - Mild neurological deficit - Required general anesthesia or endotracheal intubation - Severe agitation - Contraindication for general anesthesia - Suspected difficult airway - Age < 18 years (BASEC)

Studienstandort

Basel

(BASEC)

Austria, Germany, Switzerland (ICTRP)

Sponsor

nicht verfügbar

Kontakt für weitere Auskünfte zur Studie

Kontaktperson Schweiz

Alex Brehm

+41 61 328 79 48

alex.brehm@usb.ch

(BASEC)

Allgemeine Auskünfte

Klinikum rechts der Isar der TU Mnchen

089 4140 9632

alex.brehm@usb.ch

(ICTRP)

Wissenschaftliche Auskünfte

Klinikum rechts der Isar der TU M?nchen

089 4140 9632

alex.brehm@usb.ch

(ICTRP)

Name der bewilligenden Ethikkommission (bei multizentrischen Studien nur die Leitkommission)

Ethikkommission Nordwest- und Zentralschweiz EKNZ

(BASEC)

Datum der Bewilligung durch die Ethikkommission

20.07.2023

(BASEC)


ICTRP Studien-ID
DRKS00023679 (ICTRP)

Offizieller Titel (Genehmigt von der Ethikkommission)
nicht verfügbar

Wissenschaftlicher Titel
Anaesthesiological Care for Thrombectomy in Stroke - ACT in Stroke (ICTRP)

Öffentlicher Titel
Anaesthesiological Care for Thrombectomy in Stroke (ICTRP)

Untersuchte Krankheit(en)

I63.5
I63.2Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteriesCerebral infarction due to unspecified occlusion or stenosis of precerebral arteriesI63.5I63.2 (ICTRP)

Untersuchte Intervention
Group 1: General anaesthesia during endovascular thrombectomy
Group 2: Sedation (or standby) during endovascular thrombectomy (ICTRP)

Studientyp
interventional (ICTRP)

Studiendesign
Allocation: Randomized controlled study; Masking: Blinded (masking used); Control: active; Assignment: parallel; Study design purpose: treatment (ICTRP)

Ein-/Ausschlusskriterien
Inclusion criteria: Acute ischemic stroke due to arterial occlusion in the anterior cerebral circulation (i. e., internal carotid artery and/or middle cerebral artery and/or anterior cerebral artery), decision for endovascular thrombectomy (ICTRP)

Exclusion criteria: Suspected procedural technical difficulties while reaching the target occlusion, isolated extracranial arterial occlusion, in-hospital onset of stroke or in-hospital worsening of symptoms, mild neurological deficit (NIH stroke scale < 5), mandatory general anaesthesia or endotracheal intubation (e.g., due to airway obstruction that cannot be controlled with naso- or oropharyngeal tubes, vomiting with risk of tracheobronchial aspiration, severe agitation (Richmond Agitation Sedation Scale +3 or +4), contraindication to general anaesthesia, such as manifest or expected haemodynamic instability (e.g., shock, or known severe aortic stenosis), or COPD with home oxygen, suspected difficult airway, inclusion in another interventional study, age < 18 years

Primäre und sekundäre Endpunkte
After 90 days: Proportion of patients with mRS less than or equal to mRS before stroke or within 0�2 (ICTRP)

Functional outcome at 30 and 90 days using the full mRS; mortality at 30 and 90 days; extent of reperfusion after ET (as graded by interventionalist using an ordinal score); final infarct size (derived from study-specific MRI or routine cCT); neurological symptoms (NIH stroke scale) at 24 hours and 7 days (or discharge, if earlier); time from start of anaesthesia care to puncture for arterial sheath placement; time from arterial puncture to reperfusion (or, in case of futility, last attempt to remove clot); proportion of patients whose mean arterial pressure dropped 20 % or more of pre-procedural values before recanalization; frequency of conversion from PS to GA: proportion of patients primarily treated awake or with PS that were subsequently treated with GA (ICTRP)

Registrierungsdatum
06.04.2021 (ICTRP)

Einschluss des ersten Teilnehmers
01.07.2021 (ICTRP)

Sekundäre Sponsoren
nicht verfügbar

Weitere Kontakte
Andreas Ranft, andreas.ranft@mri.tum.de, 089 4140 9632, Klinikum rechts der Isar der TU Mnchen (ICTRP)

Sekundäre IDs
13/21 S-SR (ICTRP)

Angaben zur Verfügbarkeit von individuellen Teilnehmerdaten
YesThe anonymised pooled data set can be made available for secondary analyses together with the study protocol. For this purpose, a specific request must be made to the steering committee in the form of a detailed study protocol after the initial publication. Prior to submission for publication, each article derived from the pooled data will be reviewed by the steering committee. (ICTRP)

Weitere Informationen zur Studie
http://drks.de/search/en/trial/DRKS00023679 (ICTRP)

Ergebnisse der Studie

Zusammenfassung der Ergebnisse

nicht verfügbar

Link zu den Ergebnissen im Primärregister

nicht verfügbar