Computed Tomography Perfusion (CTP) to Predict Response to Recanalization in Ischemic Stroke Project (CRISP)

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.

Stanford is currently not accepting patients for this trial.

Eligibility


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.

Ages Eligible for Study

18 Years - N/A

Genders Eligible for Study

All

Not currently accepting new patients for this trial

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305
Stephanie M Kemp, BS
650-723-4481
Not Recruiting

Our research team includes physicians, residents, medical students, research assistants, and volunteers. Our research topics include medical imaging, device validation,  mobile application development, and pharmaceutical trials.  

Some of the Neuro-Opthalmic concerns we investigate include Multiple Sclerosis, Optic Neuritis, IIH, and ICP.