Not recruiting

Study of cangrelor with mechanical thrombectomy in patients with acute ischemic stroke selected by perfusion imaging

Verified siteRegistered drugNo placebo

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What is this trial about?

A plain-language summary of the goals, design and what participants do

This study focuses on patients with acute ischemic stroke, a condition where blood flow to the brain is blocked by a clot. The research examines the effectiveness of combining two treatments: mechanical thrombectomy (a procedure to remove blood clots) and a blood-thinning medication called cangrelor. The medication is given through an intravenous infusion directly into the bloodstream.

The purpose of this research is to determine if adding cangrelor to the standard mechanical thrombectomy treatment can improve recovery outcomes for stroke patients. The study involves patients who arrive at the hospital within 24 hours of their stroke symptoms beginning and who show specific patterns on their brain imaging scans.

During the study, participants will be divided into two groups. One group will receive the standard mechanical thrombectomy treatment plus cangrelor, while the other group will receive only mechanical thrombectomy. The maximum daily dose of cangrelor will be 150 milligrams, and the treatment will last for one day. Doctors will monitor patients' recovery and brain function over three months to determine how well the combined treatment works.

The research process

The trial runs in 5 steps – from screening to follow-up. Each step says what happens and what the team monitors.

Step 1
Initial assessment
Your condition will be assessed to confirm acute ischemic stroke
Medical imaging will be performed to evaluate blood flow in brain vessels
Your current health status will be evaluated using specific assessment scales
Step 2
Treatment assignment
You will receive standard mechanical treatment to remove the blood clot
You may be assigned to receive an additional medication called cangrelor through intravenous infusion
Step 3
24-hour evaluation
Your condition will be assessed 24 hours after treatment
Brain imaging will be performed to check treatment results
Your neurological status will be evaluated
Step 4
24-36 hour follow-up
Additional brain scans will be performed to check for any bleeding
Your brain condition will be evaluated using a special scoring system called ASPECTS
Step 5
3-month assessment
Final evaluation of your recovery will be conducted
Your ability to perform daily activities will be assessed using a special scale
This marks the end of your participation in the study

Who can join the trial?

8 criteria

Must be 18 years of age or older
Must have a blockage in the brain's blood vessels (specifically in the internal carotid artery or middle cerebral artery) confirmed by special brain imaging scans
Symptoms must have started less than 24 hours before the brain imaging
Must be eligible for mechanical thrombectomy (a procedure to remove blood clots) and meet specific brain imaging criteria showing:
- Initial damaged brain area less than 70 ml
- Specific ratios of affected brain tissue as measured by specialized software
- Must have been independent in daily activities before the stroke (measured by a score of 2 or less on a disability scale)
- Must have a stroke severity score (NIHSS) of 6 or higher, indicating moderate to severe stroke symptoms
- Both men and women can participate

Who cannot join the trial?

15 criteria

Active or recent bleeding (within the last 30 days)
Blood clotting disorders or conditions that increase bleeding risk
Current use of blood thinners or anticoagulation medications
History of intracranial hemorrhage (bleeding in the brain)
Major surgery within the past 30 days
Severe liver disease
Severe uncontrolled high blood pressure (hypertension)
Known allergy or hypersensitivity to the study medication (cangrelor)
Pregnancy or breastfeeding
Participation in another clinical trial within the past 30 days
Life expectancy less than 3 months due to other medical conditions
Platelet count (blood cells that help with clotting) below acceptable levels
Severe kidney disease requiring dialysis
Unable to provide informed consent
History of severe allergic reactions to medications

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Verified sites

All sites with verified contact details – recruitment status may not be available; ask directly

Besancon University Hospital Center
Verified
Besançon, France
CHRU De Nancy
Responsive
Vandoeuvre Les Nancy, France
Centre Hospitalier Lyon Sud
Verified
Pierre Benite, France

Trial locations

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Investigated drugs

Cangrelor is a fast-acting blood-thinning medication that belongs to a group of drugs called P2Y12 inhibitors. It helps prevent blood clots by stopping platelets (small blood cells) from sticking together. In stroke treatment, it's used alongside mechanical thrombectomy (a procedure to remove blood clots from blood vessels in the brain) to help improve blood flow to the brain after a stroke. The medication is given directly into the bloodstream through an IV line, and its effects wear off quickly after the infusion is stopped. Mechanical thrombectomy (MT) is a minimally invasive procedure where doctors use special devices to physically remove blood clots from blocked blood vessels in the brain. During this procedure, a thin tube (catheter) is inserted through an artery, usually in the groin, and guided up to the blocked vessel in the brain. The clot is then removed using specialized tools, helping to restore blood flow to the affected area of the brain. Best Medical Management (BMM) refers to the standard medical care and treatments that stroke patients receive, including monitoring of vital signs, management of blood pressure, blood sugar levels, and other supportive care measures to help prevent complications and promote recovery.

Cangrelor Tetrasodium

What is already known about the treatment

Cangrelor - An intravenous P2Y12 receptor inhibitor used in acute ischemic stroke treatment as an antiplatelet medication. This fast-acting drug works by preventing platelets from sticking together, thereby reducing blood clot formation by blocking specific receptors on platelet cells. Cangrelor is typically administered during mechanical thrombectomy procedures alongside best medical management to improve blood flow restoration in stroke patients. The medication has shown promise in clinical trials for treating patients within 24 hours of stroke onset, particularly when selected through perfusion imaging techniques.

Investigated diseases

Acute Ischemic Stroke - A condition that occurs when blood flow to a part of the brain is suddenly blocked by a clot, preventing oxygen and nutrients from reaching brain tissue. The blockage typically happens when a blood vessel in the brain becomes narrowed or clogged with fatty deposits, or when a clot travels from another part of the body to the brain. Brain cells in the affected area begin to die within minutes of oxygen deprivation, leading to various symptoms such as sudden weakness or numbness on one side of the body, difficulty speaking, vision problems, or severe headache. The severity of symptoms depends on which area of the brain is affected and how much tissue is deprived of blood flow. The effects can range from mild to severe, depending on the location and size of the blocked area.