Intravenous Thrombolysis in Acute Ischemic Stroke with Active Cancer

Launched by SECOND AFFILIATED HOSPITAL, SCHOOL OF MEDICINE, ZHEJIANG UNIVERSITY · Feb 20, 2025

Keywords

ClinConnect Summary

This clinical trial is investigating whether a treatment called intravenous thrombolysis can help patients who have had an ischemic stroke and also have active cancer. Ischemic stroke happens when a blood vessel in the brain gets blocked, preventing blood flow. The researchers believe that using thrombolysis, which helps dissolve the blood clot, may lead to better recovery compared to standard care for these patients.

To participate in this trial, patients need to be at least 18 years old and have experienced symptoms of an ischemic stroke within the last 24 hours. They must also have been diagnosed with active cancer within the past six months or have had recent treatment for it. However, there are some conditions that would exclude patients from participating, such as having a serious bleeding risk or certain recent medical procedures. This trial is not yet recruiting participants, but it aims to help improve treatment options for patients facing both stroke and cancer.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Patients with clinical signs of acute ischemic stroke within 24 hours of onset or awakening with stroke (if within 24 hours from the midpoint of sleep). Patients with AIS within 4.5-24 hours of onset must meet the IVT inclusion criteria specified in the guideline
• • 2. Patients with active cancer (Active cancer was defined as cancer diagnosed within the previous 6 months; recurrent, regionally advanced or metastatic cancer, or cancer for which treatment had been administered within 6 months, or haematological cancer without complete remission.)
• • 3. Patients ≥ 18 years old
• • 4. Informed consent has been obtained depending on local ethics requirements.
• Exclusion Criteria:
• • (1) Intended to proceed to endovascular treatment; (2) Pre-stroke mRS score \> 2 (3) Contraindications for IVT：
• • 1. Intracranial hemorrhage (including parenchymal hemorrhage, intraventricular hemorrhage, subarachnoid hemorrhage, epidural hematoma, etc.)
• • 2. Previous history of intracranial hemorrhage
• • 3. Severe head trauma or stroke history within the last 3 months
• • 4. Intracranial tumors, giant intracranial aneurysms
• • 5. Intracranial or spinal surgery within the recent 3 months
• • 6. Major surgical procedures within the last 2 weeks
• • 7. Gastrointestinal or urinary tract bleeding within the last 3 weeks
• • 8. Active visceral bleeding
• • 9. Aortic arch dissection
• • 10. Arterial puncture in a site within the last 1 week that is not easy to compress and stop bleeding
• • 11. Elevated blood pressure: Systolic blood pressure ≥ 180 mmHg or diastolic blood pressure ≥ 100 mmHg
• • 12. Acute bleeding tendency, including platelet count \< 100 × 10⁹/L or other conditions
• • 13. Received low-molecular-weight heparin treatment within 24 hours
• • 14. Oral anticoagulants (warfarin) with INR \> 1.7 or PT \> 15 s; Receiving heparin treatment with aPTT above the upper limit of the normal range within the last 24 hours of onset, Receiving thrombin inhibitors and factor Xa inhibitors within the last 48 hours of onset.
• • 15. Blood sugar \< 2.8 or \> 22.22 mmol/L
• • 16. Head CT or MRI indicates large-area infarction (infarction area ≥ 1/3 of the middle cerebral artery supply area) (4) The judgment is left to the discretion of the investigator