Stroke Clinical Trial Research

OVERVIEW

OVERVIEW

In recent years, the stroke research of our group focused on multicenter trials for acute treatment and prevention. Regarding acute treatment, we participated in the SWIFT PRIME trial, a randomized, controlled, multicenter study comparing stent-retriever thrombectomy with intravenous tissue plasminogen activator (IV tPA) with IV tPA alone in acute ischemic stroke. We received a certificate for best clinical outcome as a participating center. In cooperation with the Department of Neuroradiology (M. Bendszus), several projects regarding endovascular stroke treatment (EST) were performed. The influence of thrombus-lengths and localization was examined in patients not qualifying for randomized trials (e.g. wake-up patients, advanced age, basilar occlusion). Overall, we could also demonstrate that in those patients EST was safe and effective. The efficacy of endovascular thrombectomy in patients with early infarct signs indicating a large core infarction (ASPECTS 3 to 5) was shown in the multicenter randomized TENSION trial (Published in The Lancet / PI M. Bendszus).

The group successfully collaborates with the European TRISP (Thrombolysis in Stroke Patients) Group, in which several local databases for systemic and endovascular stroke therapy are combined and analyzed to answer clinically relevant questions for the treatment of stroke patients with rtPA. Analysis of patients with pre-existing disabilities clearly demonstrated that those patients also benefit from iv-rtPA. In addition, the risk of iv-rtPA is not severely increased in patients with renal insufficiency. By co-leading and participating in a multicenter analysis, the safety of thrombolysis despite prior oral anticoagulation with direct oral anticoagulants was examined (Meinel et al., 2023). No increased bleeding risk was found, but prospective validation is pending.