Emergency Stroke Unit With NeuAngio-CT (ESU-ACT)

A regiszterben nem jelölt feltételek

• Inclusion Criteria:
  • Age ≥ 18 years;
  • Clinically diagnosed with acute ischemic stroke;
  • RACE score ≥ 4 points upon hospital arrival;
  • Time from symptom onset/last known normal to hospital arrival ≤ 6 hours;
  • Pre-stroke mRS score 0-1;
  • Informed consent signed by the patient or their legal representative.
• Exclusion Criteria:
  • Hemorrhagic stroke diagnosed by cranial CT or MRI during this current episode;
  • Uncontrolled hypertension with medication (defined as systolic blood pressure > 185 mmHg or diastolic blood pressure > 110 mmHg) (Note: Patients may be included if blood pressure can be successfully reduced and maintained at an acceptable level with medication);
  • Known hereditary or acquired bleeding tendency, such as coagulation factor deficiency, or INR > 3.0 or PT > 3 times the normal range after anticoagulant therapy (Patients without a history of coagulation dysfunction or suspected coagulation dysfunction do not need to wait for laboratory results of INR or prothrombin time before enrollment);
  • Received heparin, low-molecular-weight heparin (e.g., dalteparin sodium), or thrombin inhibitors (e.g., bivalirudin, argatroban) within 24 hours with a history of coagulation disorders;
  • Baseline laboratory values: blood glucose < 50 mg/dl (2.78 mmol/L) or > 400 mg/dl (22.20 mmol/L), hemoglobin count < 7 mmol/l (11.28 g/dl); platelet count < 50,000/μl;
  • Patients with renal failure, defined as serum creatinine > 3.0 mg/dl (264 μmol/l) (Note: Patients undergoing dialysis can be included regardless of serum creatinine level);
  • Cerebral embolism caused by septic emboli or bacterial endocarditis;
  • History of stroke within the past 3 months;
  • Seizure at stroke onset leading to diagnostic confusion and difficulty in accurate baseline RACE assessment;
  • History of previous neuropsychiatric disorders that make accurate neurological function assessment difficult, such as dementia patients taking cholinesterase inhibitors;
  • Diagnosis of cerebral vasculitis, brain tumor, or traumatic brain injury within the past 3 months;
  • Major organ surgery or biopsy within 30 days;
  • Active bleeding or recent bleeding within 30 days;
  • History of previous intracranial stent implantation;
  • History of severe contrast agent allergy (non-rash allergy);
  • Patients with other contraindications to reperfusion therapy or who refuse reperfusion therapy;
  • Life expectancy less than 180 days;
  • Lactating women or women with positive pregnancy test on admission;
  • Patients who refuse or cannot cooperate with follow-up.