MR and Recanalization of Stroke Clots Using Embolectomy

急性中风是一种常见的破坏性疾病，是美国第三大死亡原因和成人残疾的主要原因。本申请更新了加州大学洛杉矶分校急性卒中中心转化研究专业计划，提出了一个综合研究/培训计划，以开发急性缺血性和出血性卒中的创新疗法。提出了五个研究项目。项目1， 治疗性水氧（TAO）试验”是一项50例患者试验，旨在评价血管内输送过饱和水氧至缺血性人类脑组织的可行性和安全性。该试验将是第一项关于神经保护剂血管内输注的正式研究，这是一种非常有前途的血管内再通补充策略。项目2，“术中CT和血管内引导 脑出血手术（ICES）试验”是一项关键的2期试验，采用移动的术中CT和神经内窥镜，对一种新的微创手术技术进行原发性脑出血清除。此外，研究询问脑损伤的基本病理生理学， 人类脑出血，提出描绘差异基因表达，组织形态学，和多模态MR签名在血肿周围地区。在项目3中，“现场远程卒中：利用移动的宽带远程医疗技术改善院前卒中护理”将评估院前诊断的益处 准确性和知情同意的医生-病人互动的领域采用新兴的视频手机技术。项目4，“使用栓子切除术（MR RESCUE）试验的卒中凝块的MR和再通”，是一项国际多中心试点试验，旨在确定弥散灌注MRI是否可以识别急性脑缺血患者，这些患者将从机械栓子切除术中获益， 症状发作后8小时内使用Merci寻回犬。项目5，“反搏以改善卒中前向血流（CUFFS）试验”将评估30例持续动脉闭塞患者通过体外反搏增加缺血脑区血流量的耐受性、可行性和安全性。 五个核心支持项目：行政、患者访问、血液/组织标本、生物统计/数据管理和神经成像。职业发展计划将在医学预科，医学生和奖学金水平上培养下一代神经血管疾病的翻译科学家。

Acute stroke is a common and devastating disorder, the 3rd leading cause of death and leading cause of adult disability in the US. This application for renewal of the UCLA Specialized Program of Translational Research in Acute Stroke Center proposes an integrated research/training program to develop innovative therapies for acute ischemic and hemorrhagic stroke. Five research projects are proposed. Project 1, the Therapeutic Aqueous Oxygen (TAO) Trial" is a 50 patient trial to evaluate the feasibility and safety of endovascular delivery of supersaturated, aqueous oxygen to ischemic human cerebral tissues. This trial will be the first formal study of endovascular infusion of neuroprotective agents, a highly promising complementary strategy to endovascular recanalization. Project 2, the "Intraoperative CT and Endovascular-Guided Surgery for Intracerebral Hemorrhage (ICES) Trial" is a critical phase 2 trial of a new, minimally invasive surgical technique for the evacuation of primary intracerebral hemorrhage, using mobile intra-operative CT and neuroendoscopy. In addition, studies interrogating the fundamental pathophysiology of brain injury in human ICH are proposed delineating differential gene expression, tissue morphometrics, and multimodal MR signatures in the perihematomal region. In Project 3, "Telestroke in the Field: Improving Prehospital Stroke Care with Mobile Broadband Telemedicine Technologies," will evaluate the benefit upon prehospital diagnostic accuracy and informed consent of physician-patient interaction in the field employing emerging video handset technologies. Project 4, "The MR and Recanalization of Stroke Clots Using Embolectomy (MR RESCUE) Trial," is an international, multicenter pilot trial to determine whether diffusion-perfusion MRI can identify acute cerebral ischemia patients who will benefit substantially from mechanical embolectomy with the Merci Retriever up to 8 hrs from symptom onset. Project 5, the "Counterpulsation to Upgrade Forward Flow in Stroke (CUFFS) Trial" will assess the tolerability, feasibility, and safety of increasing blood flow to ischemic cerebral fields through external counterpulsation in 30 patients with persisting arterial occlusion. Five Cores support the Projects: Administrative, Patient Access, Blood/Tissue Specimen, Biostatistics/Data Management, and Neuroimaging. A Career Development Program will train the next generation of translational scientists in neurovascular disease at the premedical, medical student, and fellowship level.