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。这份申请续签加州大学洛杉矶分校急性卒中中心转化性研究专业计划的申请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中风的创新疗法。提出了五个研究课题。项目1、 治疗性水氧(TAO)试验“是一项50名患者的试验，旨在评估血管内给氧的可行性和安全性。这项试验将是血管内输注神经保护剂的第一次正式研究，它是血管内再通的一种非常有前途的补充策略。项目2，术中CT和血管内引导 手术治疗脑出血(ICES)试验“是一种新的微创外科技术的关键的第二阶段试验，利用术中可移动的CT和神经内窥镜清除原发性脑出血。此外，研究询问脑损伤的基本病理生理学。 人类脑出血被提议描绘血肿周围区域的差异基因表达、组织形态计量学和多模式磁共振信号。在项目3“现场远程卒中：利用移动宽带远程医疗技术改善院前卒中护理”中，将评估院前诊断的益处 使用新兴的视频手持设备技术实现现场医患互动的准确性和知情同意。项目4“使用栓子切除术治疗卒中血块的MR和再通化(MR RESAVE)试验”是一项国际性的多中心试点试验，旨在确定弥散-灌注MRI是否能够识别急性脑缺血患者，这些患者将从机械取栓术中获得实质性好处。 梅西猎犬在症状出现后长达8小时。项目5，“卒中患者的反搏提升前向血流(CUFFS)试验”将评估30名持续性动脉闭塞患者通过体外反搏增加脑缺血区域血流量的耐受性、可行性和安全性。 五个核心支持这些项目：管理、患者访问、血液/组织样本、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、医学生和研究员级别培训下一代神经血管疾病方面的转化型科学家。

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.