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Acute Ischemic StrokeFOCUSNCT06485427

Safety and Efficacy of Selective Intra-Arterial Cooling Infusion Combined With EVT in Acute Ischemic Stroke

A study testing Selective Intra-arterial Cooling Infusion (IA-SCI) in people with Acute Ischemic Stroke and Hypothermia, run by Beijing Shijitan Hospital, Capital Medical University at 12 sites in China.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This is a multicenter, randomized, controlled, subject- and assessor-blinded clinical trial. The research objective is to evaluate the safety and efficacy of selective intra-arterial cooling infusion combined with endovascular therapy in the treatment of acute anterior circulation large vessel occlusion stroke. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Acute Ischemic Stroke, Hypothermia
What is being tested?
Selective Intra-arterial Cooling Infusion (IA-SCI)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
258 participants
Where
12 sitesChina
Study dates
3 Jul 2024to 1 Mar 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥18 and ≤80.
  • Clinical signs consistent with AIS-LVO in the anterior circulation (intracranial segment of internal carotid artery, M1 segment of middle cerebral artery (MCA) demonstrated by computed tomography angiography (CTA) / magnetic resonance angiography (MRA)/ digital subtraction angiography (DSA)).
  • National Institutes of Health Stroke Scale (NIHSS) score (at screening) ≥6 and ≤25.
  • Modified Rankin Scale (mRS) score ≤1 before stroke onset.
  • Arterial puncture performed within 24 hours of symptom onset or last known well (LKW).
  • Written informed consent obtained from the patients or legally authorized representatives.
  • For patients admitted to the hospital within 6 hours of symptom onset, an Alberta Stroke Program Early CT Score (ASPECTS) ≥6 is required. For those admitted between 6 and 24 hours, the neuroimaging criteria of the DAWN or DEFUSE-3 trials are applied.

Who cannot join

  • Baseline CT/MRI reveals the presence of acute infarction in multiple vascular territories.
  • CTA/MRA/DSA confirms the presence of arterial dissection.
  • Evidence of intracranial hemorrhage or hemorrhagic transformation before thrombectomy.
  • Known allergies or intolerances to antiplatelet agents, anticoagulants, iodinated contrast, or anesthetics.
  • Severe infection (e.g., sepsis) or multiple organ failure.
  • Known hereditary or acquired hemorrhagic diathesis; coagulation factor deficiency; recent oral anticoagulant therapy with international normalized ratio (INR)>3.
Show all 19Show fewer
  • Exception: Time elapsed since the last use of a novel oral anticoagulant ≥48 hours plus a normal activated partial thromboplastin time (APTT).
  • Baseline platelet count <50 × 109/L.
  • Blood glucose concentration <50 mg/dL (2.7 mmol/L) or >400 mg/dL (22.2 mmol/L).
  • Refractory hypertension that is difficult to control by medication (persistent systolic blood pressure (BP) >185 mmHg or diastolic BP >110 mmHg).
  • Previous New York Heart Association (NYHA) functional classification >I.
  • Coronary artery stenosis >70% or history of coronary artery bypass grafting.
  • Undergoing hemodialysis or peritoneal dialysis; severe renal insufficiency with a glomerular filtration rate <30 mL/min or serum creatinine >220 mmol/L (2.5 mg/dL).
  • Known intracranial aneurysm or cerebral arteriovenous malformation.
  • Malignant brain tumor or central nervous system infection.
  • Pre-existing neurological or psychiatric diseases that could confound the neurological or functional evaluations (e.g., dementia or mental illness)
  • Pregnant or lactating at admission.
  • Anticipated life expectancy <6 months.
  • Current participation in another interventional drug or device study. For any other reasons, the responsible clinicians believe that the patient is not suitable for SI-AC.

Trial locations and contacts

12 sites in 1 country.

12 sites in 1 country

China12 sites
  • Beijing Chaoyang Hospital, Capital Medical University

    Beijing

  • Beijing Shijitan Hospital, Capital Medical University

    Beijing

  • Peking University Internation Hospital

    Beijing

  • 967 Hospital of the Joint Logistics Support Force of PLA

    Dalian

  • Dalian Municipal Central Hospital

    Dalian

  • Gansu Province Central Hospital

    Gansu

  • The First Affiliated Hospital of Harbin Medical University

    Ha’erbin

  • Zhejiang Provincial People's Hospital

    Hangzhou

  • The Second Hospital and Clinical Medical School, Lanzhou University

    Lanzhou, Gansu

  • Department of Neurosurgery, Nanshi Hospital of Nanyang

    Nanyang, Henan

  • Affiliated Hospital of Inner Mongolia University for the Nationalities

    Tongliao

  • The Affiliated Hospital of Xuzhou Medical University

    Xuzhou, Jiangsu

Other trials in China

About this study

Official title: Selective Intra-arterial Cooling Infusion With Endovascular Thrombectomy for Acute Ischemic Stroke: a Multicenter, Randomized, Controlled Trial

This is a multicenter, randomized, controlled, subject- and assessor-blinded clinical trial. The research objective is to evaluate the safety and efficacy of selective intra-arterial cooling infusion combined with endovascular therapy in the treatment of acute anterior circulation large vessel occlusion stroke. This trial aims to enroll 258 subjects. Patients assigned to the control group will receive best medical management (BMM) and endovascular therapy (EVT). Those in the selective intra-arterial cooling infusion group (IA-SCI group) will undergo selective intra-arterial cold saline infusion, in addition to BMM and EVT. Subjects will be interviewed face-to-face at randomization, 24±6 hours, 48±6 hours after randomization, 7±2 days/discharge. Telephone interviews/ face-to face interviews will be performed at 30±3 days and 90±7 days after randomization. The primary outcome is the distribution of Modified Rankin Score at 90±7days after randomization.

Read the detailed description

Acute ischemic stroke (AIS) is the leading cause of death and disability in China. Randomized trials involving patients with acute stroke due to large-artery occlusion in the anterior circulation have shown a benefit of endovascular therapy (EVT). Although EVT achieves successful recanalization in over 80% of patients, only 46% of patients are functionally independent (mRS 0-2) after the intervention . Therefore, new ancillary therapeutic strategies are needed to further improve the clinical outcomes.

Therapeutic systemic hypothermia has been suggested to be one such potential approach offering a viable neuroprotective strategy. However, several adverse events associated with the systematic hypothermia treatment have been reported. Those offset the therapeutic benefits of systemic hypothermia. Selective intra-arterial cooling infusion (IA-SCI) targets precisely the ischemic brain tissue with the infusion of hypothermic solutions. This approach induces a state of mild hypothermia in the ischemic region without causing substantial drops in core body temperature, thereby minimizing the incidence of systemic side effects. Previous studies have shown that IA-SCI with cold saline combined with EVT in AIS is safe and feasible.

Hence, the investigators design a multicenter, randomized, controlled, subject- and assessor-blinded clinical trial. The objective of this trial is to further explore the safety and efficacy of selective intra-arterial cooling infusion combined with EVT in the treatment of acute anterior circulation large vessel occlusion stroke, and 258 subjects will be enrolled. Subjects assigned to the control group will receive best medical management (BMM) and endovascular therapy (EVT). Those in the selective intra-arterial cooling infusion group (IA-SCI group) will undergo selective intra-arterial cold saline infusion, in addition to BMM and EVT. Subjects will be interviewed face-to-face at randomization, 24±6 hours, 48±6 hours after randomization, 7±2 days/discharge. Telephone interviews/ face-to face interviews will be performed at 30±3 days and 90±7 days after randomization. The primary outcome is the distribution of Modified Rankin Score at 90±7days after randomization.

Being tested
Selective Intra-arterial Cooling Infusion (IA-SCI)
Medical subject headings
Ischemic Stroke, Hypothermia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Selective Intra-arterial Cooling Infusion (IA-SCI)Procedure or surgery

    Pre-recanalization: During the procedure, the micro-catheter is advanced over a micro-guide wire, traveling up through the neck until it reaches beyond the clot. A 50 mL cold 0.9% saline (4 ℃) is infused intro into the ischemic territory at a rate of 10 mL/min via the micro-catheter. This enables the cold solution to infuse into the ischemic territory prior to revascularization.

    Post-recanalization: After recanalization, cold 0.9% saline (4 ℃) is reinfused into the vessel via the catheter at a rate of 22 mL/min for 10 min, repeated twice with a 10-minute interval between infusions.

Study groups in NCT06485427
Study groupRoleWhat they receive
Control groupNo interventionSubjects will receive best medical management (BMM) plus endovascular therapy (EVT) according to the clinical guidelines.
IA-SCI groupExperimentalSubjects randomized to the IA-SCI group will receive selective intra-arterial cooling infusion plus BMM and EVT.
Receives: Procedure: Selective Intra-arterial Cooling Infusion (IA-SCI)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Distribution of Modified Rankin scale

    the distribution of Modified Rankin scale (mRS) [ranging from 0 (normal) to 6 (death)]

    Measured: 90 ±7days

Secondary outcomes (21)
  1. Percentage of functional independence (mRS scale 0-2)

    the percentage of mRS scale 0-2 (Modified Rankin scale [ranging from 0 (normal) to 6 (death)])

    Measured: 90 ±7days

  2. Percentage of favorable outcome (mRS scale 0-1)

    the percentage of mRS scale 0-1(Modified Rankin scale [ranging from 0 (normal) to 6 (death)])

    Measured: 90 ±7days

  3. Final infarction volume

    The infarct area is defined as the low-density area. The infarct area is semi-automatically delineated by the software. The infarct volume= the sum of the infarct area of each layer × layer thickness (5mm).

    Measured: 7±2 days/discharge

  4. The changes of infarction volume

    the changes of infarction volume between baseline and 7±2 days/discharge assessed by CT

    Measured: 7±2 days/discharge

  5. National Institute of Health stroke scale (NIHSS) score

    National Institute of Health stroke scale (NIHSS) score [ranging from 0 to 42 points, with higher numbers indicating greater severity]

    Measured: 7±2 days/discharge

  6. Barthel Index score

    the Barthel Index score [the sum of the score ranging from 0 to 100, with 100 being the most independent level of function]

    Measured: 90±7 days

  7. Rapid neurologic improvement

    Rapid neurologic improvement is defined as a reduction of ≥8 on the National Institutes of Health Stroke Scale [ranging from 0 to 42 points, with higher numbers indicating greater severity] or National Institutes of Health Stroke Scale zero to one 24 hours after thrombectomy.

    Measured: 24±12 hours

  8. Changes in ipsilateral tympanic membrane temperature

    Changes in ipsilateral tympanic membrane temperature before and after intra-arterial cooling infusion in the IA-SCI group.

    Measured: during surgery.

  9. Power spectral density (PSD) assessed by continuous electroencephalogram (EEG)

    PSD is estimated using Welch's periodogram from EEG.

    Measured: within 7±2 days/discharge

  10. (delta+theta)/(alpha+beta) power ratio (DTABR) assessed by continuous electroencephalogram (EEG)

    DTABR is calculated using the absolute power for each of spectral band on EEG.

    Measured: within 7±2 days/discharge

  11. Delta/alpha power ratio (DAR) assessed by continuous electroencephalogram (EEG)

    DAR is calculated using the absolute power for each of spectral band on EEG.

    Measured: within 7±2 days/discharge

  12. Brain symmetry index (BSI) assessed by continuous electroencephalogram (EEG)

    BSI is calculated using the power values from both left and right hemispheres from EEG.

    Measured: within 7±2 days/discharge

  13. Symptomatic intracranial hemorrhage

    Defined as any intracranial hemorrhage accompanied by neurological deterioration (NIHSS score increased by more than 4 points compared with the lowest NIHSS score at enrollment or during hospitalization) or death caused by any cerebral hemorrhage according to the ECASS III study.

    Measured: 24±12 hours

  14. Any intracranial hemorrhage

    any intracranial hemorrhage assessed by CT

    Measured: 24±12 hours

  15. Procedure-related complications

    Including vascular injury, device-associated adverse events, and intracranial arterial vasospasm requiring further therapeutic intervention。

    Measured: during operation

  16. Proportion of subjects with pulmonary, urinary tract infection and gastroenteritis

    the proportion of patients with pulmonary, urinary tract infection and gastroenteritis according to the Centers for Disease Control and Prevention (CDC)/ National Healthcare Safety Network (NHSN) criteria.

    Measured: 7±2 days/discharge

  17. Proportion of subjects with coagulation abnormalities

    Defined as abnormal coagulation function

    Measured: 24±12 hours

  18. Proportion of subjects with electrolyte imbalance

    Defined as any abnormal findings, including hypernatremia, hyponatremia, hyperkalemia, or hypokalemia.

    Measured: 24±12 hours

  19. Changes in core temperature before and after intra-arterial cooling infusion in the IA-SCI group.

    Changes in rectal temperature before and after intra-arterial cooling infusion in the IA-SCI group.

    Measured: During operation

  20. any death

    any death

    Measured: 90±7 days

  21. other AE/SAE

    other adverse events/ serious adverse events

    Measured: 90±7 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 Jul 2024
  2. Study start3 Jul 2024
  3. Primary completion8 Feb 2026
  4. Study completion1 Mar 2026

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
258 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06485427
Sponsor's protocol ID
FOCUS
Acronym
FOCUS
Status last verified
Jul 2026
First submitted
22 Jun 2024
Last updated
7 Jul 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: The deidentified individual participant data underlying this article will not be publicly available. However, the data may be made available to researchers upon reasonable request to the corresponding author, subject to approval by the institutional review board and execution of a data access agreement.

Questions about this trial

What is this clinical trial studying?

A study testing Selective Intra-arterial Cooling Infusion (IA-SCI) in people with Acute Ischemic Stroke and Hypothermia, run by Beijing Shijitan Hospital, Capital Medical University at 12 sites in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 7 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Distribution of Modified Rankin scale (time frame: 90 ±7days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Jul 2026.

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