University of Calgary
Clinical Neurosciences
Jen Guo is an undergraduate student in her fourth and final year of Biomedical Sciences at University of Calgary (Canada). Her research focuses on ischemic stroke, TIA and infarct growth post endovascular therapy. She is particularly interested in neuroimaging (MRI and diffusion weighted imaging) and other tools on stroke evolution and brain segmentations.

Presenter of 1 Presentation

THE EFFECT OF NEUROPROTECTANT NA1 ON EARLY INFARCT GROWTH FOLLOWING ENDOVASCULAR THERAPY: THE REPERFUSE-NA1 STUDY

Session Type
Free Communication Session
Date
29.10.2021, Friday
Session Time
17:15 - 18:45
Room
FREE COMMUNICATIONS A
Presenter
Lecture Time
18:15 - 18:25

Abstract

Background and Aims

Unfavourable outcome despite successful endovascular therapy (EVT) recanalization may be caused by substantial infarct growth that occurs despite successful reperfusion. The REPERFUSE-NA1 study replicated the preclinical NA1 experiment by investigating the effect of NA1 on early DWI infarct growth in acute ischemic stroke patients receiving EVT.

Methods

The REPERFUSE-NA1 was sub-study of the randomized controlled trial ESCAPE-NA1 (ClinicalTrialGov NCT02930018). Patients received MRI within 5 hours and 24 hours of EVT. The primary outcome was early diffusion weighted (DWI) Infarct growth.

Results

A total of 71 patients was included, of whom 67 had sufficient MR imaging at 5h and 24h post-EVT. For patients who received NA1 compared to placebo, the median age (68.8 v 67.5), baseline NIHSS (15.5 v 16), time from symptom onset to reperfusion (161 v 167 minutes) and mTICI 2b-3 (94.4% v 94.3%) were statistically not different. Median DWI volumes post-EVT (5h) were 13.0 mL (IQR, 5.9-28.1) in NA1 and 13.3 mL (IQR, 3.1-27.0) in placebo. At 24h median DWI volumes increased to 22.6 mL (IQR, 11.2-63.4) in the NA1 group and 22.4 mL (IQR, 7.4-52.3) in the placebo group, equating to a 48.4% DWI volume growth in the NA1 group and a 66.0% growth in the placebo group. Median DWI volume growth was 55.1% for NA1 patients who received alteplase compared to 41.3% for NA1 patients who did not receive alteplase (p=0.65).

Conclusions

The study did not show an effect of NA1 in reducing early DWI growth despite there being substantial DWI infarct growth in both NA1 and control groups.

Hide