Funded by a grant from the National Institute of Neurological Diseases and Stroke (NINDS), the Comprehensive Stroke Center at UC San Diego Health System is pioneering new techniques that could potentially extend brain-saving stroke treatment to more patients. The grant, called the Specialized Program of Translational Research in Acute Stroke (SPOTRIAS), supports clinical trials in the following areas, including remote web-based consultations and hypothermia.
Search open stroke related clinical trials in San Diego
Neuro-endovascular therapies are minimally invasive procedures used to treat vascular lesions in the head, neck and spine. Using microcatheters and devices such as balloons, platinum coils, liquid adhesive and stents, the interventional radiologist navigates from the femoral artery or vein to treat the abnormal target vessels. Navigation is assisted by real-time, bi-plane digital-subtraction angiography and real-time fluoroscopy.
Patients whose neurovascular lesions have been determined to be untreatable by conventional surgical or medical techniques are often candidates for neuro-endovascular therapy.
Neuro-endovascular therapies are used in the treatment of:
- Intracranial aneurysms
- Vasospasms following subarachnoid hemorrhage
- Ischemic strokes
- Symptomatic intracranial artherosclerosis
- Arteriovenous malformations (AVMs), dural arteriovenous fistulas (AVFs)
- Carotid cavernous fistula - post-traumatic or spontaneous
UC San Diego is participating in multisite randomized trials to advance the knowledge of neuro-endovascluar therapy. Currently we are investigating the use of multimodal reperfusion therapy in selected stroke patients who arrive within 8 hours at the hospital.
In an effort to advance brain cell protection (neuroprotection), UC San Diego is using induced hypothermia in patients after ischemic stroke. Cooling has been shown to help patients recover after cardiac arrest. In these situations the entire brain is deprived of oxygen and nutrients.
In an ischemic stroke, a part of the brain is undergoing this deprivation. Cooling the brain could preserve brain cells, In combination with tPA that opens the occluded blood vessel, hypothermia may ideally prevent brain cell death while reperfusion therapy is performed.
In addition, our laboratory focuses on basic and translational research in the area of brain ischemia. Using a variety of experimental approaches, we are interested in understanding relationships between brain injury and behavior deficits. We are also interested in fundamental mechanisms of therapeutic agents, finding new therapies for stroke, and devising improved statistical analysis methods before performing such pharmacological research.
Iris-Insulin Resistance Intervention after Stroke Trial
Over 400,000 Americans and 30,000 Canadians survive an ischemic stroke and over 200,000 have a transient ischemic attack (TIA) each year.
The Insulin Resistance Intervention after Stroke (IRIS) trial is a randomized clinical trial that will test the effectiveness of a new approach to preventing stroke and heart attack among patients with a recent ischemic stroke or TIA. The new approach targets insulin resistance, a newly recognized cause of atherosclerosis.
Atherosclerosis is the underlying disease that clogs vessels in strokes and heart attacks. Insulin resistance affects nearly half of all patients with stroke and TIA. Participating stroke patients will be assigned to receive pioglitazone, a medication which reduces insulin resistance, or placebo (an inactive look-alike pill). Patients will stay on their assigned treatment for about four years. At the end of the study, investigators will compare the experience of patients on pioglitazone and placebo to see which group had fewer recurrent strokes and heart attacks. The National Institutes of Health (NIH) in Washington, D.C., is sponsoring this study.
Secondary Prevention of Small Subcortical Strokes (SPS3)
SPS3 is a study for persons who have experienced a small subcortical stroke, also known as a lacunar stroke. The main goal of this study is to learn more about preventing another stroke from occurring in patients who have already had a subcortical stroke. We also want to learn how to prevent problems with thinking and memory decline that may happen after a stroke.
This study is testing if taking both aspirin and clopidogrel will be more effective in preventing another stroke than just aspirin alone. This study is also seeking information about the best level of blood pressure control after a stroke. The National Institutes of Health (NIH) in Washington, D.C., is sponsoring this study.
Several community hospitals will participate in clinical trials initiated at UC San Diego. The long distance consultation (telemedicine) system utilizes broadband wireless internet technology to allow real-time communication with the UC San Diego stroke team over long distances.
When a suspected stroke patient arrives in the emergency room of a participating hospital, the local physician will send live video of the patient to a wireless, laptop computer operated by the on-call member of the UC San Diego stroke team. The UC San Diego stroke specialist then participates in the physical exam while it is taking place, consulting with the community physician and advising in administration of appropriate therapies.
For More Information
For more information on clinical trials and research, please call the Stroke Center at 858-657-8530.