RECRUITING Phase 2 ClinicalTrials.gov

CO2 Modulation in Endovascular Thrombectomy for Acute Ischemic Stroke

Sponsor: University Hospital, Clermont-Ferrand • ClinicalTrials.gov ID: NCT05051397

Registry updated: 2026-09-03

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Description

Acute ischemic stroke due to large vessel occlusion is responsible of cerebral blood flow impairment with a progressive and extensive ischemic process. Cerebral collateral circulation may preserve an ischemic penumbra that could recover providing timely reperfusion of the occluded vessel. Mechanical thrombectomy is the standard of care for anterior circulation large vessel reperfusion. Strategy to promote cerebral blood flow in collateral circulation before reperfusion is scarce and rely mainly on blood pressure maintenance. Carbon dioxide is a potent cerebral vasodilator that could enhance collateral circulation blood flow and cerebral protection before reperfusion. General anesthesia with endotracheal mechanical ventilation could be used for thrombectomy and give the opportunity to modulate and control carbon dioxide tension in the blood. This study will test the effect of moderate hypercapnia on penumbral collateral circulation before reperfusion during mechanical thrombectomy for anterior circulation acute ischemic stroke under general anesthesia.

Interventions

HYPERCAPNIA (Biological)
Controlled moderate hypercapnia PaCO2 50mmHg under general anesthesia with mechanical ventilation
NORMOCAPNIA (Biological)
Controlled normocapnia PaCO2 40mmHg under general anesthesia with mechanical ventilation

Eligibility criteria

Inclusion Criteria: • Large vessel occlusion anterior circulation stroke (terminal carotid artery and/or middle cerebral artery M1-M2 segment) eligible to mechanical thrombectomy under general anesthesia Exclusion Criteria : * Active smoker * Chronic respiratory failure with ambulatory oxygen supplementation * Obesity with BMI\>40Kg/ m2 * Intubation before the procedure * Heart failure with intolerance to decubitus * Severe renal failure * Suspected elevated intracranial pressure * Pregnant or breastfeeding women

Conditions

Ischemic Stroke, Acute Thrombectomy Anesthesia, General Cerebrovascular Circulation Carbon Dioxide

Locations

CHU — Clermont-Ferrand, France

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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