The Specialized Program of Translational Research in Acute Stroke (SPOTRIAS) at the University of California San Diego (UCSD) Stroke Center currently applies the resources of 4 Cores to conduct 3 interrelated clinical trials designed to meet the overarching SPOTRIAS goal of increasing the number of thrombolytic-treated patients. Over the course of the 5-year renewal period, we propose to move this agenda forward with 6 new clinical trials: (1) Intravascular Cooling in the Treatment of Stroke-Caffeinol (ICTuS-C), which builds on the ongoing hypothermia research track of ICTuS-L, evolving from demonstration of the feasibility and safety of intravascular cooling in combination with thrombolysis to collaborative assessment, with Houston SPOTRIAS, of the safety, feasibility, and early efficacy of the endovascular induction of hypothermia and caffeinol in acute ischemic stroke patients presenting within the 3-hour window;(2) Transcranial Ultrasound in Acute Stroke, which builds on the ongoing ultrasound imaging research track to study the potential of diagnostic ultrasound in combination with rt-PA and/or ultrasound contrast agent microbubbles on image-guided transcranial thrombolysis;(3) Stroke Team Remote Evaluation Using a Digital Observation Camera - Optimizing Practitioners'Use in Stroke (STRokE DOC OPUS), which builds on the ongoing audio-visual telemedicine research track to explore the utility of remote telemedicine consultations for acute stroke by determining whether our pioneering hub-and-spoke model can be replicated in other communities and whether next-generation, optimized technology will increase use of the STRokE DOC system in areas with limited access to Internet-based technology;(4) Counterpulsation to Upgrade Forward Flow in Stroke (CUFFS), a new pilot assessment of the tolerability, feasibility, and safety of noninvasive external counterpulsation (ECP) in acute ischemic stroke patients within 0-48 hours of symptom onset;(5) Safety of tPA plus Transcranial Emission of Low-Energy Lasers for Acute Stroke Recovery (StELLAR), the first combination study of the NeuroThera Laser System with rt-PA;and (6) Spot Sign for Predicting and Treating ICH Growth (STOP IT), a study of acute intracerebral hemorrhages to determine the sensitivity and specificity of CT angiography for the prediction of hematoma growth and to test the feasibility of CT angiography for the guidance of hemostatic therapy. Altogether, our SPOTRIAS proposal for the renewal period aims to integrate and synthesize further the considerable strengths of the UCSD Stroke Center in conducting translational research that ultimately benefits stroke victims within our geographical practice range and worldwide as we treat more patients under 2 hours and explore new ways to safely and effectively treat other, guideline-ineligible patients outside the 3-hour rt-PA window, including through improved patient selection and stratification and additional treatments combined with and potentially augmenting thrombolysis.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Specialized Center (P50)
Project #
5P50NS044148-10
Application #
8267660
Study Section
Special Emphasis Panel (ZNS1-SRB-G (21))
Program Officer
Janis, Scott
Project Start
2002-07-01
Project End
2014-04-30
Budget Start
2012-05-01
Budget End
2014-04-30
Support Year
10
Fiscal Year
2012
Total Cost
$2,142,290
Indirect Cost
$390,101
Name
University of California San Diego
Department
Neurosciences
Type
Schools of Medicine
DUNS #
804355790
City
La Jolla
State
CA
Country
United States
Zip Code
92093
Lyden, Patrick; Hemmen, Thomas; Grotta, James et al. (2016) Results of the ICTuS 2 Trial (Intravascular Cooling in the Treatment of Stroke 2). Stroke 47:2888-2895
Spokoyny, Ilana; Raman, Rema; Ernstrom, Karin et al. (2015) Defining mild stroke: outcomes analysis of treated and untreated mild stroke patients. J Stroke Cerebrovasc Dis 24:1276-81
Schlick, Konrad H; Hemmen, Thomas M; Lyden, Patrick D (2015) Seizures and Meperidine: Overstated and Underutilized. Ther Hypothermia Temp Manag 5:223-7
Spokoyny, Ilana; Raman, Rema; Ernstrom, Karin et al. (2015) Accuracy of First Recorded "Last Known Normal" Times of Stroke Code Patients. J Stroke Cerebrovasc Dis 24:2467-73
Neil, William P; Raman, Rema; Hemmen, Thomas M et al. (2015) Association of Hispanic ethnicity with acute ischemic stroke care processes and outcomes. Ethn Dis 25:19-23
Coffman, Clarity R; Raman, Rema; Ernstrom, Karin et al. (2015) The "DeyeCOM Sign": Predictive Value in Acute Stroke Code Evaluations. J Stroke Cerebrovasc Dis 24:1299-304
Guluma, Kama Z; Liebeskind, David S; Raman, Rema et al. (2015) Feasibility and Safety of Using External Counterpulsation to Augment Cerebral Blood Flow in Acute Ischemic Stroke-The Counterpulsation to Upgrade Forward Flow in Stroke (CUFFS) Trial. J Stroke Cerebrovasc Dis 24:2596-604
Lyden, Patrick D; Hemmen, Thomas M; Grotta, James et al. (2014) Endovascular therapeutic hypothermia for acute ischemic stroke: ICTuS 2/3 protocol. Int J Stroke 9:117-25
Spokoyny, Ilana; Raman, Rema; Ernstrom, Karin et al. (2014) Imaging negative stroke: diagnoses and outcomes in intravenous tissue plasminogen activator-treated patients. J Stroke Cerebrovasc Dis 23:1046-50
Spokoyny, Ilana; Raman, Rema; Ernstrom, Karin et al. (2014) Pooled assessment of computed tomography interpretation by vascular neurologists in the STRokE DOC telestroke network. J Stroke Cerebrovasc Dis 23:511-5

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