ACUTE TRIALS:

ASPIRE: To determine if apixaban is superior to aspirin for prevention of the composite outcome of any stroke (hemorrhagic or ischemic) or death from any cause in patients with recent ICH and AF.
Aspire Recruitment Video
Coordinator – Ashlynn Solomon

CAPTIVA: To determine if low-dose rivaroxban (2.5 mg BID), ticagrelor, or clopidogrel on top of standard aspirin therapy is safe and effective for prevention of recurrent vascular events in patients with 70-99% intracranial stenosis.

Coordinator – Nichole

DISCOVERY: This is a prospective, multi-center, observational, nested-cohort study. A total of 8,000 patients hospitalized at the DISCOVERY clinical sites with acute-onset AIS, ICH or aSAH and no history of dementia will be enrolled. All participants will undergo baseline screening for evidence of pre-stroke dementia. Those who pass baseline screening will complete a blood draw and a series of cognitive and functional assessments at baseline. In addition, some participants will also undergo brain MRI scanning, comprehensive cognitive assessment batteries and longitudinal blood collection.
Coordinator: Lexy

OCEANIC – Blinded RCT testing efficacy asundexian (investigational FXI inhibitor) on top of standard antiplatelet therapy (including DAPT) for long-term stroke prevention in patients with non-cardioembolic TIA or ischemic stroke (NIHSS 15 or less).  Enrollment must within 72 hours of onset, and additional inclusion critieria (either ESUS or evidence of athero) – Caroline

PRESTA – A double-blind, randomized-controlled, phase 2 clinical trial of amantadine (100 mg twice daily or 100 mg once daily if 65 or older) versus placebo for promoting recovery in patients with ischemic or hemorrhagic stroke. Over 1 year at 3 sites, 60 patients will be enrolled. Subjects will be followed for 3 months to establish feasibility and tolerability. We aim to test the hypothesis that this medication is tolerable for post-stroke patients. We also hypothesize it will increase patient’s subjective sense of improvement. In addition, we plan to assess objective measures of improvement on various validated motor, cognitive, and mood scales. This trial addresses an important unmet therapeutic need.
Coordinator – Caroline

SATURN: To determine the effects of continuation vs. discontinuation of statins on the risk of ICH recurrence during 24 months of follow-up in patients presenting with a spontaneous lobar lCH while taking a statin drug. Specifically, we wish to determine the effects of discontinuing vs. continuing statins on the risk of recurrent symptomatic ICH. We hypothesize that discontinuation of statins in patients with lobar ICH is likely associated with reduced risk of ICH recurrence.
Saturn Recruitment Video
Coordinator – Ashlynn

SLEEPSMART: The primary goals of this study are to determine whether treatment of OSA with positive airway pressure starting shortly after acute ischemic stroke or high risk TIA (1) reduces recurrent stroke, acute coronary syndrome, and all-cause mortality 6 months after the event, and (2) improves stroke outcomes at 3 months in patients who
experienced an ischemic stroke.
Coordinator -Caroline

NON ACUTE TRIALS:

ASPIRE: To determine if apixaban is superior to aspirin for prevention of the composite outcome of any stroke (hemorrhagic or ischemic) or death from any cause in patients with recent ICH and AF.
Aspire Recruitment Video
Coordinator – Ashlynn

TRAINS: Subjects with cognitive impairment after stroke will undergo neuropsychological testing before and after receiving 5 semi-consecutive daily sessions of real or sham tDCS paired with cognitive therapy. Subjects will have experienced a stroke within 3 months of enrollment and will be undergoing inpatient rehabilitation at Penn Institute for Rehabilitation Medicine. Neuropsychological testing will be repeated immediately after completion of and 3 months following completion of treatment.
Coordinator –

INVESTIGATOR INITIATED TRIALS:

COMETS: DCS-based intraprocedural monitoring during ICA or M1 thrombectomy, measuring cerebral blood flow before and after thrombo
Coordinator: Sarah

SERIAL MRI IN MINOR LVO: This is a prospective observational study aimed at quantifying and predicting the evolution of stroke in patients with LVO and low NIHSS (<6) being treated with medical therapy. Current imaging techniques are ineffective at predicting which patients with deteriorate and require rescue thrombectomy. Here, we will use short interval serial MRI (baseline MRI, +2 hour MRI) to quantify changes in tissue physiology that may predict tissue outcome and clinical outcome.
Coordinator: Sarah

SLAM: Patients with ischemic stroke with unilateral weakness, NIHSS >1 (including limb weakness), Control patients include: TIA with negative MRI and normal exam OR EMU patients with normal MRI and exam
Coordinator: Steph 

CH in LVAD: TCD-based study to assess cerebral autoregulation and cerebral vasoreactivity before and after implantation of LVAD (pts on Cardiothoracic Surgery service, recruited by HF/Cardiology)
Coordinator: Sarah

Optical Biomarkers of Neurodegeneration in Chronic Cerebrovascular Disease (CVD): Correlating optically measured (DCS) cerebral hemodynamics (CA/CVR) with neurodegenerative changes on MRI for chronic carotid occlusive disease and small vessel ischemic disease.
Coordinator: Sarah

Photon Counting CTA (PCCT) Study: Imaging cervical carotid plaque composition by research multiphase photon counting (spectral) CTA  +/- carotid VWI MRI (no gad). Eligible if patient has >2mm noncalcified carotid plaque (with or without stenosis), will be in-house 2 or more days, and medically stable (for MRI). Contact Jae Song.

Carotid Occlusion/Stenosis MRI study:  Oxygen extraction fraction imaging via MR in inpatients or outpatients with carotid or MCA occlusion (or severe stenosis).