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Acute Ischemic StrokePhase 2CARE-EVTNCT06339411

Cerebrolysin After Reperfusion in Extended-window EndoVascular Thrombectomy

A Phase 2 study testing Cerebrolysin in people with Acute Ischemic Stroke, run by Chang Gung Memorial Hospital.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Acute ischemic stroke caused by blockage of a large brain artery can lead to severe disability. Endovascular thrombectomy is a catheter-based procedure used to remove the blood clot and restore blood flow. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Acute Ischemic Stroke
What is being tested?
Cerebrolysin
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
100 participants
Where
No sites listed yet
Study dates
1 Sep 2026to 31 Dec 2030
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age 18 to 80 years.
  • Acute anterior-circulation ischemic stroke caused by internal carotid artery or M1 or M2 middle cerebral artery occlusion confirmed by computed tomography angiography.
  • Stroke onset-to-groin-puncture interval greater than 6 hours and no more than 24 hours.
  • Prestroke modified Rankin Scale score of 0 to 2.
  • Baseline National Institutes of Health Stroke Scale score of at least 6 with cortical signs.
  • Alberta Stroke Program Early Computed Tomography Score greater than 3.
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  • Computed tomography perfusion target mismatch defined as ischemic core volume less than 70 mL, mismatch ratio at least 1.8, and mismatch volume at least 15 mL.
  • Moderate-to-good collateral circulation, defined as filling of more than 50% of the middle cerebral artery territory on computed tomography angiography.
  • Successful endovascular reperfusion, defined as modified Thrombolysis in Cerebral Infarction grade 2b or 3, confirmed before randomization.
  • Study treatment can be initiated within 36 hours of stroke onset.
  • Written informed consent obtained before randomization from the participant or a legally authorized representative.

Who cannot join

  • Life expectancy less than 6 months or a serious medical, neurological, or psychiatric condition likely to interfere with study treatment, follow-up, or outcome assessment.
  • Current pregnancy or breastfeeding.
  • Known iodinated contrast allergy that precludes required endovascular or imaging procedures.
  • Acute or chronic renal failure with creatinine clearance less than 30 mL/min.
  • Known hypersensitivity or contraindication to Cerebrolysin.
  • Aspartate aminotransferase or alanine aminotransferase greater than 2 times the upper limit of normal, or total bilirubin greater than 2 mg/dL.
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  • Blood glucose less than 50 mg/dL or greater than 400 mg/dL.
  • Platelet count less than 50,000/mm3 or international normalized ratio greater than 3.
  • Seizure at stroke onset that prevents reliable neurological assessment.
  • Pre-existing intracranial hemorrhage or multiple vascular occlusions on baseline neuroimaging.

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

Chien H Chang, MD contact

+886978009593

cva9514@gmail.com

About this study

Official title: Cerebrolysin After Reperfusion in Extended-Window Endovascular Thrombectomy: A Multicenter Randomized Controlled Trial

Acute ischemic stroke caused by blockage of a large brain artery can lead to severe disability. Endovascular thrombectomy is a catheter-based procedure used to remove the blood clot and restore blood flow. It can benefit selected patients treated 6 to 24 hours after stroke onset, but some patients remain disabled even when the blocked artery is successfully reopened. Ongoing injury to brain tissue, small blood vessels, and the blood-brain barrier may contribute to this incomplete recovery.

This multicenter randomized clinical trial will evaluate whether Cerebrolysin, given after successful extended-window endovascular thrombectomy, can reduce brain tissue injury and support recovery. The study will enroll 100 adults aged 18 to 80 years at three stroke centers in Taiwan. Participants will be randomly assigned, after successful reperfusion has been confirmed, to receive either Cerebrolysin 30 mL or a matched normal saline placebo by intravenous infusion once daily for 10 consecutive days. The first infusion will begin within 36 hours of stroke onset. All participants will also receive standard stroke care and rehabilitation.

Read more

The primary outcome is final infarct volume measured by diffusion-weighted magnetic resonance imaging on Day 7 to Day 10. Other outcomes include functional recovery at 3 and 12 months, neurological improvement, symptomatic intracranial hemorrhage, cerebral edema, recurrent stroke, mortality, cognition, language, and mood. The study will also examine blood-brain barrier injury using computed tomography perfusion, dynamic contrast-enhanced magnetic resonance imaging, and serial plasma Claudin-5 measurements.

This study will determine whether Cerebrolysin shows evidence of reducing postreperfusion brain injury after successful thrombectomy and will help guide the design of a larger trial focused on clinical outcomes.

Read the detailed description

This is an investigator-initiated, multicenter, randomized, placebo-controlled, participant- and outcome-assessor-blinded proof-of-concept trial conducted at three stroke centers within the Chang Gung Memorial Hospital system in Taiwan.

The study will enroll 100 participants aged 18 to 80 years with anterior-circulation acute ischemic stroke caused by internal carotid artery or M1/M2 middle cerebral artery occlusion. Eligible participants must undergo endovascular thrombectomy more than 6 hours and no more than 24 hours after stroke onset and must achieve successful reperfusion, defined as modified Thrombolysis in Cerebral Infarction grade 2b or 3, before randomization.

Participants will be randomized in a 1:1 ratio to receive Cerebrolysin 30 mL diluted in 70 mL normal saline or matched normal saline placebo. Study treatment will be administered intravenously over 60 minutes once daily for 10 consecutive days and will begin after randomization and within 36 hours of stroke onset. Both groups will receive standard post-thrombectomy stroke care, secondary prevention, and rehabilitation.

The primary outcome is final infarct volume measured on diffusion-weighted magnetic resonance imaging performed on Day 7 to Day 10. The key secondary clinical outcome is functional independence, defined as a modified Rankin Scale score of 0 to 2, at Month 3. Other outcomes include ordinal modified Rankin Scale, National Institutes of Health Stroke Scale, Barthel Index, symptomatic intracranial hemorrhage, asymptomatic hemorrhagic transformation, cerebral edema, recurrent stroke, all-cause mortality, vessel patency, cognition, language, and mood through Month 12.

Mechanistic assessments will evaluate blood-brain barrier injury. Computed tomography perfusion-derived blood-brain barrier permeability will be measured before thrombectomy and approximately 24 hours after reperfusion. Dynamic contrast-enhanced magnetic resonance imaging will assess subacute permeability on Day 7 to Day 10. Plasma Claudin-5, an exploratory marker of endothelial tight-junction injury, will be measured at groin puncture before reperfusion, 24 hours after reperfusion, and on Day 7.

The trial is designed to determine whether adjunctive Cerebrolysin reduces tissue-level injury and provides biological signals consistent with preservation of blood-brain barrier integrity after successful extended-window thrombectomy. The study is not powered to establish definitive clinical efficacy, and clinical and mechanistic secondary analyses will be considered exploratory.

Being tested
Cerebrolysin, Normal saline placebo
Keywords
Endovascular Thrombectomy, Large Vessel Occlusion, Extended Time Window, Cerebrolysin, Blood-Brain Barrier, Claudin-5, Neuroprotection, Computed Tomography Perfusion
Medical subject headings
Ischemic Stroke

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • CerebrolysinDrug

    Cerebrolysin 30 mL diluted in 70 mL normal saline will be administered intravenously over 60 minutes once daily for 10 consecutive days. Treatment will begin after successful endovascular reperfusion and randomization and within 36 hours of stroke onset.

  • Normal saline placeboDrug

    Also called cerebrolysin

    Normal saline 100 mL will be administered intravenously over 60 minutes once daily for 10 consecutive days according to the same schedule as Cerebrolysin. Infusion bags, drip chambers, and visible tubing will be covered to maintain masking.

Study groups in NCT06339411
Study groupRoleWhat they receive
Cerebrolysin After Successful Extended-Window ThrombectomyExperimentalParticipants will receive Cerebrolysin 30 mL diluted in 70 mL normal saline, administered intravenously over 60 minutes once daily for 10 consecutive days. The first infusion will begin after successful endovascular reperfusion and randomization and within 36 hours of stroke onset. All participants will also receive standard post-thrombectomy stroke care, secondary prevention, and rehabilitation.
Receives: Drug: Cerebrolysin
Matched Placebo After Successful Extended-Window ThrombectomyPlacebo comparatorParticipants will receive 100 mL normal saline placebo, administered intravenously over 60 minutes once daily for 10 consecutive days according to the same schedule as the experimental arm. The first infusion will begin after successful endovascular reperfusion and randomization and within 36 hours of stroke onset. All participants will also receive standard post-thrombectomy stroke care, secondary prevention, and rehabilitation.
Receives: Drug: Normal saline placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Final Infarct Volume on Diffusion-Weighted MRI

    Final infarct volume will be quantified on Day 7-10 diffusion-weighted magnetic resonance imaging using standardized semiautomated lesion segmentation with manual correction when required. Imaging readers will be blinded to treatment allocation. Participants who are unable to undergo MRI will remain in the intention-to-treat population, and missing primary-outcome data will be addressed using prespecified imputation and sensitivity analyses.

    Measured: Day 7 to Day 10 after stroke onset

Secondary outcomes (6)
  1. Functional Independence Defined as Modified Rankin Scale Score 0-2

    The proportion of participants achieving functional independence, defined as a modified Rankin Scale score of 0 to 2, will be assessed using a validated structured interview.

    Measured: Month 3 and Month 12 after stroke onset

  2. Symptomatic Intracranial Hemorrhage

    Symptomatic intracranial hemorrhage will be defined according to the ECASS III criteria.

    Measured: Within 7 days after stroke onset

  3. Change in Computed Tomography Perfusion-Derived Blood-Brain Barrier Permeability

    Blood-brain barrier permeability surface area product will be measured using the Patlak model before thrombectomy and approximately 24 hours after reperfusion. The change from baseline will be compared between treatment groups.

    Measured: Pre-EVT and 24 ± 6 hours after reperfusion

  4. Plasma Claudin-5 Concentration-Time Profile

    Plasma Claudin-5 concentrations will be measured as an exploratory marker of endothelial tight-junction injury.

    Measured: At groin puncture before reperfusion, 24 ± 6 hours after reperfusion, and Day 7 ± 1

  5. Montreal Cognitive Assessment Score

    Global cognitive function will be assessed using the Montreal Cognitive Assessment, with lower scores indicating greater cognitive impairment.

    Measured: Months 3, 6, and 12

  6. Recurrent Stroke

    The occurrence of recurrent ischemic or hemorrhagic stroke will be recorded through clinical follow-up and review of available medical records.

    Measured: Through Month 12

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Apr 2024
  2. Study start1 Sep 2026 (estimated)
  3. Primary completion31 Dec 2029 (estimated)
  4. Study completion31 Dec 2030 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants will be randomized in a 1:1 ratio after successful endovascular reperfusion to receive either intravenous Cerebrolysin or matched normal saline placebo in parallel for 10 consecutive days. Randomization will occur only after confirmation of modified Thrombolysis in Cerebral Infarction grade 2b or 3 reperfusion.
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06339411
Sponsor's protocol ID
202302239A3
Acronym
CARE-EVT
Status last verified
Aug 2026
First submitted
25 Mar 2024
Last updated
11 Aug 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Deidentified individual participant data may be shared after publication of the primary trial results upon reasonable request. Data sharing will require approval by the investigators, applicable ethical and regulatory review, protection of participant confidentiality, institutional approval, and execution of a data-use agreement. The trial protocol and statistical analysis plan will be made available with the primary trial publication. Statistical code may also be shared upon reasonable request, subject to institutional approval.

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Cerebrolysin in people with Acute Ischemic Stroke, run by Chang Gung Memorial Hospital.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 11 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 11 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Chien H Chang, MD (+886978009593, cva9514@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Final Infarct Volume on Diffusion-Weighted MRI (time frame: Day 7 to Day 10 after stroke onset). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Aug 2026; AzTrials last refreshed its copy on 26 Oct 2026.

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