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Intra-arterial Magnesium Therapy: a Novel Platform for Neuroprotectant Delivery in Acute Stroke
Stroke is the second leading cause of death and the leading cause of adult disability
worldwide. This investigation will address the safety and feasibility of directed,
intra-arterial Magnesium measurement and therapy, through endovascular access, in acute
stroke patients. The proposal represents the first study to directly quantify levels of a
systemically administered neuroprotectant in the region of cerebral ischemia. It also
establishes a novel endovascular platform for direct delivery of neuroprotective agents to
ischemic cerebral tissue distal to an occlusive thrombus. This research seeks to improve
patient care by establishing a novel delivery mechanism for the rescue of threatened brain
parenchyma that can be administered rapidly following acute stroke. If successful, this
selective distribution will allow delivery to "at risk" tissue in a rapid manner. Salvage of
viable, but threatened, penumbral tissue could afford stroke patients an increased
probability of favorable long term outcome. The investigators hypothesize that endovascular,
intra-arterial, Magnesium administration will deliver high concentration of this
neuroprotective agent to otherwise inaccessible cerebral territories, while limiting
systemic concentrations. The proposed investigation will evaluate the safety and feasibility
of this novel treatment technique
Inclusion and Exclusion Criteria
- Patient with acute cerebral ischemia due to ICA or MCA occlusion,
- Patient's clinical attending physician plans mechanical embolectomy procedure as part of routine clinical care.
- Age 21-95.
- Severe renal impairment with creatinine 3.0 or higher,
- Myasthenia gravis,
- Second or third degree heart block without a pacemaker in place,
- Technical inability to navigate microcatheter to target clot,
- Patient already enrolled in another experimental treatment trial. Exclusion criteria 1-3 are all contraindications to magnesium therapy.
- University of Southern California University and LA County Hospitals, Los Angeles, California, 90033