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Trial Review
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
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Trial registered on ANZCTR
Registration number
ACTRN12621001346864
Ethics application status
Approved
Date submitted
6/09/2021
Date registered
7/10/2021
Date last updated
19/01/2025
Date data sharing statement initially provided
7/10/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Head cooling in stroke clot retrieval.
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Scientific title
Head COOLing in iscHemic Stroke Patients Undergoing EndovAscular Thrombectomy: a Feasibility and Safety stuDy (COOLHEAD-2a)
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Secondary ID [1]
305230
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Nil known.
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Secondary ID [2]
313395
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NCT06335641
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Universal Trial Number (UTN)
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Trial acronym
COOLHEAD-2a
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Ischaemic stroke.
323510
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Condition category
Condition code
Stroke
321072
321072
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0
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Ischaemic
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A non-invasive head cooling device* will be applied to the participants' head from the time of enrolment at the participating hospital's emergency department, until the completion of the endovascular clot retrieval. Head cooling will be administered by a clinician with a background in internal medicine/neurology or anaesthesia. The duration of the intervention will therefore range between 30 minutes and 2 hours, depending on the duration of the endovascular clot retrieval. During the cooling period, the participant will have their core body temperature measured with a nasopharyngeal temperature probe, along with standard anaesthetic monitoring, including non-invasive heart rate and blood pressure measurements, and usually intra-arterial blood pressure measurements. The procedural anaesthetist will be responsible for monitoring these parameters.
*The non-invasive head cooling device will be one of either The WElkins Temperature Regulation System, 2nd Gen, or the Orbis Paxman System. Both devices are thermoregulatory systems that automatically reduces and maintains the temperature of coolant within a flexible cap. The coolant has a target temperature of -4 to -5°C, which results in heat exchange between the participant and the coolant.
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Intervention code [1]
321628
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Treatment: Devices
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Comparator / control treatment
Not applicable.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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The proportion of recruited participants that are ‘adherent’ to the intervention. Adherence is defined as having head cooling successfully administered for >=50% of the time from application in the Emergency Department to the end of the endovascular clot retrieval.
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Assessment method [1]
328847
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Timepoint [1]
328847
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Endovascular clot retrieval completion.
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Secondary outcome [1]
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Recruitment rate (proportion of all eligible patients who are enrolled over the study duration) will be collected by auditing the study records.
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Assessment method [1]
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Timepoint [1]
400633
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Study completion.
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Secondary outcome [2]
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Core body temperature will be measured with a nasopharyngeal temperature probe. The probe will be connected to an anaesthetic monitoring unit that continuously stores the temperature data.
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Assessment method [2]
401366
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Timepoint [2]
401366
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Endovascular clot retrieval completion.
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Eligibility
Key inclusion criteria
Patients with anterior circulation large vessel occlusion stroke (internal carotid artery, M1 or proximal M2 segments of the middle cerebral artery) where endovascular clot retrieval is planned.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
- Pre-stroke modified Rankin Scale score >2
- BP >=185/110 mmHg not responsive to guideline-directed intravenous antihypertensive
therapy
- Admission core body temperature <35°C
- Known contraindications to hypothermia, including haematological dyscrasias that affect
thrombosis (cryoglobulinemia, sickle cell disease, serum cold agglutinins), or vasospastic
disorders such as Raynaud's or thrombo-angiitis obliterans
- Skin lesions not allowing secure application of the cooling cap
- Unable to participate in follow-up at 3 months (e.g., travelling overseas)
- Terminal illness with expected survival <1 year
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
This is a feasibility study.
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/07/2024
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Actual
28/07/2024
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
40
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Accrual to date
40
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Final
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Recruitment outside Australia
Country [1]
24099
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New Zealand
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State/province [1]
24099
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Auckland
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Country [2]
26733
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Canada
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State/province [2]
26733
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Alberta
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Funding & Sponsors
Funding source category [1]
317292
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Charities/Societies/Foundations
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Name [1]
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Neurological Foundation of New Zealand
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Address [1]
317292
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Country [1]
317292
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New Zealand
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Primary sponsor type
Individual
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Name
Professor P. Alan Barber
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Address
Department of Medicine, Faculty of Medical and Health Sciences, The University of
Auckland, Private Bag 92019, Auckland 1142, New Zealand.
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Country
New Zealand
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Secondary sponsor category [1]
310620
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None
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Name [1]
310620
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Address [1]
310620
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Country [1]
310620
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
309380
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Central Health and Disability Ethics Committee
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Ethics committee address [1]
309380
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Ministry of Health Level 3, Rangitoto Room, Unisys Building 650 Great South Road Penrose 1051 Auckland
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
309380
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13/09/2021
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Approval date [1]
309380
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14/12/2021
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Ethics approval number [1]
309380
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Summary
Brief summary
Stroke is a major cause of disability and death and is caused by blood clots blocking arteries in the brain. Clot retrieval, whereby the blood clot is removed with a minimally invasive procedure, significantly reduces disability after stroke. Unfortunately, many patients suffer irreversible brain damage before the clot is removed due to transport delays from regional to clot-retrieval capable hospitals. Lowering brain temperature during transport may slow brain damage and lead to better outcomes. This study will examine whether it is feasible to use a cooling cap in adult stroke patients treated with clot retrieval.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr William K Diprose
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Address
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Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland 1023, New Zealand.
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Country
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New Zealand
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Phone
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+6499236520
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Fax
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Email
113954
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[email protected]
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Contact person for public queries
Name
113955
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William K Diprose
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Address
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Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland 1023, New Zealand.
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Country
113955
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New Zealand
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Phone
113955
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+6499236520
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Fax
113955
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Email
113955
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[email protected]
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Contact person for scientific queries
Name
113956
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William K Diprose
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Address
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Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland 1023, New Zealand.
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Country
113956
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New Zealand
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Phone
113956
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+6499236520
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Fax
113956
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Email
113956
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
Yes
Will there be any conditions when requesting access to individual participant data?
Persons/groups eligible to request access:
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On a case-by-case basis at the discretion of Primary Sponsor.
Conditions for requesting access:
•
-
What individual participant data might be shared?
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De-identified data can be shared for the purposes of stroke research if participants opt in.
What types of analyses could be done with individual participant data?
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Stroke research.
When can requests for individual participant data be made (start and end dates)?
From:
Following the publication of the study until 10 years after study completion.
To:
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Where can requests to access individual participant data be made, or data be obtained directly?
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From the Primary Sponsor, Professor P. Alan Barber.
Email address:
[email protected]
Are there extra considerations when requesting access to individual participant data?
No
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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