Patient Eligibility
Q. What is the age limit?
A. The inclusion age for this study is 70 years or less. This inclusion age is the age at which the patient was at the time they had their stroke, not their age at the time of recruitment to the study.
Q. Is an Echo an essential investigation?
A. Whenever possible we would like to see an echo report. However, if an echo is not completed as a part of routine care then this is OK - the patient can still be included and you do not need to do an additional echo.
Q. My patient has a reported stenosis of 50%. Are they eligible?
A. If the patient's stenosis is reported as 50% or very close to 50% it is a clinical decision as to whether the stenosis contributed to the cause of the stroke. If this is the case the patient is NOT eligible. Either consult the PI at your site to make a decision or fax the report to Prof Markus to make the decision for you.
Q. Does the MRI have to show a lacunar infarct?
A. Yes. Patients cannot be included unless a lesion is seen on the MRI
Q. Does the infarct on the MRI have to be appropriate to the presenting lacunar syndrome?
A. No. Evidence of small vessel disease (even if the infarct location doesn't fit the symptoms) along with lacunar syndrome presentation is sufficient to include the patient in this study.
Q. The infarct shows evidence of old lacunar infarcts. Is the patient still eligible?
A. Yes. As long as there is evidence of an infarct for the current stroke it doesn't matter of they have had lacunar infarcts in the past.
Q. The infarct shows evidence of an old cortical stroke. Is the patient still eligible?
A. No. Lesions seen on the MRI should be lacunar only. Evidence of past cortical stroke is an exclusion criteria for this study.
Q. If a retrospective patient has not had an MRI completed, what is an acceptable delay between the stroke and the MRI being done?
A. We suggest that as long as the MRI shows a lacunar infarct and also shows no evidence of any other type of stroke, then a 3 year delay would be acceptable.
Q. What information do I need to send to St George's immediately after I have recruited a patient?
A. The Baseline Entry Form should be faxed to us on the same day that you recruit a patient. The Data Collection Form, ECG/MRI/Doppler/Echo copies should be sent as soon as possible after that. Please note you should not send any of the above anonymised confidential information with the baseline form as this will make all information identifiable.
Q. What is the time limit for recruiting retrospective patients?
A. We recommend that you start with the most recent patients and then work your way backwards. We don't recommend you recruit anyone who had their stroke more than 5 years ago.
Q. How soon after taking the blood samples should I send the sample to ECACC?
A. This must be sent the same day. If you miss the last post, it will be OK to send the sample the next day as the solution in the tube will keep the blood fresh long enough. However, the sooner the sample reaches ECACC the better the cell lines will be.
Q. It is Friday afternoon, should I send the blood sample to ECACC today?
A. Yes, this is fine. ECACC have someone working on a Saturday morning to receive samples and produce cell lines.
Q. I have only managed to obtain a very small CPDA sample is this OK?
A. ECACC request that the CPDA be as full as possible in order to successfully make the cell lines. If it was only possible to take a small sample then send it anyway and if there is a problem ECACC will contact us to send the sample again.
Q. I couldn't get all 3 EDTA tubes of blood from the patient - is this OK?
A. Unfortunately not. We need all 3 tubes to be able to perform the DNA analyses here at St George's. You will have to ask the patient to come back, or go and visit them at home to collect the final samples.
Q. There isn't enough serum plasma to fill all 6 Eppendorf tubes - should I fill less tubes or put a bit in all 6?
A. Please put a bit of serum/plasma into all 6 tubes (minimum 200ul). It should still be OK for analysis even if the tube is not completely full.
Q. There is no ECG in the casenotes for the time of the patient's stroke.
A. We need evidence from an ECG that the patient did not have an embolic stroke. If there are other ECGs in the casenotes, please send the ECG for the nearest time to the stroke. If there are no ECGs, please send the patient's discharge summary which should clearly state the result of the ECG taken at the time of stroke.
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