Stroke
Conditions
Keywords
stroke, Remote ischemic postconditioning, symptomatic atherosclerotic intracranial arterial stenosis
Brief summary
The purpose of this study is to evaluate the protective effects of upper limb ischemic postconditioning on collateral circulationin young symptomatic intracranial atherosclerosis and the baseline characteristics of trial participants, as an open, randomized controlled, prospective controlled trial.
Detailed description
Stroke is a common cardia-cerebrovascular disease with high morbidity, disability and mortality rate. And more and more young patients account for the increasing morbidity. Among them, Symptomatic intracranial atherosclerotic stenosis（sICAS）is a major cause, especially in Asians. Currently, traditional therapeutic methods present reluctant achievements on reducing stroke recurrence and pose threat on patients'health because of invasive operation and severe side effects. Therefore, other treatment methods are called for urgently. Remote ischemic post-conditioning refers to local or distal ischemia treatment after the occurrence of cerebral ischemia. Prior research has shown that repeatedly ischemic reperfusion have protective effect on lowering the occurrence rate of ischemic events of patients with carotid stenosis. However, in-depth research on cerebral protection and correlation with collateral circulation has not been proven in an open, definitive clinical trial. Thus, the EPIC-sICAS trial will provide important information on the protective effects of upper limb ischemic post-conditioning on collateral circulation after cerebral Infarction. Hopefully to present us a very meaningful way to improve the patient's quality of life.
Interventions
Remote ischemic postconditioning（RIPC）treatment was performed by the inflating a cuff around bilateral arms to 180 mmHg with 5 cycles of 3 min inflation and 5 min relax alternation automatically.
Sponsors
Xuanwu Hospital, Beijing
Xi'an Jiaotong University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
1. Age between 18 to 45 Years old; 2. Symptomatic intracranial atherosclerotic stenosis (sICAS): cranial CTA/MRA/TCD/DSA confirm the diagnosis, patients got ischemic stroke or transient ischemic attack in the brain region supplied by the stenosis artery; 3. National Institutes of Health Stroke Scale(NIHSS) score 0-15 4. Written informed consent was signed.
Exclusion criteria
1. Cerebral hemorrhage and other parts of the active bleeding disease; 2. Severe aphasia, unable to express himself; 3. A history of brain tumor, brain trauma, cerebral embolism or other brain lesions; 4. Severe lesions of severe cardiac, liver or kidney disease, malignancy or other systemic organ dysfunction; 5. Blood Pressure\< 90 mmHg/60 mmHg or \>200 mmHg/110 mmHg after treatment; 6. Dementia and mental illness; 7. Using angiotensin-converting enzyme inhibitors; 8. A history of major surgery or trauma 4 weeks prior to admission; 9. Without informed consent. Elimination Criteria： 1. Patients with poor compliance，refuse to take regular treatment and examination; 2. patients' condition get exacerbated, with NIHSS score elevate for more than 4.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mean Change of Collateral Circulation from Baseline and at 6 months | Baseline and at 6 months | Collateral circulation measured in iconography test: Magnetic Resonance Angiography (MRA)、 Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI)、Arterial spin-labeled (ASL) perfusion magnetic resonance、Transcranial Cerebral Doppler (TCD)、single photon emission computed tomography（SPECT） Baseline was defined as the onset of stroke within 48h. A higher score represents better collateral circulation status functioning. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mean Change of Symptomatic Recovery | Baseline and at 14 days, 1 month, 6 months, and 1 year | Functional test: National Institute of Health stroke scale（NIHSS）scores、Activity of Daily Living Scale (ADL) For NIHSS scores, a lower score represents better functioning. For ADL scores, a higher score represents better functioning. |
| Mean Change of serum vascular endothelial growth factor (VEGF) and basic Fibroblast Growth Factor (bFGF) from Baseline and at 10 days. | Baseline and at 10 days | A higher amount represents a better outcome |
Countries
China
Contacts
Primary ContactMeng Wei, Master
Backup ContactGuoGang Luo, M.D/Ph.D
Outcome results
None listed