Acute Ischemic Stroke
Conditions
Brief summary
The purpose of this study is to determine the efficacy and safety of remote ischemic conditioning combined with intravenous thrombolysis in treating acute ischemic stroke.
Detailed description
In this study, cases of ischemic stroke who undergo intravenous thrombolysis within 4.5 hours from onset are included. The experimental group receive basic treatment and remote ischemic conditioning for 200mmHg, 2 times within 6 hours to 24 hours from thrombolysis. The control group receive basic treatment and remote ischemic conditioning control for 60mmHg, 2 times within 6 hours to 24 hours from thrombolysis . Two groups will be followed up for 90 days to evaluate the efficacy and safety of remote ischemic conditioning combined with intravenous thrombolysis in treating acute ischemic stroke.
Interventions
DEVICEremote ischemic conditioning
Remote ischemic conditioning (RIC) is induced by 4 cycles of 5 min of healthy upper limb ischemia followed by 5 min re-perfusion. Limb ischemia was induced by inflation of a blood pressure cuff to 200 mm Hg.
DEVICEsham remote ischemic conditioning
Sham remote ischemic conditioning (RIC) is induced by 4 cycles of 5 min of healthy upper limb ischemia followed by 5 min re-perfusion. Limb ischemia was induced by inflation of a blood pressure cuff to 60 mm Hg.
Sponsors
Yi Yang
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* 1\) Age≥18 years, \< 80 years, regardless of sex; * 2\) Patients with clinically definite diagnosis of acute ischemic stroke and undergo intravenous thrombolysis; * 3\) Baseline NIHSS \>= 5, and \<= 25; * 4\) Baseline GCS ≥8; * 5\) Signed and dated informed consent is obtained
Exclusion criteria
* 1\) Patients who undergo endovascular treatment; * 2\) mRS ≥ 2 before the onset of the disease; * 3\) Double upper limbs or lower limbs paralysis was found in this case; * 4\) Active bleeding of organs within 6 months of admission or current, including cerebral hemorrhage, subarachnoid hemorrhage, gastrointestinal hemorrhage, fundus hemorrhage and so on; * 5\) Other intracranial lesions, such as cerebrovascular malformation cerebral venous diseases, tumor and other diseases involving the brain; * 6\) Concurrent use of anticoagulation drugs including Warfarin, dabigatran, rivaroxaban; * 7\) Severe organ dysfunction or failure; * 8\) Patients suffering from severe hematological diseases or severe coagulation disorder dysfunction * 9\) Those who have a history of severe trauma or had major surgery within 6 months prior to admission; * 10\) Those who have a history of atrial fibrillation; * 11\) The patients who have the contraindication of remote ischemic conditioning treatment, such as severe soft tissue injury, fracture or vascular injury in the upper limb#Acute or subacute venous thrombosis, arterial occlusive disease, subclavian steal syndrome, etc; * 12\) Pregnant or lactating women; * 13\) Previous remote ischemic conditioning therapy or similar treatment; * 14\) Patients with a life expectancy of less than 3 months or patients unable to complete the study for other reasons; * 15\) Severe hepatic and renal dysfunction; * 16\) Unwilling to be followed up or treated for poor compliance; * 17\) He/She is participating in other clinical research or has participated in other clinical research or has participated in this study within 3 months prior to admission; * 18\) Other conditions that the researchers think are not suitable for the group.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Frequency of adverse events during hospitalization | 7 days | All adverse events until day-7 or discharge (whichever is earlier) |
| Frequency of adverse events during follow-up | 3 months | Severe adverse events through day-90 after the onset of acute ischemic stroke. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| National Institute of Health stroke scale (NIHSS) at 7 days from onset or discharge | 7 days | National Institute of Health stroke scale (NIHSS) at 7 days from onset or discharge. Ranged from 0 to 42, a low value represents a better outcome. |
| Proportion of patients with Modified Rankin Scale (mRS) Score 0-2 | 3 months | Proportion of patients with Modified Rankin Scale (mRS) Score 0-2. Ranged from 0 to 6, a low value represents a better outcome. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Changes of hematological indicators | 24 hours | Hematological samples are collected at right before thrombolysis and 24 hours after thrombolysis, and changes of hematological indicators related to hemorrhagic transformation (such as Axl, ANGPTL4) are compared between the two groups. |
| Changes of the function of dynamic cerebral autoregulation | 10 days | The function of patients' dynamic cerebral autoregulation are tested 3 times within 10 days from onset and compared between the two groups. |
Countries
China
Outcome results
None listed