Actively Recruiting

Phase Not Applicable
Age: 18Years +
All Genders
NCT07172789

Head dOwn Position Before Endovascular Treatment for Large veSsel Occlusion (HOPES5)

Led by General Hospital of Shenyang Military Region · Updated on 2025-09-15

210

Participants Needed

1

Research Sites

56 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

Recent studies suggest that head-down positioning (HDP) intervention may improve outcomes in ischemic stroke. In the era of reperfusion therapy, a key protective strategy is to administer neuroprotective interventions before recanalization to reduce the loss of the ischemic penumbra, thereby salvaging more penumbral tissue after revascularization and ultimately improving clinical outcomes. Based on this concept, and considering the neuroprotective effects of HDP, the investigators hypothesize that HDP intervention prior to endovascular therapy (EVT) in patients with large vessel occlusion could improve clinical outcomes. This hypothesis is further supported by a recent clinical study (NCT03728738), which demonstrated that compared to a sitting up position (30°), a flat supine position (0°) before EVT significantly reduced the incidence of neurological deterioration prior to the procedure. Building on the above rationale, this trial aims to investigate the efficacy and safety of HDP intervention prior to EVT in patients with large vessel occlusion.

CONDITIONS

Official Title

Head dOwn Position Before Endovascular Treatment for Large veSsel Occlusion (HOPES5)

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Age ≥ 18 years;
  • Patients with acute large vessel occlusion scheduled for endovascular thrombectomy within 24 hours of symptom onset;
  • Baseline National Institute of Health Stroke Scale (NIHSS) ≥ 6;
  • Expected waiting time from randomization to femoral artery puncture is more than 30 minutes;
  • ASPECTS/pc-ASPECTS score ≥ 6 on baseline non-contrast CT or DWI;
  • Modified Rankin Scale score before stroke onset ≤ 1;
  • Signed informed consent by patient or their legally authorized representative.
Not Eligible

You will not qualify if you...

  • Hemorrhagic stroke: cerebral hemorrhage, subarachnoid hemorrhage;
  • Severe hepatic or renal dysfunction, increase in ALT or AST (more than 2 times of upper limit of normal value), increase in serum creatinine (more than 1.5 times of upper limit of normal value) or requiring dialysis;
  • Severe hypertension before randomization (systolic blood pressure >185 mmHg or diastolic blood pressure >110 mmHg);
  • Cardiac insufficiency (NYHA Class ≥II);
  • Pregnancy, plan to get pregnant or during lactation;
  • Patients at significant risk of aspiration (e.g., obvious nausea and vomiting);
  • The estimated life expectancy is less than 6 months due to other serious diseases;
  • Other conditions unsuitable for this clinical study assessed by researcher.

AI-Screening

AI-Powered Screening

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Trial Site Locations

Total: 1 location

1

Hui-Sheng Chen

Shenyang, None Selected, China, 110016

Actively Recruiting

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How is the study designed?

Study Type

INTERVENTIONAL

Masking

SINGLE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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