A randomized trial on Hemodynamic Optimization of cerebral Perfusion after successful Endovascular therapy in patients with acute ischemic stroke (HOPE).
Cerebrovasc Dis
; 2024 Aug 29.
Article
en En
| MEDLINE
| ID: mdl-39208776
ABSTRACT
INTRODUCTION:
In patients with acute ischemic stroke (AIS) secondary to intracranial large vessel occlusion (LVO), optimal blood pressure (BP) management following endovascular treatment (EVT) has not yet been established. The randomized trial on Hemodynamic Optimization of cerebral Perfusion after successful Endovascular therapy in patients with acute ischemic stroke (HOPE) (clinicaltrials.gov id NCT04892511), aims to demonstrate whether hemodynamic optimization using different systolic BP targets following EVT according to the degree of final recanalization, is more effective than currently recommended BP management in improving functional outcomes of patients with AIS.METHODS:
HOPE is an investigator-initiated multicentre clinical trial with randomized allocation, open label treatment, and blinded endpoint evaluation (PROBE). Patients with an anterior circulation AIS within 24h of symptom onset, treated with EVT, and showing successful recanalization (mTICI ≥2b) at the end of the procedure, are equally allocated (11) to hemodynamic optimization according to the study protocol vs. BP management according to current guidelines (≤180/105mmHg). The protocol includes two different targets of systolic BP depending on the recanalization status (mTICI=2b 140-160 mmHg; mTICI=2c/3 100-140 mmHg). The protocol is applied within the first 72h and includes BP lowering as well as vasopressor therapies when needed. The primary outcome is the proportion of favorable outcome (modified Rankin Scale [mRS] 0-2) at 90 days. Secondary outcomes include the shift on the mRS score, neurological deterioration, symptomatic intracerebral haemorrhage and mortality.CONCLUSION:
The HOPE trial will provide new information on the safety and efficacy of different BP targets following EVT according to the degree of final recanalization in patients with AIS.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
Cerebrovasc Dis
Asunto de la revista:
ANGIOLOGIA
/
CEREBRO
Año:
2024
Tipo del documento:
Article
Pais de publicación:
Suiza