- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05718622
Evaluation and Prediction of the Effect of EECP on HR-NICE Patients
February 22, 2023 updated by: First Affiliated Hospital Xi'an Jiaotong University
A Neuroimaging Prediction Study Based on Multi-model Magnetic Resonance Imaging Technology to Evaluate the Therapeutic Effect of EECP on HR-NICE Patients
Stroke is one of the most threatening causes of mortality and disability worldwide.
High risk non-disabling ischemic cerebrovascular events (HR-NICE), defined by mild stroke complicating with greater than 50% atherosclerotic stenosis in intracranial or extracranial arteries, is more likely to develop severe stroke in future.
Currently, the clinical treatment for HR-NICE patients is limited to dual antiplatelet therapy or endovascular treatment, both of which are taken controversially due to the side effect or high risk.
Enhanced external counterpulsation (EECP) is an established non-invasive treatment for circulatory support.
By inflating repeatedly and sequentially from calves to hips in the early diastolic phase of every cardiac cycle, EECP has been demonstrated to increase the shear stress of blood vessels, enhance the collateral circulation and improve brain perfusion in patients with stroke.
However, few studies have devoted exclusively to patients with HR-NICE.
It is not clear whether EECP can improve the clinical performance or reduce the rate of recurrent stroke in 90 days.
In this trial, HR-NICE patients will be divided into two groups according to true or sham EECP treatment.
Based on multi-model magnetic resonance imaging, the investigators explore the central neural characteristic before and after EECP treatment.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Detailed Description
Due to the conventional impression that mild stroke would lead to a good recovery outcome rather than disability, it is easy for patients or clinicians to ignore or delay the secondary prevention therapy.
However, the latest research findings indicate that these patients have a high risk of neurological deterioration within hours to days after the onset of the disease.
The risk of recurrence within 90 days is much higher than normal people as well.
These patients are at greater risk complicating with atherosclerotic stenosis of the large arteries.
This study designs a randomized, double-blind, controlled clinical trial to observe the improvement effect of EECP in HR-NICE patients.
Random numbers are used to divide HR-NICE patients into two groups with true or sham EECP treatment separately.
All the patients and technicians are blind of the group assignments of the subjects except the therapist responsible for setting the parameters of each patient's treatment.
By observing the difference of Stroke Impact Scale before and after a course of EECP treatment, the investigators explore its effect on symptom improvement in HR-NICE patients.
Based on multi-model magnetic resonance imaging, hematological parameter detection and genetic test, it's comprehensive to clarify the central neural features and peripheral abnormalities of HR-NICE patients, so as to provide objective proof for efficacy evaluation of pre-existing neural damage.
What's more, on the basis that neuroimaging characteristics and inflammatory factors have important effects on the progression of disease as well as the presentation of symptoms, this study intends to reveal the potential mechanism of EECP to improve performance of central neural system on different neuroimaging aspects and find sensitive neuroimaging biomarkers in predicting the therapeutic effect of EECP.
This study is not only contributing to explore the validity of EECP on HR-NICE patients, but also exploring the intrinsic and peripheral mechanism for classifying sensitive population based on neuroimaging and other predictive markers.
Study Type
Interventional
Enrollment (Anticipated)
100
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Shaanxi
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Xi'an, Shaanxi, China, 710061
- Recruiting
- First Affiliated Hospital of Xian Jiaotong University
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 80 years (Adult, Older Adult)
Accepts Healthy Volunteers
Yes
Genders Eligible for Study
All
Description
Inclusion Criteria:
- In accordance with the diagnostic criteria of Chinese Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke 2018
- Patients who have had a clinically significant ischemic stroke for the first time and are currently stable
- Unilateral internal carotid artery or middle cerebral artery was confirmed for the first time as moderate to severe stenosis (≥50%) or occlusion on digital subtraction angiography examination (DSA).
- Did not receive surgical treatment such as balloon dilation
- National Institute of Health stroke scale (NIHSS) score ≤3
- The clinical data is completed and be able to consistently complete the study
- Age 18-80, education level≥ 6 years and agree to sign informed consent
Exclusion Criteria:
- Progressive stroke
- Diseases with severe damage to other organs
- Moderate to severe aortic insufficiency
- Dissection aneurysm, aortic aneurysm, cerebral aneurysm
- Significant pulmonary hypertension
- Various bleeding disorders, bleeding tendencies, or use of anticoagulants, Prothrombin international normalized ratio (INR) >2.0
- Active phlebitis, venous embolism, venous thrombosis of lower extremity
- The presence of infection in the body
- Valvular disease, congenital heart disease, cardiomyopathy
- Uncontrolled hypertension (>170/110mmHg)
- Uncontrolled arrhythmia
- Left heart failure
- Pregnancy
- Patients with cardiac pacemakers
- Patients with arterial clamp after craniocerebral operation
- Patients with metal implants, such as metal joints, shrapnel and orbital foreign bodies
- History of moderate to severe cognitive impairment or psychiatric disorders
- History of malignancy
- moyamoya patients
- Lower extremity arterial thrombosis
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: real EECP
|
Real EECP treatment is delivered 45min per day for 14 sessions continuously.
The treatment pressure sets at 150 millimeters of mercury.
|
Sham Comparator: sham EECP
|
Sham EECP treatment is delivered 45min per day for 14 sessions continuously.
The treatment pressure sets at 75 millimeters of mercury.
|
No Intervention: Health Control
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
the change of stroke impact scale (SIS)
Time Frame: baseline(the day before the first EECP treatment); after a course of EECP treatment(14 days)
|
Stroke Impact Scale (SIS) is an evaluation of stroke severity affecting daily life and health.
It includes 59 items in 8 domains among strength, hand function, mobility, activities of daily living, memory, communication, emotion and social participation.
Each item is scored on a scale of 1 - 5 and each domain is scored on a scale of 0 - 100 after conversion.
The sum score of 8 domains is set as the total of SIS.
A higher score corresponds to a better outcome.
In this trial, SIS is evaluated before and after the EECP treatment course, total score of each evaluation is calculated and the change of them is set as the primary outcome measure.
|
baseline(the day before the first EECP treatment); after a course of EECP treatment(14 days)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
the change of cerebral perfusion
Time Frame: baseline(the day before the first EECP treatment); after a course of EECP treatment(14 days)
|
Arterial spin labeling(ASL) is used for the evaluation of cerebral perfusion before and after the EECP treatment.
Cerebral blood flow(CBF) map is calculated after each scan.
The difference of these two CBF maps is set as the secondary outcome measures.
|
baseline(the day before the first EECP treatment); after a course of EECP treatment(14 days)
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
November 10, 2022
Primary Completion (Anticipated)
November 30, 2026
Study Completion (Anticipated)
November 30, 2027
Study Registration Dates
First Submitted
January 30, 2023
First Submitted That Met QC Criteria
January 30, 2023
First Posted (Actual)
February 8, 2023
Study Record Updates
Last Update Posted (Actual)
February 24, 2023
Last Update Submitted That Met QC Criteria
February 22, 2023
Last Verified
November 1, 2022
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- XJTU1AF-CRF-2022-023
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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