[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100606225":3},{"organization":4,"outcomesModule":7,"designInfo":62,"detailedDescription":41,"studyPopulation":41,"armGroups":70,"interventions":80,"overallOfficials":41,"centralContacts":41,"locations":87,"responsibleParty":108,"collaborators":41,"id":111,"slug":112,"hasResults":113,"nctId":114,"briefTitle":115,"officialTitle":116,"acronym":41,"eligibilityCriteria":117,"healthyVolunteers":113,"sex":118,"minAge":119,"maxAge":41,"enrollmentInfo":120,"targetDuration":41,"studyType":123,"phases":124,"briefSummary":126,"conditions":127,"keywords":41,"overallStatus":90,"whyStopped":41,"lastUpdateSubmitDate":129,"lastUpdatePostDateStruct":130,"startDateStruct":133,"completionDateStruct":135,"leadSponsor":137,"locationsCount":138},{"fullName":5,"class":6},"General Hospital of Shenyang Military Region","OTHER",{"primaryOutcomes":8,"secondaryOutcomes":13,"otherOutcomes":52},[9],{"measure":10,"description":11,"timeFrame":12},"early neurologic improvement (ENI)","ENI was defined as more than 4-point decrease in NIHSS within 24±8 hours;","24±8 hours",[14,18,22,23,26,29,31,35,37,39,42,44,47,50],{"measure":15,"description":16,"timeFrame":17},"proportion of good collateral circulation status","good collateral circulation status was defined as ASITN\u002FSIR grade 3-4.","during the first angiography examination",{"measure":19,"description":20,"timeFrame":21},"Change in National Institutes of Health Stroke Scale (NIHSS)","the minimum and maximum values of NIHSS are 0 and 42, respectively; higher NIHSS mean a worse outcome.","Immediately before endovascular treatment",{"measure":19,"description":20,"timeFrame":12},{"measure":24,"description":25,"timeFrame":12},"Changes in cerebral infarct volume","infarct volume was measured by MRI-DWI",{"measure":27,"description":28,"timeFrame":12},"Changes in cerebral edema","change in cerebral edema was measured based on middle shift on CT or MRI",{"measure":19,"description":20,"timeFrame":30},"10±2 days",{"measure":32,"description":33,"timeFrame":34},"proportion of modified Rankin Scale (mRS) 0-1","The minimum and maximum values of mRS are 0 and 6, respectively; higher score mean a worse outcome","90±7 days",{"measure":36,"description":33,"timeFrame":34},"proportion of modified Rankin Scale (mRS) 0-2",{"measure":38,"description":33,"timeFrame":34},"ordinal distribution of modified Rankin Scale (mRS)",{"measure":40,"description":41,"timeFrame":34},"new stroke or other vascular event(s)",null,{"measure":43,"description":41,"timeFrame":12},"percentage of severe adverse events",{"measure":45,"description":46,"timeFrame":12},"proportion of symptomatic intracranial hemorrhage","symptomatic intracranial hemorrhage is defined as a NIHSS increase ≥4 caused by intracranial hemorrhage",{"measure":48,"description":49,"timeFrame":12},"proportion of intraparenchymal hemorrhage (PH)","PH was defined as confluent bleeding occupying and causing mass effect",{"measure":51,"description":41,"timeFrame":30},"all-cause mortality",[53,56,59],{"measure":54,"description":55,"timeFrame":12},"changes in dynamic cerebral autoregulation (dCA)","dCA data include phase difference (the main parameter, determined as the phase shift angle ranging from 0° to 90°), gain (difference in the amplitude between CBFV and ABP), and the coherence function (indicates signal-to-noise ratio), which is determined according to previous report (Guo ZN, Guo WT, Liu J, et al. Changes in cerebral autoregulation and blood biomarkers after remote ischemic preconditioning.)",{"measure":57,"description":58,"timeFrame":12},"changes in cortical oxygen saturation","cortical oxygen saturation is determined by near infrared spectroscopy",{"measure":60,"description":61,"timeFrame":12},"changes in serum biomarkers","serum biomarkers include MMP-9, TNF-alpha, IL-1beta, etc.",{"allocation":63,"interventionModel":64,"interventionModelDescription":41,"primaryPurpose":65,"observationalModel":41,"timePerspective":41,"maskingInfo":66},"RANDOMIZED","PARALLEL","TREATMENT",{"masking":67,"maskingDescription":41,"whoMasked":68},"SINGLE",[69],"OUTCOMES_ASSESSOR",[71,77],{"label":72,"type":73,"description":74,"interventionNames":75},"HDP","EXPERIMENTAL","the HDP group receive -20° Trendelenburg prior endovascular treatment.",[76],"Other: head down position",{"label":78,"type":79,"description":41,"interventionNames":41},"Control","NO_INTERVENTION",[81],{"type":6,"name":82,"description":83,"armGroupLabels":84,"otherNames":85},"head down position","the patient is positioned at a -20° Trendelenburg",[72],[86],"Trendelenburg",[88],{"facility":89,"status":90,"city":91,"state":92,"zip":93,"country":94,"countryCode":95,"cosmosGeoPoint":96,"geoPoint":101,"contacts":102},"Hui-Sheng Chen","RECRUITING","Shenyang","None Selected","110016","China","CN",{"type":97,"coordinates":98},"Point",[99,100],123.43278,41.79222,{"lat":100,"lon":99},[103],{"name":104,"role":105,"phone":106,"phoneExt":41,"email":107},"Zi-Ai Zhao, Ph.D.","CONTACT","86-2428897517","zhaoziai@hotmail.com",{"type":109,"investigatorFullName":89,"investigatorTitle":110,"investigatorAffiliation":5,"oldNameTitle":41,"oldOrganization":41},"PRINCIPAL_INVESTIGATOR","Director","100606225","head-down-position-before-endovascular-treatment-for-large-vessel-occlusion-hopes5-100606225",false,"NCT07172789","Head dOwn Position Before Endovascular Treatment for Large veSsel Occlusion (HOPES5)","Head dOwn Position Before Endovascular Treatment for Large veSsel Occlusion (HOPES5): a Prospective, Randomized, Open Label, Blinded-end Point, Multi-center Study","Inclusion Criteria:\n\n* Age ≥ 18 years;\n* Patients with acute large vessel occlusion scheduled for endovascular thrombectomy within 24 hours of symptom onset;\n* Baseline National Institute of Health Stroke Scale (NIHSS) ≥ 6;\n* Expected waiting time from randomization to femoral artery puncture is more than 30 minutes;\n* ASPECTS\u002Fpc-ASPECTS score ≥ 6 on baseline non-contrast CT or DWI;\n* Modified Rankin Scale score before stroke onset ≤ 1;\n* Signed informed consent by patient or their legally authorized representative.\n\nExclusion Criteria:\n\n* Hemorrhagic stroke: cerebral hemorrhage, subarachnoid hemorrhage;\n* 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;\n* Severe hypertension before randomization (systolic blood pressure \\>185 mmHg or diastolic blood pressure \\>110 mmHg);\n* Cardiac insufficiency (NYHA Class ≥II);\n* Pregnancy, plan to get pregnant or during lactation;\n* Patients at significant risk of aspiration (e.g., obvious nausea and vomiting);\n* The estimated life expectancy is less than 6 months due to other serious diseases;\n* Other conditions unsuitable for this clinical study assessed by researcher.","ALL","18 Years",{"count":121,"type":122},210,"ESTIMATED","INTERVENTIONAL",[125],"NA","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.",[128],"Ischemic Stroke","2026-09-15",{"date":131,"type":132},"2026-09-18","ACTUAL",{"date":134,"type":132},"2025-09-02",{"date":136,"type":122},"2027-09-30",{"name":5,"class":6},1]