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REmote iSchemic Conditioning in acUtE BRAin INfarction Study

Watumiaji waliosajiliwa tu ndio wanaweza kutafsiri nakala
Ingia / Ingia
Kiungo kimehifadhiwa kwenye clipboard
HaliInatumika, sio kuajiri
Wadhamini
Versailles Hospital
Washirika
Unité de Recherche Clinique Paris IDF Ouest

Maneno muhimu

Kikemikali

Cerebral infarction is the most common form of stroke (80% of strokes). Stroke is the first cause of acquired disability, and the 2nd cause of dementia and death. The only approved treatment in the first 4.5 hour is intravenous rt-PA thrombolysis (Actilyse ®) whose objective is recanalization of occluded artery and reperfusion of the brain parenchyma. Few patients are treated (1-5%) and they keep disability in 50-60% of cases. This handicap is mainly correlated to the final infarct size. The objective of neuroprotective treatments is to reduce the final size of the cerebral infarction.
The per-conditioning remote ischemic (Per-CID) showed a neuroprotective effect in cerebral ischemia by reducing the final size of cerebral infarction animal models. The per-CID corresponds, in cases of cerebral ischemia, to iterative ischemia realization of a member with a cuff. In humans, the per-CID has shown a cardioprotective effect in a randomized control trial involving 250 patients within 6 first hours of myocardial infarction and candidate for primary angioplasty.

Tarehe

Imethibitishwa Mwisho: 08/31/2018
Iliyowasilishwa Kwanza: 06/09/2014
Uandikishaji uliokadiriwa Uliwasilishwa: 07/10/2014
Iliyotumwa Kwanza: 07/14/2014
Sasisho la Mwisho Liliwasilishwa: 09/02/2018
Sasisho la Mwisho Lilichapishwa: 09/04/2018
Tarehe halisi ya kuanza kwa masomo: 12/31/2014
Tarehe ya Kukamilisha Msingi iliyokadiriwa: 12/31/2018
Tarehe ya Kukamilisha Utafiti: 12/31/2018

Hali au ugonjwa

Cerebral Infarction

Uingiliaji / matibabu

Device: With per-CID protocol

Other: Without per-CID protocol

Awamu

-

Vikundi vya Arm

MkonoUingiliaji / matibabu
Experimental: With per-CID protocol
Usual care patients (thrombolysis or not ) with remote ischemic per-conditioning using an electronic tourniquet .
Device: With per-CID protocol
Lower limb tourniquet will be put on half thigh. The protocol will include 4 cycles of inflation cuff 110 mm Hg above systolic blood pressure followed by 4 cycles of deflation in between. The total duration of per-CID protocol will be 40 minutes (4 phases of 5 minutes inflations' of and 4 phases of 5 minutes deflations').
Other: Without per-CID protocol
Usual care patients (thrombolysis or not).
Other: Without per-CID protocol

Vigezo vya Kustahiki

Zama zinazostahiki Kujifunza 18 Years Kwa 18 Years
Jinsia Inastahiki KujifunzaAll
Hupokea Wajitolea wa AfyaNdio
Vigezo

Inclusion Criteria:

- Patients ≥ 18 years

- Carotid ischemic stroke

- NIHSS score between 5 and 25

- Brain MRI performed within 6 hours from symptoms onset

- Obtaining a written informed consent of the patient or a third party (parent or close), or emergency inclusion process

- Affiliated with a Medicare (or rightful beneficiary)

Exclusion Criteria:

- Presence of a leg ulcer or a bad skin condition in the lower limbs

- History of arterial occlusive disease of the lower limbs

- Sickle cell disease known (risk of vaso-occlusive crisis)

- History of phlebitis in the lower limbs

- History of cerebral infarction older than 3 months

- Participation in another interventional acute phase protocol

- Patients under guardianship

- Pathologies involving life-threatening within 6 months and making it impossible to evaluate to 3 months

- Patient non-self before the ischemic stroke (Rankin Score previous> 2)

- Pregnant Women

Matokeo

Hatua za Matokeo ya Msingi

1. Brain MRI changes of DWI ( Diffusion-Weighted Imaging) brain infarction volume (cc) between baseline ( [24 hours]

Central lecture of brain MRI, blinded to clinical data, randomisation group and day of MRI realization ( day 0 or day 1) Endpoint criteria: DWI volume d1-d0 (cc) measured by a dedicated software (Neurinfarct) Comparison of DWI volume d1-d0 between the 2 groups ( Per-CID group and control)

Hatua za Matokeo ya Sekondari

1. Percentage of patients with Modified Rankin Scale (mRS) <2 at 3 months in the 2 groups (PerCID and control) [3 months]

Percentage of patients with Modified Rankin Scale (mRS) <2 ( i.e. favorable outcome with no disability) at 3 months in the 2 groups (PerCID and control)

Hatua Nyingine za Matokeo

1. safety of remote perconditioning ischemic process [7 days]

- Rate of lower limb ischemia and deep venous thrombosis in Per CID group

2. safety of remote perconditioning ischemic process [7 days]

Rate of early neurological worsening (NIHSS score (d1- d0) > 4 points) in Per-CID and control group

3. safety of remote perconditioning ischemic process [7 days]

Percentage of hemorrhagic transformation in case of IV thrombolysis in the 2 groups

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