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REmote iSchemic Conditioning in acUtE BRAin INfarction Study

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赞助商
Versailles Hospital
合作者
Unité de Recherche Clinique Paris IDF Ouest

关键词

抽象

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.

日期

最后验证: 08/31/2018
首次提交: 06/09/2014
提交的预估入学人数: 07/10/2014
首次发布: 07/14/2014
上次提交的更新: 09/02/2018
最近更新发布: 09/04/2018
实际学习开始日期: 12/31/2014
预计主要完成日期: 12/31/2018
预计完成日期: 12/31/2018

状况或疾病

Cerebral Infarction

干预/治疗

Device: With per-CID protocol

Other: Without per-CID protocol

-

手臂组

干预/治疗
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

资格标准

有资格学习的年龄 18 Years 至 18 Years
有资格学习的性别All
接受健康志愿者
标准

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

结果

主要结果指标

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)

次要成果指标

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)

其他成果措施

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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