Stroke Clinical Trial
Official title:
A Randomized, Controlled Phase 1 Study of External Counterpulsation as a Treatment for Acute Ischemic Stroke
The purpose of this study is to determine if external counterpulsation (ECP) is feasible to perform, tolerable, and safe as a treatment for patients with acute ischemic stroke (i.e., a blockage of one of the arteries supplying a part of the brain), and to assess what type of effect it might have on 1) the velocity of blood flow in the arteries supplying the brain and 2) stroke symptoms. The hypothesis of the study is that ECP will be feasible and safe to perform, and will be tolerable for patients with acute ischemic stroke at pressures that increase the velocity of arterial blood flow to the brain.
A stroke is usually caused by a blockage of one of the arteries that carries blood to the
brain. Sometimes with a stroke, there may be a small amount of blood flow that manages to
get through or around the blockage, and it may be possible that the amount of damage from a
stroke may be reduced by increasing this blood flow. External counterpulsation (ECP) is a
procedure in which a machine uses electrical signals from the heart that are detectable on
the surface of the body in order to time the inflation of cuffs (similar to a blood pressure
cuff) that are wrapped around a patient's legs (calves, thighs and buttocks). Using a
reading of the electrical activity from the patient's heart (an electrocardiogram, or ECG,
monitor), the machine inflates the cuffs with air at just the right time during each heart
beat, during diastole, in order to change the blood pressure in a way that has been shown to
increase blood flow to the kidneys, skin, eyes, heart, and brain.
In this study, patients presenting within the first 48 hours of an acute ischemic stroke
(i.e., a blockage of one of the arteries supplying a part of the brain) will be randomly
assigned to either of (1) a 1-hour treatment of external counterpulsation (ECP) applied at a
pressure that is typically therapeutic, or (2) a 1-hour treatment of ECP at a minimal
pressure in a control group. ECP-induced changes in brain artery flow velocity will be
assessed with an ultrasound prior to and then during ECP in each group, and an optimal
pressure that results in an augmentation of flow velocity will be determined. A neurological
exam will be performed prior to, during, and after ECP in each group, in order to assess any
changes in stroke symptoms related to ECP. Patients will be followed to 30 days. The main
goal of this trial is to evaluate if ECP is safe and feasible to use as a treatment for
stroke. In addition, the trial will enable an assessment of whether or not ECP increases
blood flow to the brain or affects the neurological symptoms of a patient with a stroke.
;
Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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