Head-down positioning before clot removal for large-vessel ischemic stroke.

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This interventional trial tests whether head-down positioning (HDP) applied before endovascular thrombectomy can reduce early neurological deterioration and increase salvage of the ischemic penumbra. Eligible patients are adults with acute large-vessel occlusion within 24 hours, NIHSS ≥ 6, and ASPECTS/pc-ASPECTS ≥ 6 who expect more than a 30-minute wait before femoral artery puncture. Participants will receive HDP prior to the procedure and will be monitored for clinical outcomes and safety events compared with usual positioning. The trial builds on prior work showing benefit from flat supine positioning and seeks to determine whether a head-down tilt provides additional neuroprotection prior to recanalization.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Age ≥ 18 years;
* Patients with acute large vessel occlusion scheduled for endovascular thrombectomy within 24 hours of symptom onset;
* Baseline National Institute of Health Stroke Scale (NIHSS) ≥ 6;
* Expected waiting time from randomization to femoral artery puncture is more than 30 minutes;
* ASPECTS/pc-ASPECTS score ≥ 6 on baseline non-contrast CT or DWI;
* Modified Rankin Scale score before stroke onset ≤ 1;
* Signed informed consent by patient or their legally authorized representative.

Exclusion Criteria:

* Hemorrhagic stroke: cerebral hemorrhage, subarachnoid hemorrhage;
* 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;
* Severe hypertension before randomization (systolic blood pressure \>185 mmHg or diastolic blood pressure \>110 mmHg);
* Cardiac insufficiency (NYHA Class ≥II);
* Pregnancy, plan to get pregnant or during lactation;
* Patients at significant risk of aspiration (e.g., obvious nausea and vomiting);
* The estimated life expectancy is less than 6 months due to other serious diseases;
* Other conditions unsuitable for this clinical study assessed by researcher.

Where it's running

• Hui-Sheng Chen
  Shenyang, None Selected, China Recruiting

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.