Reducing brain swelling in patients with large ischemic stroke using a specialized medication

Reduction of Edema With a Specialized Cocktail for Ultra-early Management in Ischemic Stroke

Phase 3 Interventional Second Affiliated Hospital, School of Medicine, Zhejiang University · NCT06863571

This study is testing a new medication to see if it can help reduce brain swelling in people who have had a large ischemic stroke.

Quick facts

PhasePhase 3
Study typeInterventional
Enrollment68 (estimated)
Ages18 Years and up
SexAll
SponsorSecond Affiliated Hospital, School of Medicine, Zhejiang University Academic / other
Locations1 site (Hangzhou, Zhejiang)
Trial IDNCT06863571 on ClinicalTrials.gov

What this trial studies

This multicenter, randomized controlled trial evaluates the safety and efficacy of a pharmacological cocktail (PPA) designed to reduce cerebral edema in patients suffering from large ischemic stroke. The study will enroll 68 patients with middle cerebral artery territory infarction who are not undergoing decompressive craniectomy. Participants will be randomly assigned to receive either the PPA therapy or standard treatment, with the primary outcome being the reduction of cerebral edema assessed through follow-up imaging at 5-7 days. Secondary outcomes will include functional assessments to evaluate overall patient recovery.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 and older diagnosed with acute ischemic stroke in the middle cerebral artery territory, with specific infarct volume criteria.

Not a fit: Patients with severe comorbidities, contraindications to PPA medications, or those scheduled for decompressive craniectomy may not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could significantly improve outcomes for patients with large ischemic strokes by reducing brain swelling and associated complications.

How similar studies have performed: While the approach is based on promising preclinical findings, this specific trial represents a novel application of the pharmacological cocktail in a clinical setting.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Age ≥18 years
* Clinical diagnosis of acute ischemic stroke (AIS) in the middle cerebral artery (MCA) territory
* Symptom onset within 3 days (≤72 hours) before randomization
* Infarct volume of 80-300 mL or ASPECTS 1-5 involving at least two cortical regions
* Not scheduled for decompressive craniectomy (either not indicated or declined by the patient/family)
* Written informed consent obtained from the patient or legally authorized representative

Exclusion Criteria:

* Baseline evidence of brain herniation or severe hypotension (SBP \<90 mmHg)
* Contraindications to PPA medications (terazosin, urapidil, esmolol, propranolol), such as asthma or severe bradycardia
* Severe comorbidities that may interfere with efficacy assessment or safety monitoring (e.g., end-stage organ failure, advanced malignancy)
* Pregnancy or lactation
* Participation in another interventional trial that may influence study outcomes

Where this trial is running

Hangzhou, Zhejiang

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Ischemic Stroke
Last reviewed 2026-06-09 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.