A Randomized Trial on Hemodynamic Optimization of Cerebral Perfusion after Successful Endovascular Therapy in Patients with Acute Ischemic Stroke (HOPE).

Autor:	Camps-Renom P; Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain., Guasch-Jiménez M; Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain., Martínez-Domeño A; Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain., Prats-Sánchez L; Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain., Ramos-Pachón A; Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain., Álvarez-Cienfuegos J; Stroke Unit, Department of Neurology, Hospital Dr. Josep Trueta, Girona, Spain., Silva Y; Stroke Unit, Department of Neurology, Hospital Dr. Josep Trueta, Girona, Spain., Fortea-Cabo G; Stroke Unit, Hospital Universitario La Fe, Valencia, Spain., Morales-Caba L; Stroke Unit, Hospital Universitario La Fe, Valencia, Spain., Rodríguez-Campello A; Stroke Unit, Department of Neurology, Hospital del Mar, Neurovascular Research Group, Hospital del Mar Research Institute, Barcelona, Spain., Giralt-Steinhauer E; Stroke Unit, Department of Neurology, Hospital del Mar, Neurovascular Research Group, Hospital del Mar Research Institute, Barcelona, Spain., Flores A; Stroke Unit, Department of Neurology, Hospital Universitari de Tarragona Joan XXIII, Institut d'Investigació Sanitaria Pere Virgili, Tarragona, Spain., Ustrell X; Stroke Unit, Department of Neurology, Hospital Universitari de Tarragona Joan XXIII, Institut d'Investigació Sanitaria Pere Virgili, Tarragona, Spain., López-Hernández N; Stroke Unit, Department of Neurology, Hospital General Universitario de Alicante, Alicante, Spain., Corona-García DJ; Stroke Unit, Department of Neurology, Hospital General Universitario de Alicante, Alicante, Spain., Freijo-Guerrero MM; Biobizkaia Health Research Institute, Grupo Neurovascular, Servicio Neurología, Hospital Universitario Cruces, Barakaldo, Spain., Luna A; Biobizkaia Health Research Institute, Grupo Neurovascular, Servicio Neurología, Hospital Universitario Cruces, Barakaldo, Spain., Tejada-Meza H; Stroke Unit, Department of Neurology, and Interventional Neuroradiology Unit, Department of Radiology, Hospital Universitario Miguel Servet, Zaragoza, Spain.; Grupo de Investigación en Neurociencias, Instituto de Investigación Sanitaria (IIS) Aragón, Zaragoza, Spain., Marta-Moreno J; Grupo de Investigación en Neurociencias, Instituto de Investigación Sanitaria (IIS) Aragón, Zaragoza, Spain.; Stroke Unit, Department of Neurology, Hospital Universitario Miguel Servet, Zaragoza, Spain., Moniche F; Stroke Unit, Department of Neurology, Hospital Universitario Virgen del Rocío, Sevilla, Spain., Pardo-Galiana B; Stroke Unit, Department of Neurology, Hospital Universitario Virgen del Rocío, Sevilla, Spain., Castellanos M; Department of Neurology, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain., Albert-Lacal L; Stroke Unit, Department of Neurology, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain., Sanz-Monllor A; Stroke Unit, Department of Neurology, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain., Aguilera-Simón A; Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain., Marín R; Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain., Ezcurra-Díaz G; Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain., Lambea-Gil Á; Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain., Martí-Fàbregas J; Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain.
Jazyk:	angličtina
Zdroj:	Cerebrovascular diseases (Basel, Switzerland) [Cerebrovasc Dis] 2024 Aug 29, pp. 1-8. Date of Electronic Publication: 2024 Aug 29.
DOI:	10.1159/000540606
Abstrakt:	Introduction: In patients with acute ischemic stroke (AIS) secondary to intracranial large vessel occlusion, optimal blood pressure (BP) management following endovascular treatment (EVT) has not yet been established. The randomized trial on Hemodynamic Optimization of Cerebral Perfusion after Successful Endovascular Therapy in Patients with Acute Ischemic Stroke (HOPE) (clinicaltrials.gov id: NCT04892511) aims to demonstrate whether hemodynamic optimization using different systolic BP targets following EVT according to the degree of final recanalization, is more effective than currently recommended BP management in improving functional outcomes of patients with AIS. Methods: HOPE is an investigator-initiated multicenter clinical trial with randomized allocation, open-label treatment, and blinded endpoint evaluation (PROBE). Patients with an anterior circulation AIS within 24 h of symptom onset, treated with EVT, and showing successful recanalization (mTICI ≥2b) at the end of the procedure, are equally allocated (1:1) to hemodynamic optimization according to the study protocol versus BP management according to current guidelines (≤180/105 mm Hg). The protocol includes two different targets of systolic BP depending on the recanalization status (mTICI = 2b: 140-160 mm Hg; mTICI = 2c/3: 100-140 mm Hg). The protocol is applied within the first 72 h and includes BP lowering as well as vasopressor therapies when needed. The primary outcome is the proportion of favorable outcome (modified Rankin Scale [mRS] 0-2) at 90 days. Secondary outcomes include the shift on the mRS score, neurological deterioration, symptomatic intracerebral hemorrhage, and mortality. Conclusion: The HOPE trial will provide new information on the safety and efficacy of different BP targets following EVT according to the degree of final recanalization in patients with AIS. (© 2024 The Author(s). Published by S. Karger AG, Basel.)
Databáze:	MEDLINE
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