A Randomized Trial on Hemodynamic Optimization of Cerebral Perfusion after Successful Endovascular Therapy in Patients with Acute Ischemic Stroke (HOPE)
Camps-Renom, Pol (Institut de Recerca Sant Pau)
Prats-Sánchez, Luis Antonio (Institut de Recerca Sant Pau)
Ramos-Pachón, Anna (Institut de Recerca Sant Pau)
Silva, Y. (Hospital Dr. Josep Trueta)
Giralt Steinhauer, Eva (Institut Hospital del Mar d'Investigacions Mèdiques)
Flores, A. (Institut d'Investigacio Sanitaria Pere Virgili)
Ustrell, X. (Institut d'Investigacio Sanitaria Pere Virgili)
Moniche, F. (Hospital Universitario Virgen Del Rocio)
Castellanos, M. (Complejo Hospitalario Universitario A Coruna)
Aguilera-Simón, Ana (Institut de Recerca Sant Pau)
Ezcurra-Díaz, Garbiñe (Institut de Recerca Sant Pau)
Lambea-Gil, Álvaro (Institut de Recerca Sant Pau)
Martí-Fàbregas, Joan (Institut de Recerca Sant Pau)
Guasch-Jiménez, Marina (Institut de Recerca Sant Pau)
Martínez-Domeño, Alejandro (Hospital de la Santa Creu i Sant Pau)
Álvarez-Cienfuegos, J. (Hospital Dr. Josep Trueta)
Fortea-Cabo, G. (Hospital Universitario la Fe)
Morales-Caba, L. (Hospital Universitario la Fe)
Rodriguez Campello, Ana Maria (Institut Hospital del Mar d'Investigacions Mèdiques)
López-Hernández, N. (Hospital General Universitario de Alicante)
Corona-García, D.J. (Hospital General Universitario de Alicante)
Freijo-Guerrero, M.M. (Hospital Universitario Cruces)
Luna, A. (Hospital Universitario Cruces)
Tejada-Meza, H. (Instituto de Investigación Sanitaria (IIS) Aragon)
Marta-Moreno, J. (Hospital Universitario Miguel Servet)
Pardo-Galiana, B. (Hospital Universitario Virgen Del Rocio)
Albert-Lacal, L. (Hospital Clínico Universitario Virgen de la Arrixaca)
Sanz-Monllor, A. (Hospital Clínico Universitario Virgen de la Arrixaca)
Marín, Rebeca (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Universitat Autònoma de Barcelona. Departament de Medicina

Data:	2025
Resum:	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.
Ajuts:	Instituto de Salud Carlos III ICI20/ 00137
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Blood pressure ; Endovascular treatment ; Ischemic stroke ; Protocol
Publicat a:	Cerebrovascular Diseases, Vol. 54, Num. 4 (January 2025) , p. 559-566, ISSN 1421-9786

DOI: 10.1159/000540606
PMID: 39208776

8 p, 792.7 KB

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