Head-down position tested after acute ischemic stroke from artery narrowing
Tests lying head-down after stroke caused by narrowed large arteries, in adults.
Plain-language title generated from the registry record
Registry title: Trendelenburg Position for Acute Anterior Circulation Ischemic Stroke With Large Artery Atherosclerosis Etiology (HOPES 3)
Key facts
- Where
- Shenyang, ChinaSee the site
AI summary: who the study is looking for
From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.
The trial is looking for adults with a moderate sudden stroke caused by narrowed or blocked arteries at the front of the brain. It tests lying with the head down.
- Age
- 18 years or older
- Sex
- Women and men can join.
- Disease stage
- Sudden stroke from a blood clot or blockage, confirmed on a scan. Moderate deficit (NIHSS 6 to 16) within 24 hours of onset, or a worsening from mild (NIHSS 5 or less) to moderate within 24 hours. Cause is probably a narrowed or blocked artery (stenosis 50% or more or occlusion) in the front part of the brain (internal carotid artery, M1 or M2 of the middle cerebral artery).
- Earlier treatment
- People who plan to have, or have already had, clot-dissolving treatment or mechanical clot removal cannot join.
Main reasons for not taking part
- Disability before the stroke (mRS 3 or more)
- Disturbance of consciousness
- Bleeding stroke, or ischemic and bleeding stroke together
- Other causes of stroke, such as a clot from the heart or a torn artery
- Any reason against lying head down, such as active vomiting, pneumonia or uncontrolled heart failure
Read by machine on 9 November 2026.
Where in China
- Department of Neurology, General Hospital of Northern Theater CommandShenyang, ChinaContact: Hui-Sheng Chen, Ph.D.Taking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Contact the study team: see the registry record → Contacts and Locations
Print a page for my doctorTrial details
- Who runs it
- General Hospital of Shenyang Military Region
- Trial code
- NCT06010641
- Record updated
- 27 April 2026
- Original description
The effect of head position as a nonpharmacological therapy on acute ischemic stroke (AIS) remains inconclusive. Recent HOPES2 (Head dOwn-Position for acutE moderate ischemic Stroke with large artery atherosclerosis) suggest the safety, feasibility, and potential benefit of the head-down position (HDP) in acute ischemic stroke. The current study aims to investigate the efficacy and safety of HDP in acute moderate ischemic stroke patients with large artery atherosclerosis.Read full original descriptionShow less
Trendelenburg Position for Acute Anterior Circulation Ischemic Stroke With Large Artery Atherosclerosis Etiology (HOPES 3): a Prospective, Randomized, Open-label, Blinded-endpoint, Multi-center Trial
The effect of head position as a nonpharmacological therapy on acute ischemic stroke (AIS) remains inconclusive. Recent HOPES2 (Head dOwn-Position for acutE moderate ischemic Stroke with large artery atherosclerosis) suggest the safety, feasibility, and potential benefit of the head-down position (HDP) in acute ischemic stroke. The current study aims to investigate the efficacy and safety of HDP in acute moderate ischemic stroke patients with large artery atherosclerosis.
Inclusion: Age ≥ 18 years old; Acute ischemic stroke confirmed by NCCT or MRI; Moderate neurologic deficit (6≤ NIHSS ≤ 16) within 24 hours of onset, or progressing from mild (NIHSS ≤ 5) to moderate neurologic deficit (6≤ NIHSS ≤ 16) within 24 hours, requiring ≥ 4 point increase in NIHSS score although the onset time is beyond 24 hours; Probable large artery atherosclerosis etiology based on the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria (responsible artery stenosis ≥ 50% or occlusion); Anterior circulation stroke (internal carotid artery, M1 or M2 of middle cerebral artery); First stroke onset or past stroke without obvious neurological deficit (mRS≤2); Signed informed consent.
Exclusion: Previous history of intracerebral hemorrhage within 1 year; Pre-stroke disability (mRS≥3); Hemorrhagic stroke or combined ischemic and hemorrhagic stroke; Serious comorbidity, such as liver or kidney insufficiency, malignant tumor, etc; Other stroke etiologies, such as cardiogenic embolism, arteritis, arterial dissection, moyamoya disease, etc; Any contraindication to head-down position (e.g. active vomiting, pneumonia, uncontrolled heart failure); Severe uncontrolled hypertension (systolic blood pressure over 180mmHg or diastolic blood pressure over 100 mmHg); Cardiac insufficiency (NYHA Class ≥II); Comorbidity with other serious diseases; Patients with disturbance of consciousness; Patients who plan to undergo or have completed thrombolysis or mechanical thrombectomy; Planned carotid or intracranial revascularization within 3 months; Pregnant or lactating women; Participating in other clinical trials within 3 months; Patients not suitable for the study considered by researcher.