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
Where in China
- Department of Neurology, General Hospital of Northern Theater CommandShenyang, ChinaTaking 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?
Trial 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.