Head Down Tilt 15° to Increase Collateral Flow in Acute Ischemic Stroke: Rationale and Study Protocol of a Multicenter, Randomized, Proof-of-Concept, Phase 2a/b Trial in Patients Treated With Mechanical Thrombectomy (DOWN-SUITE).

Head Down Tilt 15° to Increase Collateral Flow in Acute Ischemic Stroke: Rationale and Study Protocol of a Multicenter, Randomized, Proof-of-Concept, Phase 2a/b Trial in Patients Treated With Mechanical Thrombectomy (DOWN-SUITE).

CED Clinical Relevance  #80High Clinical Relevance  Strong evidence or policy relevance with direct clinical implications.
🔬 Evidence Watch  |  CED Clinic
Journal Stroke (Hoboken, N.J.)
Study Type Randomized Trial
Population Human participants
Why This Matters

This item covers developments relevant to cannabis medicine and clinical practice. Clinicians monitoring evidence in this area should review the source material.

Clinical Summary

Collateral blood flow is a critical determinant of successful recanalization in acute ischemic stroke caused by large vessel occlusion. Head down tilt -15° (HDT15), similar to Trendelenburg positioning, is a simple, low-cost positional therapy that may augment cerebral collateral blood flow and penumbral survival. The aim of the study is to assess the safety, feasibility, and efficacy of HDT15 in improving cerebral collateral circulation and clinical outcomes in patients with large vessel occlusion-acute ischemic stroke treated with mechanical thrombectomy (MT). The DOWN-SUITE trial (Head Down Tilt 15° to Increase Collateral Flow in Acute Ischemic Stroke) is a multicenter, randomized, open-label, phase 2a/b clinical trial with blinded outcome assessment, conducted across 7 Italian stroke centers. A total of 118 patients with acute ischemic stroke due to M1 segment middle cerebral artery occlusion will be randomized 1:1 in the emergency department to receive HDT15 or standard positionin

Dr. Caplan’s Take

“This is a development worth tracking. The clinical implications will become clearer as more evidence accumulates.”

Clinical Perspective
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