Head Down Tilt 15° to Increase Collateral Flow in Acute Ischemic Stroke: Rationale and Study Protocol
| Journal | Stroke (Hoboken, N.J.) |
| Study Type | Randomized Trial |
| Population | Human participants |
This item covers developments relevant to cannabis medicine and clinical practice. Clinicians monitoring evidence in this area should review the source material.
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
“This is a development worth tracking. The clinical implications will become clearer as more evidence accumulates.”
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FAQ
What is head down tilt 15 degrees in stroke care?
HDT15 is a positional therapy in which the patient is tilted head down at 15 degrees, similar to Trendelenburg positioning. The article describes it as simple and low cost, and says it may augment cerebral collateral blood flow and penumbral survival in acute ischemic stroke.
Why does collateral blood flow matter in acute ischemic stroke?
Collateral blood flow is a critical determinant of successful recanalization in acute ischemic stroke caused by large vessel occlusion. That is the rationale for this trial: if HDT15 augments collateral flow, it might improve cerebral collateral circulation and clinical outcomes in patients treated with mechanical thrombectomy.
What is the DOWN-SUITE trial trying to find out?
The trial aims to assess the safety, feasibility, and efficacy of HDT15 in improving cerebral collateral circulation and clinical outcomes. It focuses on patients with large vessel occlusion acute ischemic stroke treated with mechanical thrombectomy, specifically those with occlusion of the M1 segment of the middle cerebral artery.
How is the DOWN-SUITE trial designed, and how many patients will enroll?
It is a multicenter, randomized, open-label, phase 2a/b trial with blinded outcome assessment, conducted across 7 Italian stroke centers. A total of 118 patients will be randomized 1:1 in the emergency department to receive either HDT15 or standard positioning. The publication presents the rationale and protocol, so the trial is planned rather than completed.
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