Frontiers in Neurology (May 2023)

Enhanced external counter pulsation therapy in patients with symptomatic and severe intracranial steno-occlusive disease: a randomized clinical trial protocol

  • Vijay K. Sharma,
  • Vijay K. Sharma,
  • Anil Gopinathan,
  • Benjamin Y. Q. Tan,
  • Poay Huan Loh,
  • Jennifer Hung,
  • David Tang,
  • Christopher Chua,
  • Amanda C. Y. Chan,
  • Jonathan J. Y. Ong,
  • Amanda Chin,
  • Mingxue Jing,
  • Yihui Goh,
  • Sibi Sunny,
  • Chin Howe Keat,
  • Zhang Ka,
  • Shivani Pandya,
  • Lily Y. H. Wong,
  • Jin Tao Chen,
  • Leonard L. L. Yeo,
  • Leonard L. L. Yeo,
  • Bernard P. L. Chan,
  • Hock Luen Teoh,
  • Arvind K. Sinha

DOI
https://doi.org/10.3389/fneur.2023.1177500
Journal volume & issue
Vol. 14

Abstract

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Intracranial stenosis is prevalent among Asians and constitutes a common cause of cerebral ischemia. While the best medical therapy carries stroke recurrence rates in excess of 10% per year, trials with intracranial stenting have been associated with unacceptable peri-procedural ischemic events. Cerebral ischemic events are strongly related to the severity of intracranial stenosis, which is high in patients with severe intracranial stenosis with poor vasodilatory reserve. Enhanced External Counter Pulsation (EECP) therapy is known to improve myocardial perfusion by facilitating the development of collateral blood vessels in the heart. In this randomized clinical trial, we evaluate whether EECP therapy may be useful in patients with severe stenosis of intracranial internal carotid (ICA) or middle cerebral artery (MCA). The review of literature, methods of evaluation, status of currently used therapeutic approaches, and trial protocol have been presented.Clinical trial registrationClinicalTrials.gov, Identifier: NCT03921827.

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