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Sharma VK, Gopinathan A, Tan BYQ, Loh PH, Hung J, Tang D, Chua C, Chan ACY, Ong JJY, Chin A, Jing M, Goh Y, Sunny S, Keat CH, Ka Z, Pandya S, Wong LYH, Chen JT, Yeo LLL, Chan BPL, Teoh HL, Sinha AK. Enhanced external counter pulsation therapy in patients with symptomatic and severe intracranial steno-occlusive disease: a randomized clinical trial protocol. Front Neurol 2023; 14:1177500. [PMID: 37325226 PMCID: PMC10262049 DOI: 10.3389/fneur.2023.1177500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/02/2023] [Indexed: 06/17/2023] Open
Abstract
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 registration ClinicalTrials.gov, Identifier: NCT03921827.
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Affiliation(s)
- Vijay K. Sharma
- Divisin of Neurology, National University Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Anil Gopinathan
- Department of Diagnostic Imaging, National University Hospital, Singapore, Singapore
| | - Benjamin Y. Q. Tan
- Divisin of Neurology, National University Hospital, Singapore, Singapore
| | - Poay Huan Loh
- Department of Cardiology, National University Hospital, Singapore, Singapore
| | - Jennifer Hung
- Divisin of Neurology, National University Hospital, Singapore, Singapore
| | - David Tang
- Divisin of Neurology, National University Hospital, Singapore, Singapore
| | - Christopher Chua
- Divisin of Neurology, National University Hospital, Singapore, Singapore
| | - Amanda C. Y. Chan
- Divisin of Neurology, National University Hospital, Singapore, Singapore
| | - Jonathan J. Y. Ong
- Divisin of Neurology, National University Hospital, Singapore, Singapore
| | - Amanda Chin
- Divisin of Neurology, National University Hospital, Singapore, Singapore
| | - Mingxue Jing
- Divisin of Neurology, National University Hospital, Singapore, Singapore
| | - Yihui Goh
- Divisin of Neurology, National University Hospital, Singapore, Singapore
| | - Sibi Sunny
- Divisin of Neurology, National University Hospital, Singapore, Singapore
| | - Chin Howe Keat
- Divisin of Neurology, National University Hospital, Singapore, Singapore
| | - Zhang Ka
- Divisin of Neurology, National University Hospital, Singapore, Singapore
| | - Shivani Pandya
- Divisin of Neurology, National University Hospital, Singapore, Singapore
| | - Lily Y. H. Wong
- Divisin of Neurology, National University Hospital, Singapore, Singapore
| | - Jin Tao Chen
- Divisin of Neurology, National University Hospital, Singapore, Singapore
| | - Leonard L. L. Yeo
- Divisin of Neurology, National University Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Bernard P. L. Chan
- Divisin of Neurology, National University Hospital, Singapore, Singapore
| | - Hock Luen Teoh
- Divisin of Neurology, National University Hospital, Singapore, Singapore
| | - Arvind K. Sinha
- Department of Diagnostic Imaging, National University Hospital, Singapore, Singapore
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Adams JA, Martínez A. Editorial: Non-pharmacologic Sustained Endothelial Shear Stress: An Evolving Clinical Paradigm. Front Physiol 2021; 12:790022. [PMID: 34867490 PMCID: PMC8635141 DOI: 10.3389/fphys.2021.790022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 10/27/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Jose A Adams
- Division of Neonatology, Mount Sinai Medical Center, Miami Beach, FL, United States
| | - Alfredo Martínez
- Angiogenesis Group, Oncology Area, Center for Biomedical Research of La Rioja, Logroño, Spain
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