Grant: Project Grant

Stroke is a serious medical condition where blood flow to a part of the brain is blocked, causing brain cells to die. A treatment called endovascular thrombectomy (EVT) has helped improve recovery for people who suffer from a type of stroke caused by a large blood clot. However, half of the patients undergoing EVT to remove the clot from a brain vessel still face lasting disabilities or even die within three months. Studies have shown that even after a blood vessel is successfully reopened with EVT, abnormal blood flow to the brain can still occur, potentially affecting recovery. Previous research suggests that lying flat (at a 0-degree angle) improves blood flow to the brain. HoBIT (Head of Bed after Ischemic stroke Thrombectomy) is testing whether lying flat for 24 hours after EVT is better than being slightly upright (at a 30-degree angle) for improving recovery. Patients that are eligible and agree to participate are randomly assigned (like flipping a coin) to either lie flat or at a 30-degree angle after the end of EVT. The ultimate goal of our study is to see how well patients recover at approximately 90 days after their stroke, using a scale that measures how much help they need with daily activities. A very large study at many hospitals is needed to answer this question. We are starting with a smaller study to gain information on whether it is possible to perform a larger definitive one, and if so, how best to plan for it. This first step will involve 750 participants from 16 stroke centres in three different countries. We will evaluate how many patients show signs of improvement, how many days they stay in the hospital, and their overall quality of life. We will also monitor for any complications, like worsening stroke symptoms, bleeding in the brain, lung infections, or death. Data from those participants will provide important information to refine our methods and plan our larger study with the goal of improving the outcomes of patients undergoing EVT.