title: Preliminary findings of external counterpulsation for ischemic stroke patient with large artery occlusive disease.
abstract: OBJECTIVE
  We aimed to investigate the feasibility and therapeutic effect of external counterpulsation (ECP) in ischemic stroke.
  
  
  METHODS
  The trial was a randomized, crossover, assessment-blinded, proof-of-concept trial. ECP treatment consisted of 35 daily 1-hour sessions. Patients were randomized to either early (ECP weeks 1 to 7 and no ECP weeks 8 to 14) or late group (no ECP weeks 1 to 7 and ECP weeks 8 to 14). Primary outcomes were an overall change in National Institutes of Health Stroke Scale (NIHSS) and cerebral blood flow estimated by color velocity imaging quantification. Secondary outcomes were change in NIHSS, color velocity imaging quantification, favorable functional outcome (modified Rankin scale, 0 to 2), and stroke recurrence at weeks 7 and 14, respectively.
  
  
  RESULTS
  Fifty patients were recruited. At week 7, there was a significant change in NIHSS (early 3.5 vs late 1.9; P=0.042). After adjusting for treatment sequence, ECP was associated with a favorable trend of change in NIHSS of 2.1 vs 1.3 for non-ECP (P=0.061). Changes of color velocity imaging quantification were not significant but tended to increase with ECP. At week 14, a favorable functional outcome was found in 100% of early group patients compared to 76% in the late group (P=0.022).
  
  
  CONCLUSIONS
  ECP is feasible for ischemic stroke patients with larger artery disease.
authors.forename: Jing Hao
authors.initials: JH
authors.lastname: Han
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Leung
authors.forename: Wynnie W
authors.initials: WW
authors.lastname: Lam
authors.forename: Yannie O
authors.initials: YO
authors.lastname: Soo
authors.forename: Anne W
authors.initials: AW
authors.lastname: Alexandrov
authors.forename: Vincent
authors.initials: V
authors.lastname: Mok
authors.forename: Yee-Fong V
authors.initials: YF
authors.lastname: Leung
authors.forename: Raymond
authors.initials: R
authors.lastname: Lo
authors.forename: Ka Sing
authors.initials: KS
authors.lastname: Wong
mesh_terms: D000368:Aged; D001794:Blood Pressure; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000502:physiology; D002560:Cerebrovascular Circulation; D015908:Counterpulsation / Q000009:adverse effects; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D020521:Stroke / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D017585:Ultrasonography, Doppler, Transcranial