Introduction

The current standard of care in acute ischemic stroke (AIS) within window period is thrombolysis with or without endovascular therapy. The role of neuroprotective therapies especially within window period, to salvage the ischemic penumbra is unclear. Our study is targeting the effect of Citicoline immediately after the revascularization therapy. Most of the neuroprotective drug trials have included patients after the critical window period. Those patients undergoing revascularization therapy are expected to have a good ischemic penumbra. Moreover, Citicoline has never been used concurrently in any clinical trial involving endovascular therapy. 

Methods

All consecutive AIS patients aged above 18 years, satisfying criteria for reperfusion therapy (thrombolysis or thrombectomy) will be randomized to intervention and placebo arm immediately after therapy with concealed allocation. Patients in the Citicoline arm will receive 1gm intravenous therapy for 3 days followed by oral treatment (1 gm twice daily) for 39 days. Primary outcome is change in stroke volume from baseline to week 6. Secondary outcomes are mRS 0-2, NIHSS 0-2 and mortality at 90 days.

Results

We have randomized 39 patients till date and expect to enroll 114 patients in our study period (two years).

Conclusion

The benefit of Citicoline in the immediate post reperfusion therapy has never been studied. The neuroprotectant may play a significant role in salvaging the ischemic penumbra during the early stages of stroke evolution.

CITICOLINE IN ACUTE ISCHEMIC STROKE- A RANDOMIZED CONTROL TRIAL (CTRI/2018/02/011900)