CompletedPhase IIIInterventional

Remote ischaemic Conditioning After Stroke Trial - 3

A stroke occurs when a blood clot blocks blood flow to part of the brain. While doctors have treatments to clear these blockages, they must be given very quickly and are not suitable for everyone. The RECAST-3 study is testing a simple, low-cost technique called remote ischaemic conditioning to help shield the brain from further damage. The treatment involves wearing cuffs on both arms, similar to regular blood pressure monitors. The cuffs inflate and deflate over 40 minutes, twice a day for up to two weeks in hospital. This brief, harmless squeeze encourages the body to release natural protective chemicals into the blood, which travel to the brain. Around 1,300 patients across 60 UK hospitals will take part. Half will receive the cuff treatment and half will receive a dummy procedure alongside standard stroke care, followed by a check-up call three months later.

At a glance

Status

Completed

Phase

Phase III

Sponsor

University of Nottingham

Enrolment target

1,300

Start

09 Feb 2024

Estimated completion

27 Mar 2026

Adults with acute ischaemic stroke presenting in Emergency Departments and Stroke Units in the UK

What is this study about?

Every year, around 100,000 people in the UK have a stroke. Most of these are ischaemic strokes, which happen when a blood clot blocks an artery supplying blood to the brain. Without blood and oxygen, brain cells quickly become damaged or die. Doctors have treatments to dissolve or remove clots, but they can only be used in a small number of patients and within a very short timeframe. Researchers are urgently searching for simple, effective ways to protect brain cells from damage.

This trial is looking at a promising technique called remote ischaemic conditioning (RIC). It uses standard inflatable cuffs placed around both arms. The cuffs inflate to briefly pause blood flow for five minutes, followed by five minutes of rest, repeated four times. Early studies suggest that this brief pause triggers the body's natural defences, releasing protective chemicals into the bloodstream. These chemicals travel up to the brain and may help reduce the final size of the stroke and limit long-term disability.

The RECAST-3 trial will involve 1,300 stroke patients across 60 NHS hospitals. Because the cuffs are easy to use and relatively cheap, proving that this method works could make a major difference to stroke care across the UK and worldwide. Paramedics, nurses, or doctors could easily provide this treatment early on, giving more people the chance of a better recovery.

Key takeaways

Tests whether gentle arm cuff pressure can help protect the brain after an ischaemic stroke.
Open to adults arriving at participating UK hospitals within 48 hours of stroke symptoms.
Half of the participants receive the active treatment and half receive a dummy procedure.
Sessions take place twice a day for up to 14 days while you are in hospital.
All normal stroke medications and therapies continue as planned.
Follow-up is completed by a single telephone call three months after joining.

Who may be eligible?

This trial is for adults aged 18 and older who have been admitted to a participating hospital with an acute ischaemic stroke (a stroke caused by a clot). To be eligible, the stroke symptoms must have started within the past 48 hours, and a brain scan must confirm there is no bleeding in the brain.

The study is not suitable for people who already had significant memory loss, severe disability, or needed full-time care before the stroke happened. It also excludes people with very low blood pressure, severe arm injuries, active cancer with limited life expectancy, or those who are pregnant.

Because stroke treatment must start quickly, the hospital stroke team will review your scans and medical history to make sure it is safe for you to take part. If a patient is too unwell or unable to communicate, a close family member or carer can give agreement on their behalf.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

You are aged 18 or older.
You have been diagnosed with a stroke caused by a blood clot (ischaemic stroke).
Your stroke symptoms started less than 48 hours ago.
A hospital brain scan has ruled out any bleeding in the brain.
You were mostly independent and did not have dementia before the stroke.

Answer every question to see your result.

What does participation involve?

If you join the trial, you will be randomly assigned to either the real cuff treatment or a dummy (sham) treatment that feels similar but does not restrict blood flow. You have an equal 50:50 chance of being in either group. You will continue to receive all of your routine NHS stroke care, including any clot-busting medicines or rehabilitation therapies.

The treatment is given twice a day for up to 14 days while you stay in hospital. During each 40-minute session, cuffs on both arms inflate and deflate automatically. You may also have standard brain scans or blood tests so doctors can check how your brain is healing. Before you leave the hospital (around day 14), a researcher will check on your progress. Three months later, the team will call you at home for a short telephone interview to ask about your recovery, memory, mood, and daily activities.

Potential risks and benefits

We cannot promise that taking part will directly help your recovery, but the treatment may help protect your brain and reduce disability. The results will also help doctors improve stroke care for future patients. The main risk is mild discomfort, tingling, or temporary bruising on your arms while the cuffs are inflated. If you have an additional brain scan, it uses a very small amount of radiation that carries an extremely low health risk. Taking part is entirely your choice. You or your family can stop at any time without giving a reason, and your normal medical care will continue as usual.

Locations (43)

Royal Derby Hospital
Approximate
Derby, England
Leicester Royal Infirmary
Approximate
Leicester, England
University Hospital of Hartlepool
Approximate
Hartlepool, England
Addenbrookes Hospital
City only
Cambridge, England
Yeovil District Hospital
City only
Yeovil, England
Watford General Hospital
Unverified
Watford, England
Luton and Dunstable University Hospital
Unverified
Luton, England
Kent and Canterbury Hospital
Unverified
Canterbury, England
Queen's Medical Centre
Unverified
Nottingham, England
Royal Preston Hospital
Unverified
Preston, England
Southampton General Hospital
Unverified
Southampton, England
Aberdeen Royal Infirmary
Unverified
Aberdeen, Scotland

Common questions

Will taking part delay my normal stroke treatment?

No. The trial treatment is given alongside standard stroke care, including clot-busting drugs, without causing any delays.

Does the arm cuff treatment hurt?

It feels like having your blood pressure checked. It may feel tight or slightly uncomfortable for a few minutes, but it should not cause severe pain.

What is the dummy (sham) treatment?

The dummy treatment uses the same arm cuffs, but they inflate only very gently so blood flow is not paused. This allows researchers to fairly compare the results.

Can a relative decide for me if I am unable to?

Yes. If stroke symptoms make it hard for you to speak or understand the study details, a family member or carer can agree on your behalf.

Will I have to travel back to the hospital after I go home?

No extra hospital visits are required after you are discharged. The final check-up takes place over the phone after three months.

How to find out more

Diane Havard

diane.havard@nottingham.ac.uk +44 0115 823 1775 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.