Clinical Research Directory

Healthy Adults Aged 18-55, Three Ukrainian Windlass Tourniquets (SICH, DNIPRO GEN 2, PULS) Compared With CAT Gen 7, and Complete Limb Arterial Occlusion Confirmed by Doppler.

The goal of this clinical trial is to learn if three Ukrainian-made windlass tourniquets (SICH, DNIPRO GEN 2 and PULS) stop arterial blood flow in the arm or leg as well as the Combat Application Tourniquet (CAT Gen 7) does. The trial is in healthy adult volunteers, men and women aged 18 to 55 years. Limb tourniquets are used to stop life-threatening bleeding from an arm or leg. The results will support a national standard for windlass tourniquets in Ukraine. The main question it aims to answer is: Does each Ukrainian tourniquet completely stop arterial blood flow below the tourniquet within 120 seconds as often as CAT Gen 7? Stopped blood flow will be confirmed by Doppler ultrasound. Investigators will compare each Ukrainian tourniquet with CAT Gen 7 in the same participant, using one device on the arm and the other on the leg. They will look at whether blood flow is completely stopped and how quickly. They will also compare: * pain and comfort during and after use; * how fast normal blood flow returns after the tourniquet is removed; * how reliably each device can be applied; * any device problems and side effects. Participants will: Attend a screening visit with a medical history, physical examination, vital signs, ECG, tests for hepatitis B (HBsAg) and hepatitis C (anti-HCV) on the blood sample, and a rapid HIV test using a mouth swabblood, urine tests including pregnancy test (only for women). Be randomly assigned to one pair of devices: CAT Gen 7 with SICH, CAT Gen 7 with DNIPRO GEN 2, or CAT Gen 7 with PULS. The order in which the two devices are used will also be chosen at random. Have a tourniquet applied by trained study staff on two visits at least 24 hours apart. Each time, a different device is used on a different limb (upper arm or thigh), for no longer than 120 seconds. Have blood flow checked with Doppler ultrasound by a doctor who does not know which device is being used. Have skin temperature measured, and rate their pain and comfort. Receive follow-up phone calls about 24 hours and 72 hours after the second application. A clinic visit is arranged only if a side effect is reported.

Minocycline After Successful Endovascular Thrombectomy Recanalization in Posterior Circulation Arterial Occlusion (ATTRACTION-MINOP)

Acute ischemic stroke (AIS) is a leading cause of mortality and long-term disability worldwide. Among these, stroke caused by large vessel occlusion (LVO) are associated with particularly poor outcomes. Multiple randomized controlled trials have demonstrated that endovascular thrombectomy (EVT) significantly improves clinical outcomes in patients with acute LVO and is recommended as the standard of care by current guidelines. Posterior circulation strokes account for approximately 20% of all ischemic strokes and are generally associated with worse prognosis than anterior circulation strokes, especially in patients with basilar artery occlusion, who have a markedly increased risk of death or severe disability. Despite EVT treatment, more than three-quarters of these patients remain dead or functionally dependent at 90 days, indicating substantial room for improvement. Successful recanalization and restoration of effective cerebral perfusion are critical for achieving favorable outcomes. However, although recanalization rates exceed 80% with current thrombectomy techniques, fewer than 40 of patients achieve good functional outcomes at 90 days, suggesting a high incidence of futile recanalization. The underlying mechanisms may include no-reflow, reperfusion injury, and microcirculatory dysfunction, all of which are closely associated with post-recanalization neuroinflammation. Minocycline is a second-generation tetracycline with pleiotropic neuroprotective properties, including inhibition of microglial activation, reduction of inflammatory mediators, suppression of matrix metalloproteinases, attenuation of oxidative stress, and preservation of blood-brain barrier integrity. Preclinical and clinical studies suggest that minocycline may improve neurological outcomes in patients with AIS. This study is a multicenter, prospective, double-blind, randomized controlled trial designed to evaluate the safety and efficacy of adjunctive minocycline in patients with acute posterior circulation arterial occlusion who achieve successful recanalization after EVT. The trial will assess whether early administration of minocycline improves functional outcomes and reduces the incidence of futile recanalization.

Embolization Treatment of Chronic Refractory Shoulder Tendinopathy

This is a randomized controlled trial in which patients with moderate to severe shoulder pain (Visual Analog Scale (VAS) \> 40), in the setting of rotator cuff tendinopathy refractory to conservative treatment, will be enrolled. The primary aim of the study is to estimate the effect of transcatheter arterial embolization (TAE) with physical therapy (PT) vs PT alone on the change in shoulder pain at 12-month follow up. Scientific objectives also include an assessment of safety of the intervention, assessment of changes in Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity score, Shoulder Pain and Disability Index (SPADI) scores, MRI Tendinopathy Score between the TAE + PT and PT groups.