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CTRI Number  CTRI/2026/02/103841 [Registered on: 13/02/2026] Trial Registered Prospectively
Last Modified On: 10/02/2026
Post Graduate Thesis  No 
Type of Trial  Interventional 
Type of Study   Drug 
Study Design  Randomized, Parallel Group, Multiple Arm Trial 
Public Title of Study   Hypertension control in Stroke Patients after the clot removal surgery 
Scientific Title of Study   Third Enhanced Control of Hypertension and Thrombectomy Stroke Study 
Trial Acronym   
Secondary IDs if Any  
Secondary ID  Identifier 
NCT06352619  ClinicalTrials.gov 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Dr P N Sylaja  
Designation  Professor of Neurology  
Affiliation  Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum  
Address  Comprehensive Stroke Care Program, Room No:3109, Stroke Office, Department of Neurology, Medical College P.O

Thiruvananthapuram
KERALA
695011
India 
Phone  04712524482  
Fax    
Email  sylajapn@hotmail.com   
 
Details of Contact Person
Scientific Query
 
Name  Dr Jeyaraj Durai Pandian  
Designation  Principal and Professor  
Affiliation  Christian Medical College and Hospital, Ludhiana  
Address  Department of Neurology, Christian Medical College and Hospital, Brown Road, Ludhiana

Ludhiana
PUNJAB
141008
India 
Phone  9915784750  
Fax    
Email  jeyarajpandian@hotmail.com   
 
Details of Contact Person
Public Query
 
Name  Dr P N Sylaja  
Designation  Professor of Neurology  
Affiliation  Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum  
Address  Comprehensive Stroke Care Program, Room No:3109, Stroke Office, Department of Neurology, Medical College P.O

Thiruvananthapuram
KERALA
695011
India 
Phone  04712524482  
Fax    
Email  sylajapn@hotmail.com   
 
Source of Monetary or Material Support  
National Health and Medical Research Council (NHMRC) of Australia  
The Canadian Institutes of Health Research (CIHR)  
The George Institute for Global Health  
University of Calgary, Calgary, Canada  
 
Primary Sponsor  
Name  Dr Craig Anderson  
Address  The George Institute for Global Health, Level 18, International Towers 3, 300 Barangaroo Ave, Barangaroo NSW 2000 Australia Email: canderson@georgeinstitue.org.au  
Type of Sponsor  Research institution 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     Australia
Canada
China
India  
Sites of Study  
No of Sites = 25  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Sanjeev Kumar Bhoi   All India Institute of Medical Sciences, Bhubaneswar   Department of neurology, All India Institute of Medical Sciences, Sijua, Patrapada, Bhubaneswar - 751019
Khordha
ORISSA 
9919787978

neuro_sanjeev@aiimsbhubaneswar.edu.in 
Dr Ashish Sharma  All India Institute of Medical Sciences, Bilaspur   Department of Neurology, All India Institute of Medical Sciences, Bilaspur -174037
Bilaspur
HIMACHAL PRADESH 
9816397700

ashishsharmamd@yahoo.co.in  
Dr Mritunjai Singh  All India Institute of Medical Sciences, Rishikesh  Department of Neurology, All India Institute of Medical Sciences, Shivaji Nagar, Rishikesh - 249203
Dehradun
UTTARANCHAL 
9997010096

mritunjasingh@gmail.com 
Dr Vivek K Nambiar   Amrita Institute of Medical Sciences and Research Centre, Kochi   Department of Stroke Medicine, G block , Ground floor, Amrita Institute of Medical Sciences and Research Centre, Ponekkara, Edapally, Kochi, 682041
Ernakulam
KERALA 
8921485541

dr.vivek.in@gmail.com 
Dr Paul J Alapatt  Aster MIMS Hospital, Calicut   Aster MIMS Hospital, Mini- Bypass Road, Govindapuram P.O-673016, Calicut
Kozhikode
KERALA 
9447342034

pauljalapatt@gmail.com  
Dr Biman Kanti Ray  Bangur Institute of Neurosciences, Kolkata   Department of Neurosciences, Bangur Institute of Neurosciences, IPGME and R, Kolkata - 700020
Kolkata
WEST BENGAL 
9433185327

biman.kanti@rediffmail.com 
Dr S P Gorthi   Bharati Vidyapeeth DTU Medical College, Pune   Department of Neurology, Bharati Vidyapeeth (DTU) Medical College and Hospital, Pune - 411043
Pune
MAHARASHTRA 
8800233991

spgorthi@gmail.com  
Dr Ritwiz Bihari   Chandan Hospital, Lucknow   Department of Neurology, Chandan Hospital, Faizabad Road, Vijayant Khand, Gomti Nagar, Lucknow - 226010
Lucknow
UTTAR PRADESH 
7523835781

drritwizbihari@gmail.com 
Dr Jeyaraj Durai Pandian   Christian Medical College and Hospital, Ludhiana  Department of Neurology, Christian Medical College and Hospital, Ludhiana, Brown Road, Ludhiana - 141008
Ludhiana
PUNJAB 
9915784750

jeyarajpandian@hotmail.com 
Dr Sanjith Aaron  Christian Medical College, Vellore   Department of Neurological Sciences, Christian Medical College Vellore (Ranipet Campus), Kilminnal Village, Ranipet - 632 517
Vellore
TAMIL NADU 
9894022395

sanjith@cmcvellore.ac.in  
Dr Sulena   Guru Gobind Singh Medical College and Hospital, Faridkot   Department of Neurology, Guru Gobind Singh Medical College and Hospital, Faridkot - 151203
Faridkot
PUNJAB 
7087907025

sulenasingh@yahoo.co.in 
Dr Sunil K Narayan  Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry   Department of Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvanthri Nagar, Pondicherry - 605006
Pondicherry
PONDICHERRY 
9443617120

sknarayan@gmail.com 
Dr Aparna R Pai   Kasturba Hospital, Manipal  Department of Neurology, Kasturba Hospital, Manipal - 576104
Udupi
KARNATAKA 
9880182224

aparna.pai@manipal.edu  
Dr TCR Ramakrishnan   KG Hospital and Post Graduate Medical Institute & Research Centre, Coimbatore   First floor, B Block, Department of Neurology, No. 5, Government Arts College Road, Coimbatore - 641018
Coimbatore
TAMIL NADU 
9443365792

priyarams01@gmail.com  
Dr A O Saroja   KLEs Dr. Prabhakar Kore Hospital & Medical Resaerch Centre, Belagavi  Department of Neurology, KLEs Dr. Prabhakar Kore Hospital & Medical Research Centre, J.N.Medical College Campus, Nehru Nagar, Belagavi-590010
Belgaum
KARNATAKA 
9448468474

sarojaao2002@yahoo.com 
Dr P Vijaya   Lalitha Super Specialities Hospital Pvt Ltd, Guntur   Department of Neurosciences, Lalitha Super Specialities Hospital Pvt Ltd, Kothapet, Guntur - 522 001
Guntur
ANDHRA PRADESH 
9440808621

drvijayapvr@gmail.com 
Dr Radhika Lotlikar  LMFF s Deenanath Mangeshkar Hospital & Research Center  Department of Neurology, LMFF s Deenanath Mangeshkar Hospital and Research Center, Erandawane, Pune 411004
Pune
MAHARASHTRA 
9967104512

radhika.lotlikar58@gmail.com  
Dr Veena Vedartham   Manipal Hospital Bangalore   Department of Neurology, Manipal Hospital, #98 Old Airport road, Benagluru-560017
Bangalore
KARNATAKA 
9645422534

veenavedu@gmail.com  
Dr Jayanta Roy   Manipal Hospitals, Mukundapur Cluster, Kolkata   Department of Neurology, Manipal Hospitals, Mukundapur Cluster, 223 & 230, Barakhola Lane, Purba Jadavpur, Mukundapur, Kolkata -700099
Kolkata
WEST BENGAL 
9836210993

jroyneuro01@gmail.com 
Dr Girish Baburao Kulkarni   National Institute of Mental Health and Neurosciences (NIMHANS) Bangalore  Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur road Bangalore-560029
Bangalore
KARNATAKA 
9035160614

gbk5000@rediffmail.com 
Dr Darshan Doshi   PD Hinduja Hospital & MRC, Mumbai   Department of Neurology, PD Hinduja Hospital & MRC, Veer Savarkar Road, Mahim, Mumbai - 400016.
Mumbai
MAHARASHTRA 
9845633469

darshankdoshi@gmail.com 
Dr Neeraj Bhutani  Santokba Durlabhji Memorial Hospital, Jaipur   Department of Neurology, Santokba Durlabhji Memorial Hospital, Bhawani Singh Rd, Rambagh, Jaipur -302015
Jaipur
RAJASTHAN 
9828711808

drneerajbhutani@rediffmail.com 
Dr Soaham Desai  Shree Krishna Hospital, Anand   Department of Neurology, Bhaikaka University, Shree Krishna Hospital and Medical Research Centre, Gokal Nagar, Karamsad-388 325, Anand
Anand
GUJARAT 
9979937885

drsoahamdesai@yahoo.com  
Dr P N Sylaja   Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum  Room No. 3109, Stroke Office, Comprehensive Stroke Care Program, Department of Neurology, Medical College P.O. - 695011
Thiruvananthapuram
KERALA 
9446566287

sylajapn@hotmail.com 
Dr Arvind Sharma  Zydus Hospital, Ahmedabad  Department of Neurology, Zydus Hospitals & Healthcare Research Pvt. Ltd., Zydus Hospitals Road, S.G.Highway, Thaltej, Ahmedabad - 380054
Ahmadabad
GUJARAT 
9409210486

dr_arvind10@yahoo.co.in 
 
Details of Ethics Committee  
No of Ethics Committees= 25  
Name of Committee  Approval Status 
Bharati Vidyapeeth Deemed University IEC  Submittted/Under Review 
Ethics committee of Manipal Hospitals  Submittted/Under Review 
IEC (BHR) AIIMS Bilaspur   Submittted/Under Review 
IEC AIIMS Rishikesh  Submittted/Under Review 
Institute Ethics Committee (Basic and Neurosciences Division), NIMHANS, Bangalore   Submittted/Under Review 
Institutional ethics committee (IEC), AIIMS, Bhubaneswar   Submittted/Under Review 
Institutional Ethics committee, AIMS, Kochi  Submittted/Under Review 
Institutional Ethics Committee, Chandan Hospital, Lucknow   Submittted/Under Review 
Institutional Ethics Committee, CMC and H, Ludhiana   Submittted/Under Review 
Institutional Ethics Committee, DMH and RC, Pune   Submittted/Under Review 
Institutional Ethics committee, Guru Gobind Singh Medical College and Hospital, Faridkot  Approved 
Institutional Ethics committee, K G Hospital, Coimbatore   Approved 
Institutional Ethics Committee, KLEs Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi  Submittted/Under Review 
Institutional Ethics Committee, Manipal Hospitals, Mukundapur   Submittted/Under Review 
Institutional Ethics Committee, PD Hinduja Hospital and MRC  Submittted/Under Review 
Institutional Ethics Committee, SCTIMST, Trivandrum   Submittted/Under Review 
Institutional Ethics Committee, Shree Krishna Hospital and Medical Research Centre, Anand  Submittted/Under Review 
Institutional Review Board (IRB), CMC Vellore   Submittted/Under Review 
IPGME and R Research Oversight Committee  Approved 
JIPMER Institute Ethics Committee (Human-Interventional)   Submittted/Under Review 
Kasturba Medical College and Kasturba Hospital Institutional Ethics Committee (KMC and KH IEC)   Submittted/Under Review 
Lalitha Super Specialities Hospital Ethics Committee   Approved 
Malabar Institute of Medical Sciences Ethics Committee  Submittted/Under Review 
SDMH Ethics Committee   Submittted/Under Review 
Zydus Hospital Ethics Committee   Submittted/Under Review 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: I639||Cerebral infarction, unspecified,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Intervention  Conservative SBP Control  The blood pressure will be controlled with the target of 175-180 mmHg 
Intervention  Intensive SBP Control  The blood pressure will be controlled with the target of 140±5 mmHg 
Intervention  Moderate SBP Control  The blood pressure will be controlled with the target of 160±5 mmHg 
Comparator Agent  NIL  NIL 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  99.00 Year(s)
Gender  Both 
Details  1. Age greater than or equal to 18 years
2. Use of endovascular therapy (EVT) within 24 hours of symptom onset or last known well according to local guidelines;
3. Sustained high systolic blood pressure greater than or equal to 150 mmHg (2 readings less than 10 mins apart) within 3 hours after completion of EVT. 
 
ExclusionCriteria 
Details  1. Any definite contraindications to BP lowering treatment

 
 
Method of Generating Random Sequence   Stratified block randomization 
Method of Concealment   Other 
Blinding/Masking   Outcome Assessor Blinded 
Primary Outcome  
Outcome  TimePoints 
modified Rankin scale (mRS) scores  Day 90 
 
Secondary Outcome  
Outcome  TimePoints 
Excellent functional neurological outcome (mRS 0-1)
 
Day 90 
Independent functional neurological outcome (mRS 0-2)  Day 90 
Health Related Quality of Life based on EQ-5D-5L and EQ VAS  Day 90 
Ordinal shift of 7 levels of mRS
 
Day 90 
National Institute of Health Stroke Scale (NIHSS) score
 
24-48 hours 
Imaging assessment (e.g., infarct size, oedema volume)
 
NIL 
Total length of hospital stay in the first 90-days after stroke onset
 
Day 90 
Ambulatory status at discharge
 
NIL 
Place of residence  Day 90 
Mortality  Day 90 
Any intracranial haemorrhage (ICH) and Symptomatic intracerebral haemorrhage (sICH)
 
NIL 
SAEs  within 4 days 
 
Target Sample Size   Total Sample Size="1900"
Sample Size from India="100" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   Phase 3 
Date of First Enrollment (India)   01/03/2026 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  11/10/2024 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="3"
Months="0"
Days="0" 
Recruitment Status of Trial (Global)   Open to Recruitment 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - YES
  1. What data in particular will be shared?
    Response - All of the individual participant data collected during the trial, after de-identification.

  2. What additional supporting information will be shared?
    Response -  Study Protocol
    Response -  Statistical Analysis Plan
    Response - Informed Consent Form

  3. Who will be able to view these files?
    Response - Researchers whose proposed use of the data has been approved by an independent review committee identified for this purpose.

  4. For what types of analyses will this data be available?
    Response - To achieve aims in the approved proposal.

  5. By what mechanism will data be made available?
    Response - Proposals should be directed to [canderson@georgeinstitue.org.au].

  6. For how long will this data be available start date provided 01-11-2025 and end date provided 31-10-2033?
    Response - Beginning 3 months and ending 5 years following article publication.

  7. Any URL or additional information regarding plan/policy for sharing IPD? 
    Additional Information - NIL
Brief Summary  
Several clinical trials have produced variable conclusions regarding the effects of intensive blood pressure (BP) lowering in post-EVT acute ischaemic stroke (AIS) patients. Although two trials indicate harm from very intensive target-based treatment (SBP less than 130 mmHg), the others neutral effects in the SBP range 140-160 mmHg. The ENCHANTED3/MT domain of the ACT-GLOBAL platform trial aims to test different approaches to the treatment of elevated SBP in post-EVT AIS patients to find an optimal BP management strategy. ENCHANTED3/MT will randomize (1:1:1) up to 1,900 patients with SBP greater than equal to 150 mmHg post-EVT to conservative (no or minimal SBP reduction by 5-10mmHg or a target of 175-180mmHg if very-high baseline SBP [greater than equal to 180mmHg]), moderate (SBP reduction by 10-20mmHg or a target of 160 ± 5, whichever is higher; no control if low-high baseline SBP [150-160mmHg]), or intensive (SBP reduction by 30-50mmHg or a target of 140±5 mmHg, whichever is higher) BP management.

As usual, hospital care during the study period, BP will be closely assessed up to day 4 to check adherence to the BP management protocol. The BP assessment frequency will be every 15 minutes for the first hour from domain randomisation, hourly from 1 hour to 8 hours, 4 hourly from 8 hours to 24 hours, and daily from Day 2 to Day 4. NIHSS will be conducted at baseline before randomisation into this domain. Randomisation will be stratified by country/region, and eTICI scores after EVT (less than or equal to 2b vs greater than or equal to 2c), using permuted blocks of varying sizes. Response Adaptive Randomisation (RAR) is not applicable in this domain. Randomisation will be centralized, secure, and concealed, using a web-based server, thus eliminating the possibility of imbalance in baseline prognostic variables and confounding by allocation bias. Investigators will rapidly access the randomiser using a web browser/application accessible using a username and password secured via multi-factor authentication. Primary outcome is modified Rankin scale (mRS) at 90 days analysed with utility-weighted mRS using a Bayesian hierarchical linear model. Adaptive analyses will be conducted 3-monthly with prespecified statistical triggers for superiority, inferiority and equivalence.
 
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