Objective-Remote ischemic conditioning (RIC) has been demonstrated to be safe and feasible for patients with AIS,as well as for those receiving intravenous thrombolysis.We assessed the safety and feasibility of RIC for acute ischemic stroke (AIS) patients undergoing endovascular treatment (ET).Methods-We conducted a pilot study with patients with AIS who were suspected of having an emergent large-vessel occlusion in the anterior circulation and who were scheduled for ET within six hours of ictus.Four cycles of RIC were performed before recanalization,immediately following recanalization,and once-daily for the subsequent seven days.The primary outcome was any serious RIC-related adverse events.Results-Twenty subjects,aged 66.1 ± 12.1 years,were recruited.No subject experienced serious RIC-related adverse events.The intracranial pressure,cranial perfusion pressure,mean arterial pressure,heart rate,middle cerebral artery peak systolic flow velocity,and pulsatility index did not change significantly before,during or after the limb ischemia (p>0.1 for all).Of 80 cycles,71 (89%) were completed before recanalization and 80 (100%) were completed immediately after recanalization;444 of 560 cycles (78%) were completed within seven days post-treatment.No patients had to stop RIC because it affected routine clinical managements.Six subjects (30%) experienced intracerebral hemorrhage,which was symptomatic in one case (5%).At the three-month follow-up,11 subjects (55%) had achieved functional independence,and two subjects (10%) died.Interpretation-RIC appears to be safe and feasible for patients with AIS undergoing ET.Investigations are urgently needed to determine the efficacy of RIC in this patient population.
Wenbo Zhao Ruiwen Che Sijie Li Changhong Ren Chuanhui Li Chuanjie Wu Hui Lu Jian Chen Jiangang Duan Ran Meng Xunming Ji
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China;Beijing Key Lab Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine,Xuanwu Hospital, Capital Medic Department of Neurosurgery, Xuanwu Hospital, Capital Medical University,Beijing, China Department of Neurology, Brain Hospital of Cangzhou Central Hospital, Hebei,China Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine,Xuanwu Hospital, Capital Medic