Remote Ischemic Conditioning Effective in Stroke

A multicenter, open-label, blinded–end point, randomized clinical trial in China showed that remote ischemic conditioning (RIC) was associated with better neurologic function in patients with acute moderate ischemic stroke. The trial randomly assigned 1893 patients (mean age, 65 years; women 34.1%; 93.8% completed the trial) within 48 hours after symptom onset to receive treatment with RIC (using a pneumatic electronic device and consisting of 5 cycles of cuff inflation for 5 minutes and deflation for 5 minutes to the bilateral upper limbs to 200 mm Hg) twice daily for 10 to 14 days as an adjunct to guideline-based treatment or guideline-based treatment alone. Patients with excellent functional outcome at 90 days were 582 (67.4%) in the RIC group and 566 (62.0%) in the control group (risk difference, 5.4%; odds ratio, 1.27; P = .02). The proportion of patients with any adverse events was 6.8% (largely redness, swelling, or skin petechiae on the arms) in the RIC group and 5.6% in the control group. Reperfusion therapies (thrombolytic therapy and mechanical thrombectomy) are effective but are available to only a small proportion of patients with acute ischemic stroke. RIC appears to be safe and may be effective in intracerebral hemorrhage as well. Source: https://jamanetwork.com/