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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Rationale for ischemic conditioning to prevent stroke in patients with intracranial arterial stenosis

Sami Al Kasab1, David C Hess2, Marc I Chimowitz1

  • 1Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, USA.

Brain Circulation
|October 3, 2018
PubMed

Insights

Remote limb ischemic conditioning offers a promising new therapy for intracranial atherosclerotic arterial stenosis (ICAS), a major cause of stroke. This technique may protect the brain from further ischemic events in high-risk patients.

Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Ischemic Stroke Research

Background:

  • Intracranial atherosclerotic arterial stenosis (ICAS) is a leading cause of stroke globally.
  • Patients with ICAS face a high risk of recurrent stroke, even with aggressive medical management.
  • Current treatments leave a subgroup of ICAS patients with a very high risk of stroke, necessitating novel therapies.

Purpose of the Study:

  • To review limitations of current ICAS treatments.
  • To discuss the potential mechanisms and supporting data for remote limb ischemic conditioning (RLIC) in ICAS.
  • To identify future research questions for RLIC in ICAS patients.

Main Methods:

  • Literature review of current ICAS treatments.
  • Analysis of preclinical and clinical data on RLIC.
  • Discussion of RLIC's potential role and future research directions for ICAS.

Main Results:

  • Current aggressive medical management for ICAS has limitations for certain patient subgroups.
  • Remote limb ischemic conditioning (RLIC) shows potential mechanisms for neuroprotection.
  • Preclinical and clinical data suggest RLIC may be beneficial for ICAS patients.

Conclusions:

  • Effective therapies for high-risk ICAS patients are urgently needed.
  • RLIC presents a promising therapeutic avenue for ICAS.
  • Further research is required to fully establish the efficacy and optimal application of RLIC in ICAS.

Keywords:
Intracranial atherosclerosisischemic conditioningstroke

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