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Remote Limb Ischemic Preconditioning: A Neuroprotective Technique in Rodents
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Remote Ischemic Conditioning for Acute Stroke: The RESIST Randomized Clinical Trial.

Rolf Ankerlund Blauenfeldt1,2, Niels Hjort1,2, Jan Brink Valentin3

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|October 3, 2023
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Summary
This summary is machine-generated.

Remote ischemic conditioning (RIC) did not improve functional outcomes for acute stroke patients when started pre-hospital and continued in-hospital. This treatment showed no significant benefit in reducing disability at 90 days.

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Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Clinical Trials

Background:

  • Remote ischemic conditioning (RIC) involves cycles of limb ischemia and reperfusion.
  • Preclinical and clinical data on RIC for acute stroke have shown some promise.
  • The effectiveness of prehospital-initiated RIC for acute stroke remains uncertain.

Purpose of the Study:

  • To evaluate the effect of RIC, initiated pre-hospital and continued in-hospital, on functional outcomes in acute stroke patients.
  • To determine if RIC improves the modified Rankin Scale (mRS) score at 90 days.

Main Methods:

  • A randomized clinical trial involving 1500 patients with acute stroke symptoms.
  • RIC was administered using an inflatable cuff, with cycles of inflation and deflation.
  • Treatment was initiated in ambulances and continued in hospitals for up to 7 days.

Main Results:

  • Among 902 patients with confirmed stroke, RIC did not significantly improve functional outcomes at 90 days (mRS shift: OR, 0.95; P=.67).
  • No significant differences in serious adverse events were observed between the RIC and sham groups.
  • Increased incidence of upper extremity pain and skin petechiae was noted in the RIC group.

Conclusions:

  • Prehospital-initiated RIC, continued in-hospital, did not significantly improve functional outcomes in acute stroke patients.
  • The study did not support the use of RIC as an effective treatment for improving functional outcomes in acute stroke.
  • Further research may be needed to explore potential benefits or alternative protocols for RIC in stroke management.