机构:[1]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China神经内科首都医科大学宣武医院[2]Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China低氧适应转化医学北京市重点实验室首都医科大学宣武医院[3]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China神经外科首都医科大学宣武医院[4]Department of Neurology, Brain Hospital of Cangzhou Central Hospital, Hebei, China
Objective: Remote ischemic conditioning (RIC) has been demonstrated to be safe and feasible for patients with acute ischemic stroke (AIS), as well as for those receiving intravenous thrombolysis. We assessed the safety and feasibility of RIC for 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 6 hours of ictus. Four cycles of RIC were performed before recanalization, immediately following recanalization, and once daily for the subsequent 7 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 7 days posttreatment. 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 3-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.
基金:
This study was supported by National Key
R&D Program of China (No.
2017YFC1308405), Cheung Kong (Chang
jiang) Scholars Program (T2014251), The
Capital Health Research and Development of
Special (2016-4-1032), and Beijing Municipal
Administration of Hospitals Clinical Medicine
Development of Special Funding Support
(ZYLX201706).
第一作者机构:[1]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China[2]Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
通讯作者:
通讯机构:[*]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, No 45, Changchun Street, Xicheng District, Beijing, China, 100053.
推荐引用方式(GB/T 7714):
Wenbo Zhao,Ruiwen Che,Sijie Li,et al.Remote ischemic conditioning for acute stroke patients treated with thrombectomy[J].ANNALS OF CLINICAL AND TRANSLATIONAL NEUROLOGY.2018,5(7):850-856.doi:10.1002/acn3.588.
APA:
Wenbo Zhao,Ruiwen Che,Sijie Li,Changhong Ren,Chuanhui Li...&Xunming Ji.(2018).Remote ischemic conditioning for acute stroke patients treated with thrombectomy.ANNALS OF CLINICAL AND TRANSLATIONAL NEUROLOGY,5,(7)
MLA:
Wenbo Zhao,et al."Remote ischemic conditioning for acute stroke patients treated with thrombectomy".ANNALS OF CLINICAL AND TRANSLATIONAL NEUROLOGY 5..7(2018):850-856