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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Purroy, Francisco García, Cristina Mauri, Gerard Pereira, Cristina Torres, Coral Vazquez-Justes, Daniel Vicente-Pascual, Mikel Vena, Ana Arque, Gloria |
| Abstract | Background Remote ischemic conditioning during cerebral ischemia (remote ischemic perconditioning, RIPerC) refers to the application of several cycles of brief ischemia and reperfusion (I/R) commonly to a limb, and it represents a new paradigm in neuroprotection with multiple mechanisms of action in ischemic stroke (IS) patients during acute phase. Some clinical trials just finished, and a few others are still ongoing; gather the current knowledge and pull it down to influence the present and future studies was the goal of this paper. Methods A systematic review of published research papers and/or registered clinical trials since 2000 was performed. Results Nineteen studies were identified and only four studies were completed. All of them have demonstrated that RIPerC is safe, feasible and well tolerated in IS patients. However, a high heterogeneity of clinical trial characteristics was observed: five (26.3%) randomized clinical trials (RCTs) included only thrombolytic-treated patients, three (15.8%) RCTs only thrombectomy-treated patients, and five (26.3%) RCTs required radiological confirmation of IS. Temporal inclusion criteria vary from 4 h to 48 h. Most of the clinical trials used 4 cycles of RIPerC in the upper non-affected limb. Interestingly, only three (16.7%) RCTs applied RIPerC during the transportation in the ambulance. Neuroimaging outputs were the main endpoints when endovascular therapy was applied; functional outcome is also the main endpoint in large-medium size studies. Conclusions This review summarizes the completed and ongoing clinical trials on RIPerC in IS patients, where RIPerC has been used alone or in combination with recanalization therapies. Ongoing clinical trials will provide new information on the best RIPerC intervention strategy and potentially improve the functional outcome of IS patients; definition of new RIPerC strategies would ideally aim at enhancing tissue preservation, promoting neurological recovery, and stratify patients to improve treatment feasibility. |
| Related Links | https://bmcneurol.biomedcentral.com/counter/pdf/10.1186/s12883-020-01836-8.pdf |
| Ending Page | 12 |
| Page Count | 12 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 14712377 |
| DOI | 10.1186/s12883-020-01836-8 |
| Journal | BMC Neurology |
| Issue Number | 1 |
| Volume Number | 20 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2020-07-02 |
| Access Restriction | Open |
| Subject Keyword | Neurology Neurochemistry Neurosurgery Ischemic stroke Neuroprotection Remote ischemic perconditioning Randomized clinical trials Systematic review |
| Content Type | Text |
| Resource Type | Article |
| Subject | Neurology (clinical) |
| Journal Impact Factor | 2.2/2023 |
| 5-Year Journal Impact Factor | 2.5/2023 |
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