Department of Emergency, Xuanwu Hospital, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China.
Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
CNS Neurosci Ther. 2022 Sep;28(9):1365-1371. doi: 10.1111/cns.13874. Epub 2022 Jun 15.
Remote ischemic conditioning (RIC) has been demonstrated to reduce recurrent stroke in patients with intracranial artery stenosis. This study aimed to evaluate the effects of RIC in patients with the symptomatic internal carotid artery (ICA) or middle cerebral artery (MCA) occlusion.
This study is based on a high-volume single-center prospective cohort study in China, which included patients with symptomatic ICA or MCA occlusion with impaired hemodynamics and receiving chronic RIC. Clinical follow-up visits were performed regularly, and cardio-cerebrovascular events were assessed.
In total, 131 patients (68 with ICA occlusion and 63 with MCA occlusion; mean age, 52.6 ± 13.7 years; stroke, 73.5%; transient ischemic attack TIA, 26.5%) qualified for the analysis; the mean follow-up period was 8.8 years (range, 3-14 years). The compliance of RIC was 95.6 ± 3.7%, and no associated severe adverse events happened. The annual risk of ischemic stroke and ischemic cerebrovascular events was 2.4% and 3.3%, respectively. The cumulative probabilities of ischemic cerebrovascular events and major adverse cardiovascular and cerebrovascular events were 32.8% and 44.8% at 14 years, respectively.
In patients with symptomatic ICA or MCA occlusion with impaired hemodynamics, chronic RIC is well-tolerated, and it appears to be associated with a low annual risk of ischemic stroke and cardio-cerebrovascular events.
远程缺血预处理（RIC）已被证明可减少颅内动脉狭窄患者的复发性卒中。本研究旨在评估 RIC 对有症状的颈内动脉（ICA）或大脑中动脉（MCA）闭塞患者的影响。
本研究基于中国一项大容量单中心前瞻性队列研究，该研究纳入了有症状的 ICA 或 MCA 闭塞且血液动力学受损并接受慢性 RIC 的患者。定期进行临床随访，评估心脑血管事件。
共有 131 例患者（ICA 闭塞 68 例，MCA 闭塞 63 例；平均年龄 52.6±13.7 岁；卒中 73.5%，短暂性脑缺血发作 TIA 26.5%）符合分析条件；平均随访时间为 8.8 年（范围 3-14 年）。RIC 的依从性为 95.6±3.7%，无相关严重不良事件发生。缺血性卒中和缺血性脑血管事件的年风险分别为 2.4%和 3.3%。14 年后缺血性脑血管事件和主要不良心脑血管事件的累积概率分别为 32.8%和 44.8%。
在有症状的血液动力学受损的 ICA 或 MCA 闭塞患者中，慢性 RIC 耐受良好，似乎与较低的缺血性卒中和心脑血管事件的年风险相关。
