Department of Neurology, General Hospital of Northern Theater Command, Shenyang 110016, China.
Department of Neurology, Radiology, Boston Medical Center, Boston, MA, USA.
Cell Rep Med. 2024 Nov 19;5(11):101796. doi: 10.1016/j.xcrm.2024.101796. Epub 2024 Oct 28.
In patients with severe internal carotid artery stenosis (sICAS), cerebral circulation time (CCT) is associated with cerebral hyperperfusion syndrome. This study aims to investigate the effect of remote ischemic preconditioning (RIC) on CCT in patients with sICAS. Patients are randomly assigned to the RIC group (RIC twice daily, for 2-4 days before carotid artery stenting [CAS] as an adjunct to standard medical therapy) and the control group. The results show that RIC produces a significant decrease in CCT of the stenosis side (sCCT) from baseline to pre-CAS, and the occurrence of contrast staining on brain computed tomography (CT) is lower in RIC versus control group after CAS. In addition, significant changes in some serum biomarkers suggest that anti-neuroinflammation, anti-oxidative stress, protecting endothelial injury, and improving cerebral autoregulation may be associated with the effect of RIC. These findings provide supporting evidence that RIC can modulate cerebral circulation in patients with sICAS. This study was registered at ClinicalTrials.gov (NCT05451030).
在严重颈内动脉狭窄（sICAS）患者中，脑循环时间（CCT）与脑过度灌注综合征有关。本研究旨在探讨远程缺血预处理（RIC）对 sICAS 患者 CCT 的影响。患者随机分为 RIC 组（RIC 每日两次，在颈动脉支架置入术 [CAS] 前 2-4 天作为标准药物治疗的辅助治疗）和对照组。结果显示，RIC 可显著降低 sCCT 从基线到术前的 CCT，并且在 CAS 后 RIC 组比对照组的脑 CT 对比染色发生率更低。此外，一些血清生物标志物的显著变化表明，抗神经炎症、抗氧化应激、保护内皮损伤和改善脑自动调节可能与 RIC 的作用有关。这些发现为 RIC 可以调节 sICAS 患者脑循环提供了支持证据。本研究在 ClinicalTrials.gov 注册（NCT05451030）。
