- 2025-08-12
- European heart journal 47(6)
- Zhen-Ni Guo
- Reziya Abuduxukuer
- Chao Wang
- Yang Qu
- Peng Zhang
- Jun-Feng Zhao
- Xue-Feng Hu
- Dong-Sheng Ju
- Tao Hao
- Chang-Ming Wen
- Yi-Feng Liu
- Yang Zhou
- Hong-Yu Li
- Jiangang Zhang
- Zhi-Mei Yuan
- Jie Min
- Xixi Qiu
- Zhi-Dan Li
- Yan Jia
- Wen-Bo Zhang
- Xiao-Guang Song
- Jian-Xin Xu
- Hui-Sheng Chen
- Jin-Li Zhang
- Li-Ping Wang
- Hong-Jian Guan
- Xiao-Lin Tan
- Peng Jiang
- Yan-Li Zhao
- Zhen-Jiang Yu
- Hang Jin
- Xin Sun
- Duo-Lao Wang
- Thanh N Nguyen
- Yi Yang
Study Design
- Type
- Randomized Controlled Trial (RCT)
- Sample size
- n = 498
- Population
- 488 participants (244 in the RIC group and 244 in the sham RIC group) with acute ischaemic stroke who underwent endovascular thrombectomy
- Methods
- Participant-blinded, randomized controlled clinical trial; patients randomized 1:1 to RIC (cuff pressure, 200 mmHg; twice daily for 7 days) or sham RIC (60 mmHg; same procedure)
- Blinding
- Single-blind
- Duration
- 7 days
Background and aims
Even after endovascular thrombectomy, more than half of patients with acute large vessel occlusion stroke do not achieve favourable outcomes. This study aimed to assess the efficacy and safety of remote ischaemic conditioning (RIC), a promising neuroprotective treatment, in patients with acute ischaemic stroke who received endovascular thrombectomy.Methods
This participant-blinded, randomized controlled clinical trial was conducted at 25 hospitals. Patients were randomized 1:1 to either the RIC (cuff pressure, 200 mmHg; twice daily for 7 days) or sham RIC (60 mmHg; same procedure) groups. The primary outcome was the proportion of patients with a modified Rankin Scale score of 0-2 on Day 90. The primary safety outcome was the proportion of patients with haemorrhagic transformation within 7 days.Results
In total, 498 participants were recruited. Ten patients (2.0%) were excluded because they did not receive any intervention. Thus, 488 participants (244 in the RIC group and 244 in the sham RIC group) were included in the modified intention-to-treat analysis. At 90 days, 61.1% of the patients in the RIC group and 48.9% in the sham RIC group achieved a modified Rankin Scale score of 0-2 (unadjusted risk ratio 1.25, 95% confidence interval 1.06-1.47; P = .009). The proportion of patients with haemorrhagic transformation was 37.7% and 35.2% in the RIC and sham RIC groups, respectively.Conclusions
Among patients with acute ischaemic stroke who underwent endovascular thrombectomy, intervention with RIC for 7 days, compared with sham RIC, resulted in an improved functional outcome at 90 days.