Effect of remote ischemic preconditioning on cerebral circulation time in severe carotid artery stenosis: Results from the RIC-CCT trial
Quanying Liu, Yu Cui, Wei Li, Jing Qiu, Thanh N. Nguyen, Dawei Chen
Abstract
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 ). • Remote ischemic preconditioning (RIC) significantly improves cerebral circulation time • RIC reduces the occurrence of contrast staining on brain CT after carotid artery stenting • Multiple mechanisms are involved in the effect of RIC Liu et al. show that short-term remote ischemic conditioning (RIC) can significantly improve cerebral circulation time (CCT) of stenosis side in patients with severe internal carotid artery stenosis (sICAS), which may involve multiple mechanisms. These findings provide supporting evidence that RIC can modulate cerebral circulation in patients with sICAS.