Remote ischemic conditioning approach for the treatment of ischemic stroke

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Stroke is the leading cause of disability and death in North Ameri-ca. There has been growing interest in identifying neuroprotective strategies to reduce ischemic burden in patients with acute isch-emic stroke. However, despite extensive clinical trials, no neuropro-tective agent has been found for prevention of ischemic damage. Remote ischemic preconditioning (RIC) is a promising non-inva-sive strategy that has been proven to provide renal and cardiopro-tection and has recently found to have a potential broad application in the treatment of neurovascular disease, which has bee linked to its possible effects on the release and activation of endogenous neu-roprotective substances against the ischemia/reperfusion injuries in experimental studies. This endogenous neuroprotection might vac-cinate neural tissues against effects of acute IR following primary infarction insult. Regardless of the method of RIC administration, through manual or automated blood pressure cuff, RIC procedure is inexpensive and easy to use. Based on the experimental and clinical data, application of RIC avoids possible adverse effects and interactions associated with chemical pharmacological agents. In previous clinical studies RIC was safe and associated with only minor transient adverse effects in few cases, including petechia and minor limb pain, which were mostly resolved shortly after com-pleting the treatment. RIC involves between three to five cycles of 5 minutes blood pressure cuff inflation and 5 minutes of deflation on the upper or lower extremity. RIC can be applied before (Pre-RIC), during (Per-RIC) and after (Post-RIC) infarction and can be safely continued for a prolonged period of time in human.
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