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. 2018 Nov 15;6(1):186–196. doi: 10.1002/acn3.691

Table 1.

Clinical studies of remote ischemic conditioning in stroke

Study n Type of patients RIC protocol Main results Type Status
AIS
Hougaard et al. (2014)11 274/196 Patients with suspected AIS

  1. 4 × 5 min inflations/deflations of cuff on one arm

  2. Cuff pressure: 200 mmHg or 25 mmHg above systolic pressure

  3. Times: Once during transportation to hospital

 RIC was safe, feasible, and may reduce tissue risk of infarction in AIS patients receiving intravenous thrombolysis Phase 3 Completed
England et al. (2017)23 13/13 Patients with AIS of 24 h of ictus

  1. 4 × 5 min inflation/deflation of cuff on one arm

  2. Cuff pressure: 20 mmHg above systolic pressure

  3. Times: Once within 24 h of ictus

 RIC was safe, feasible, and may improve neurological outcome in AIS patients Not applicable Completed
Zhao et al. (2018)24 20 Anterior circulation stroke patients treated with ET

  1. 4 × 5 min inflation/deflation of cuff on one arm

  2. Cuff pressure: 200 mmHg

  3. Times: Once pre‐ET and post‐ET, respectively, and once daily for 7 consecutive days

 RIC was safe and feasible in AIS patients undergoing thrombectomy Phase 1 Completed
RESCUE‐BRAIN 100/100 AIS patients within 6 h of ictus

  1. 4 × 5 min inflation/deflation of cuff on one arm

  2. Cuff pressure: 110 mmHg above systolic pressure

  3. Times: Once prehospital

 No available Not applicable Ongoing
RESIST 2500 Patients with acute stroke (including both ischemic and hemorrhagic stroke) within 4 h of ictus

  1. 5 × 5 min inflations/deflations of cuff on one arm

  2. Cuff pressure: 200 mmHg or 35 mmHg above systolic pressure if the systolic pressure is above 175 mmHg

  3. Times: Once prehospital, 6 h later in‐hospital, and twice daily for 7 days

 No available Not applicable Ongoing
REMOTE‐CAT 286/286 AIS patients within 8 h of ictus

  1. 5 × 5 min inflation/deflation of cuff on one arm

  2. Cuff pressure: unclear

  3. Times: Once prehospital

 No available Not applicable Ongoing
RECAST‐2 30/30 AIS patients within 6 h of ictus

  1. 4 × 5 min inflation/deflation of cuff on one arm

  2. Cuff pressure: 20 mmHg above systolic blood pressure

  3. Times: Once, again one hour after first treatment, or twice daily until day 4

 No available Phase 2 Ongoing
RICE PAC 30/30 Anterior circulation stroke patients treated with ET

  1. Unclear

  2. Times: Once at time of revascularization and then daily for 7 days

 No available Phase 1 Ongoing
REVISE‐2 90/90 Anterior circulation stroke patients treated with ET

  1. 4 × 5 min inflation/deflation of cuff on one arm

  2. Cuff pressure: 200 mmHg

  3. Times: Once pre‐ET and post‐ET, respectively, and once daily for 3 consecutive days

 No available Phase 2 Ongoing
ICAS
Li et al. (2015)30 34 10 patients with ICAS24 healthy volunteers

  1. 5 × 5 min inflation/deflation of cuff on both arms

  2. Cuff pressure: 200 mmHg

  3. Times: Once

 RIC was safe and feasible in ICAS patients. Not applicable Completed
Meng et al. (2012)12 51/52 Symptomatic ICAS (age <80 years)

  1. 5 × 5 min inflations/deflations of cuff on both arms

  2. Cuff pressure: 200 mmHg

  3. Times: Twice daily for 300 days

 RIC improved cerebral perfusion and reduced stroke recurrence Phase 2 Completed
Meng et al. (2015)13 40/39 Symptomatic ICAS (age 80–95 years)

  1. 5 × 5 min inflations/deflations of cuff on both arms

  2. Cuff pressure: 200 mmHg

  3. Times: Twice daily for 180 days

 RIC safe and effective in inhibiting stroke recurrence Phase 2 Completed
Hou et al. (2016)31 1500/1500 Symptomatic ICAS (age <80 years)

  1. 5 × 5 min inflation/deflation of cuff on both arms

  2. Cuff pressure: 200 mmHg

  3. Times: Twice daily for 360 days

 No available Phase 3 Ongoing
EPIC‐sICAS 50/50 Symptomatic ICAS (age 18–45 years)

  1. Five cycles of 3 min inflation and 5 min deflation of cuff on both arms

  2. Cuff pressure: 180 mmHg

  3. Times: Twice daily for 180 days

 No available Not applicable Ongoing
PICASSO 5/5 Symptomatic ICAS (age 30–90 years)

  1. 4 × 5 min inflation/deflation of cuff on both arms

  2. Cuff pressure: 200 mmHg

  3. Times: Once daily for 30 days

 No available Not applicable Ongoing
CAS and CEA
Zhao et al. (2017)39 63/63/63 Carotid artery stenosis patients undergoing CAS

  1. 5 × 5 min inflation/deflation of cuff on both arms

  2. Cuff pressure: 200 mmHg

  3. Times: Twice daily for 2 weeks

 RIC reduced incidence of new brain lesion on MRI after CAS Phase 2 Completed
Walsh et al. (2010)40 34/36 Patients undergoing CEA

  1. 10 min ischemia of each leg

  2. Cuff pressure: Doppler‐confirmed occlusion of posterior tibial or dorsalis pedis artery

  3. Times: Once

 RIC safe in patients undergoing CEA Not applicable Completed
Garcia et al. (2016)41 30/19 Patients undergoing CEA

  1. 3 × 5 min inflation/deflation of cuff on one arm

  2. Cuff pressure: 200 mmHg (sham RIC:40–50 mmHg)

  3. Times: Once, initiated 12–24 h before surgery

 Unknown Phase 2 Completed
Healy et al. (2015)42 24/21 Patients undergoing CEA

  1. 4 × 5 min inflation/deflation of cuff on one arm

  2. Cuff pressure: 200 mmHg or ≥15 mmHg above systolic pressure

  3. Times: Once, initiated 50–60 min before surgery

 No reduction in stroke with RIC Not applicable Completed
CSVD
Mi et al. (2016)47 9/8 Patients with CSVD

  1. 5 × 5 min inflation/deflation of cuff on both arms

  2. Cuff pressure: 200 mmHg

  3. Times: Twice daily for 1 year

 RIC may benefit patients with CSVD Phase 2 Completed
Wang et al. (2017)48 18/18 Patients with CSVD‐related mild cognitive impairment

  1. 5 × 5 min inflation/deflation of cuff on both arms

  2. Cuff pressure: 200 mmHg

  3. Times: Twice daily for 1 year

 RIC slowed cognition decline and reduced white matter hyperintensities Phase 2 Completed
REM‐PROTECT 40/20 Patients with clinical lacunar stroke syndrome

  1. 4 × 5 min inflation/deflation of cuff on one arm

  2. Cuff pressure: 200 mmHg

  3. Times: Once daily for 1 year

 No available Not applicable Ongoing
ASAH
Koch et al. (2011)51 26/7 Patients with aSAH

  1. Lead‐in phase: 3 × 5 min inflation/deflation of cuff on one arm or leg

  2. Dose escalation phase: 3 × 7.5 min or 3×10 min ischemia of one leg

  3. Cuff pressure: 200 mmHg or 20 mmHg above systolic pressure

  4. Times: Cuff pressure: Once

 RIC safe and well tolerated Phase 1b Completed
Gonzalez et al. (2014)52 20 Patients with aSAH

  1. 4 × 5 min inflation/deflation of cuff on one leg

  2. Cuff pressure: 20 mmHg above systolic pressure

  3. Times: four sessions on nonconsecutive days

 RIC safe and well tolerated Phase 1 Completed
Laiwalla et al. (2016)53 21/61 Patients with aSAH

  1. 4 × 5 min inflation/deflation of cuff on one leg

  2. Cuff pressure: 20 mmHg above systolic pressure, increased until dorsalis pedis pulse abolished

  3. Times: four sessions on nonconsecutive days

 RIC improved functional outcome Not applicable Completed
RIPC‐SAH 50/50 Patients with SAH

  1. 4 × 5 min inflation/deflation of cuff on one leg

  2. Cuff pressure: 20 mmHg above systolic pressure

  3. Times: Once

 No available Not applicable Ongoing
PreLIMBS 30/30 Patients with SAH within 2 weeks of initial bleeding

  1. Three cycles of 10 min inflation and 5 min deflation of cuff on arm or leg

  2. Cuff pressure: 200 mmHg

  3. Times: 3 cycles every 24–48 h during the first 14 days after SAH

 No available Not applicable Ongoing

RIC, remote ischemic conditioning; AIS, acute ischemic stroke; ICAS, intracranial atherosclerosis; CAS, carotid stenting; CEA, carotid endarterectomy; CSVD, cerebral small vessel disease; ET, endovascular thrombectomy; aSAH, aneurysmal subarachnoid hemorrhage.