Effects of Combined Remote Ischemic Pre-and Post-Conditioning on Neurologic Complications in Moyamoya Disease Patients Undergoing Superficial Temporal Artery-Middle Cerebral Artery Anastomosis

Choi, Eun Su; Lee, Yoon Sook; Park, Byeong Seon; Kim, Byung Gun; Sohn, Hye Min; Jeon, Young Tae

doi:10.3390/jcm8050638

Cited by 6 publications

(3 citation statements)

References 43 publications

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“…Thirteen trials 23–25 , 27 , 28 , 30–36 , 40 reported on cardiovascular events and were included in the meta-analysis. They reported on cardiovascular death, myocardial infarction, myocardial injury, new arrhythmia, cardiac arrest, cardiac failure, low cardiac output syndrome, ischaemic ECG changes, stroke, hypoperfusion syndrome, transient ischaemic attack and newly ischaemic brain lesions on MRI.…”

Section: Resultsmentioning

confidence: 99%

Effect of remote ischaemic preconditioning on mortality and morbidity after non-cardiac surgery: meta-analysis

et al. 2021

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Background Remote ischaemic preconditioning (RIPC) has been shown to have a protective role on vital organs exposed to reperfusion injury. The aim of this systematic review was to evaluate the effects of non-invasive RIPC on clinical and biochemical outcomes in patients undergoing non-cardiac surgery Methods A systematic literature search of PubMed, EMBASE, Scopus, and Cochrane databases was carried out in February 2020. RCTs investigating the effect of non-invasive RIPC in adults undergoing non-cardiac surgery were included. Meta-analyses and trial sequential analyses (TSAs) were performed on cardiovascular events, acute kidney injury, and short- and long-term mortality. Results Some 43 RCTs including 3660 patients were included. The surgical areas comprised orthopaedic, vascular, abdominal, pulmonary, neurological, and urological surgery. Meta-analysis showed RIPC to be associated with fewer cardiovascular events in non-cardiac surgery (13 trials, 1968 patients, 421 events; odds ratio (OR) 0.68, 95 per cent c.i. 0.47 to 0.96; P = 0.03). Meta-analyses of the effect of RIPC on acute kidney injury (12 trials, 1208 patients, 211 events; OR 1.14, 0.78 to 1.69; P = 0.50; I2 = 9 per cent), short-term mortality (7 trials, 1239 patients, 65 events; OR 0.65, 0.37 to 1.12; P = 0.12; I2 = 0 per cent), and long-term mortality (4 trials, 1167 patients, 9 events; OR 0.67, 0.18 to 2.55; P = 0.56; I2 = 0 per cent) showed no significant differences for RIPC compared with standard perioperative care in non-cardiac surgery. However, TSAs showed that the required information sizes have not yet been reached. Conclusion Application of RIPC to non-cardiac surgery might reduce cardiovascular events, but not acute kidney injury or all-cause mortality, but currently available data are inadequate to confirm or reject an assumed intervention effect.

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Section: Resultsmentioning

confidence: 99%

Effect of remote ischaemic preconditioning on mortality and morbidity after non-cardiac surgery: meta-analysis

et al. 2021

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“…In particular, psychological intervention for pediatric MMD patients is important to improve post-operative quality of life and physical, emotional, social, and school functional outcomes [ 200 ]. Choi et al [ 201 ] also confirmed the effectiveness of remote ischemic pre- and post-conditioning in reducing neurological complications and the duration of hospitalization in MMD patients undergoing STA-MCA anastomosis. Taken together, neuroprotection and neurorecovery enhancement have marked potential as MMD treatments.…”

Section: Treatmentmentioning

confidence: 87%

Progression in Moyamoya Disease: Clinical Features, Neuroimaging Evaluation, and Treatment

Zhang

Xiao

Zhang

et al. 2022

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: Moyamoya disease (MMD) is a chronic cerebrovascular disease characterized by progressive stenosis of the arteries of the circle of Willis, with the formation of the collateral vascular network at the base of the brain. Its clinical manifestations are complicated. Numerous studies have attempted to clarify the clinical features of MMD, including its epidemiology, genetic characteristics, and pathophysiology. With the development of neuroimaging techniques, various neuroimaging modalities with different advantages have deepened the understanding of MMD in structural, functional, spatial, and temporal dimensions. At present, the main treatment for MMD focuses on neurological protection, cerebral blood flow reconstruction, and neurological rehabilitation, such as pharmacological treatment, surgical revascularization, and cognitive rehabilitation. In this review, we discuss recent progress in understanding the clinical features, neuroimaging evaluation, and treatment of MMD.

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“…A 2019 RCT randomised 108 patients with Moya-Moya disease undergoing middle cerebral artery-super cial temporal artery anastomosis (MCA-STA) into 4 cycles of RIC (pre and post-surgery) or into a sham RIC group [120]. The RIC-treated group had a shorter hospital length of stay.…”

Section: Moya-moya Diseasementioning

confidence: 99%

Remote Ischaemic Conditioning for Neurological Disorders – A Systematic Review and Narrative Synthesis

Alhashimi,

Kamarova,

et al. 2024

Preprint

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Introduction: Remote ischaemic conditioning (RIC) refers to the use of controlled transient ischemic and reperfusion cycles, commonly of the upper or lower limb, to mitigate cellular damage from ischaemic injury. Preclinical studies demonstrate that RIC may have a neuroprotective effect and therefore could represent a novel therapeutic option in the management of neurological disorders. The aim of this review is to comprehensively describe the current clinical evidence of RIC in neurological disorders. Methods: A computerised search of EMBASE and OVID MEDLINE was conducted from 2002 to October 2023, for randomised controlled trials (RCTs) investigating RIC in neurological diseases. Results: A total of 46 different RCTs in 12 different neurological disorders (n=7544) were included in the analysis. Conditions included acute ischaemic stroke, symptomatic intracranial stenosis and vascular cognitive impairment. The most commonly used RIC protocol parameters in the selected studies were as follows: cuff pressure at 200mmHg (27 trials), 5-minute cycle length (42 trials), 5 cycles of ischaemia and reperfusion (24 trials), and the application to the upper limb unilaterally (23 trials) . Conclusions: The comprehensive analysis of the included studies reveals promising results regarding the safety and therapeutic effect of RIC as an option for managing neurological diseases. Particularly, the strongest evidence supports its potential use in chronic stroke patients and vascular cognitive impairment. The neuroprotective effects of RIC, as demonstrated in preclinical studies, suggest that this therapeutic approach could extend its benefits to various other diseases affecting the nervous system. However, to establish the efficacy of RIC across different neurological disorders, further trials with larger sample sizes and more diverse patient populations are warranted. Upcoming trials are expected to provide valuable evidence that will not only confirm the efficacy of RIC in neurological disease management but also help identify the most optimal RIC regimen for specific conditions.

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Effects of Combined Remote Ischemic Pre-and Post-Conditioning on Neurologic Complications in Moyamoya Disease Patients Undergoing Superficial Temporal Artery-Middle Cerebral Artery Anastomosis

Cited by 6 publications

References 43 publications

Effect of remote ischaemic preconditioning on mortality and morbidity after non-cardiac surgery: meta-analysis

Effect of remote ischaemic preconditioning on mortality and morbidity after non-cardiac surgery: meta-analysis

Progression in Moyamoya Disease: Clinical Features, Neuroimaging Evaluation, and Treatment

Remote Ischaemic Conditioning for Neurological Disorders – A Systematic Review and Narrative Synthesis

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