Remote Ischemic Conditioning: Challenges and Opportunities

Abstract

Remote ischemic conditioning (RIC) has been investigated as a promising, safe, and well-tolerated nonpharmacological therapy for cardio-cerebrovascular disease over the past 3 decades; variable results have been found when it is used in cerebrovascular versus cardiovascular disease. For patients with cardiovascular disease, milestone studies suggest that the roles of RIC may be limited. Recently, however, 2 large trials investigating RIC in patients with cerebrovascular disease found promising results, which may reignite the field’s research prospects after its setbacks in the cardiovascular field. This perspectives article highlights several important clinical trials of RIC in the cardio-cerebrovascular disease and describes the many challenges of RIC in clinical translation. Finally, based on the available evidence, several promising research directions such as chronic RIC, early initiation in target population, improvement of compliance, better understanding of dosing, and identification of specific biomarkers are proposed and should be investigated before RIC can become applied into clinical practice for patient benefit.

Remote ischemic conditioning improves cerebral hemodynamics in symptomatic intracranial atherosclerosis: A PET/CT‐guided randomized controlled study

“…Despite these findings, the optimal RIC protocol remained undetermined. The challenge primarily stemmed from the absence of specific molecular or image biomarkers capable of monitoring the biological effects of RIC (Zhao et al., 2023). In our study, we conducted the first investigation into the impact of RIC on cerebral hemodynamics of sICAS patients using PET/CT in conjunction with methazolamide.…”