The effect of remote ischemic conditioning on blood coagulation function and cerebral blood flow in patients with aneurysmal subarachnoid hemorrhage

Fibrinolysis and Remote Ischemic Conditioning: Mechanisms and Treatment Perspectives in Stroke

“…In a recent study, a prospective cohort of patients with subarachnoid hemorrhage from aneurysm rupture (n ¼ 30) was administered five RIC treatment sessions over a 7-day period after aneurysm clipping or embolization, and these patients were compared with a retrospective control group matched for age, gender, and Hunt Hess grade (n ¼ 30). 41 The fibrin D-dimer level was significantly lower at the end of treatment in the prospective RIC cohort compared with the retrospective cohort, indicating either reduced endogenous fibrinolytic activity or reduced hemostatic activation in the RIC group. However, temporal differences in blood sampling in relation to aneurysm obliteration may have influenced the comparison of fibrin D-dimer data both within the prospec-tive RIC group and between the two groups because RIC was initiated 0 to 10 days after aneurysm obliteration in the prospective group, whereas the exact time point of blood sample collection was not defined for the retrospective control group.…”

“…20 ("Ischemic Preconditioning"[Mesh] OR "Ischemic Postconditioning"[Mesh] OR "remote ischemic conditioning" OR "remote ischemic perconditioning" OR "ischemic preconditioning" OR "ischemic postconditioning") AND ("Fibrinolysis"[Mesh] OR "fibrinoly à " OR "Plasminogen Activators"[Mesh] OR "plasminogen activator à " OR "urokinase" OR "Plasminogen Activator Inhibitor 1"[Mesh] OR "Plasminogen Activator Inhibitor 2"[Mesh] OR "PAI à " OR "Carboxypeptidase B2"[Mesh] OR "carboxypeptidase B2" OR "thrombin-activatable fibrinolysis inhibitor" OR "TAFI" OR "alpha-2-Antiplasmin"[Mesh] OR "antiplasmin" OR "Plasminogen"[Mesh] OR "plasminogen" OR "Fibrinolysin"[Mesh] OR "plasmin" OR "Fibrin Clot Lysis Time"[Mesh] OR "fibrin clot lysis time" OR "clot lysis" OR "clot degradation" OR "fibrin degradation" OR "Fibrin Fibrinogen Degradation Products"[-Mesh] OR "fibrin and fibrinogen degradation products" OR "fibrin degradation products" OR "fibrinogen degradation products" OR "FDP" OR "D-dimer") (((((((((((((((((((((((((((((((((((((((((( In a recent study, a prospective cohort of patients with subarachnoid hemorrhage from aneurysm rupture (n ¼ 30) was administered five RIC treatment sessions over a 7-day period after aneurysm clipping or embolization, and these patients were compared with a retrospective control group matched for age, gender, and Hunt Hess grade (n ¼ 30). 41 The fibrin D-dimer level was significantly lower at the end of treatment in the prospective RIC cohort compared with the retrospective cohort, indicating either reduced endogenous fibrinolytic activity or reduced hemostatic activation in the RIC group. However, temporal differences in blood sampling in relation to aneurysm obliteration may have influenced the comparison of fibrin D-dimer data both within the prospec-tive RIC group and between the two groups because RIC was initiated 0 to 10 days after aneurysm obliteration in the prospective group, whereas the exact time point of blood sample collection was not defined for the retrospective control group.…”

“…However, temporal differences in blood sampling in relation to aneurysm obliteration may have influenced the comparison of fibrin D-dimer data both within the prospec-tive RIC group and between the two groups because RIC was initiated 0 to 10 days after aneurysm obliteration in the prospective group, whereas the exact time point of blood sample collection was not defined for the retrospective control group. 41…”

Viscoelastic Testing in the Clinical Management of Subarachnoid Hemorrhage and Intracerebral Hemorrhage

“…Full-text screening was performed on 87 studies and of these, 24 were included for analysis. The 24 studies were then subdivided into the following: studies including (1) SAH patients prior to stenting or coiling (n ¼ 12), 14,25,[28][29][30][31][32][33][34][35][36][37] (2) ICH patients not taking anticoagulant or antiplatelet medications (n ¼ 4), 30,[38][39][40] (3) ICH patients on antiplatelet or anticoagulant medications (n ¼ 4), [41][42][43][44] (4) SAH patients undergoing stenting or coiling or ischemic stroke patients following thrombolysis or thrombectomy, developing ICH as a complication to treatment (n ¼ 5). 26,[45][46][47][48] One study contained data on both ICH and SAH patients.…”

“…Of the 12 studies applying viscoelastic testing in SAH patients, three used ROTEM, 29,30,32 seven used TEG, 14,25,31,[33][34][35][36] one used TEG6, 28 and the last study applied TEG platelet mapping. 37 The data extracted are presented in ►Table 1.…”