Previous post here;
Detrimental effect of blood pressure reduction in the first 24 hours of acute stroke onset
The counterpulsation one here;
http://stroke.ahajournals.org/content/43/11/3007.abstract
Abstract
Background and Purpose—External
counterpulsation (ECP) is a novel noninvasive method used to improve
the perfusion of vital organs, which may benefit
ischemic stroke patients. We hypothesized
that ECP may augment cerebral blood flow of ischemic stroke patients via
induced
hypertension.
Methods—We
recruited ischemic stroke patients with cerebral intracranial large
artery occlusive disease and healthy elderly controls
into this study. Bilateral middle cerebral
arteries of subjects were monitored using transcranial Doppler. Flow
velocity changes
before, during, and after ECP were,
respectively, recorded for 3 minutes while continuous beat-to-beat blood
pressure data
were recorded. Cerebral augmentation index
was the increase in percentage of middle cerebral artery mean flow
velocity during
ECP compared with baseline. Transcranial
Doppler data were analyzed based on ipsilateral or contralateral to the
infarct side.
Results—ECP
significantly increased mean blood pressure of stroke patients and
controls. During ECP, middle cerebral artery mean flow
velocities of stroke patients increased on
both ipsilateral and contralateral sides when compared with baseline
(ipsilateral
cerebral augmentation index, 9.64%;
contralateral cerebral augmentation index, 9%; both P<0.001),
but there was no increase in difference between the 2 sides when
compared with each other. Mean flow velocities of
controls did not change under ECP. After ECP,
blood pressure and flow velocity of stroke patients returned to
baseline level.
Conclusion—ECP
provides a new method of cerebral blood flow augmentation in ischemic
stroke by elevation of blood pressure. Flow augmentation
induced by ECP suggests the improvement of
cerebral perfusion and collateral supply from infarct ipsilateral and
contralateral
sides.
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