Remote Ischemic Postconditioning in Endovascular Thrombectomy for Stroke: The EnTRIPS Randomized Clinical Trial

 

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remote ischemic postconditioning (5 posts to March 2021)

And much earlier, this might be 

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Remote Ischemic Postconditioning in Endovascular Thrombectomy for Stroke: The EnTRIPS Randomized Clinical Trial

Yawen Cheng, MD https://orcid.org/0000-0001-9841-9800, Wanying Chen, MD https://orcid.org/0000-0003-0812-1408, 

Mingze Chang, MD https://orcid.org/0000-0001-8475-6603, Xiangning Han, MS https://orcid.org/0000-0003-2282-6279, 

Jia Yu, MD https://orcid.org/0009-0001-9199-2046, Meng Wei, MD https://orcid.org/0009-0004-5765-7414, 

Yi Qi, MS, … Show All … , and Guogang Luo, MD https://orcid.org/0000-0003-3991-8962 lguogang@163.comAuthor Info & Affiliations

Stroke

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https://doi.org/10.1161/STROKEAHA.126.054857

 

Abstract

BACKGROUND:

Although the neuroprotective potential of remote ischemic postconditioning (RIPC) has been reported, the efficacy and safety of ultra-early RIPC administered after endovascular treatment (EVT) in patients with acute ischemic stroke remain unclear. This study evaluated the efficacy and safety of ultra-early RIPC in patients with acute ischemic stroke undergoing EVT.

METHODS:

The EnTRIPS trial (Endovascular Treatment Combined with Remote Ischemic Postconditioning in Patients with Acute Ischemic Stroke) was a multicenter, randomized, controlled, outcome assessor-blinded, prospective clinical trial. The trial was conducted at 8 hospitals in China between April 12, 2021, and March 26, 2025. Eligible patients were adults with acute ischemic stroke due to large vessel occlusion who presented within 24 hours of symptom onset, underwent EVT, and achieved successful recanalization. A total of 270 eligible patients were randomized within 6 hours after EVT to receive either RIPC plus guideline-based therapy (n=135) or guideline-based therapy alone (n=135). RIPC was administered for 7 days using pneumatic devices consisting of 5 cycles of bilateral upper-arm cuff inflation (5 minutes at 180 mm Hg) followed by deflation (3 minutes). The primary outcome was functional independence at 90 days, defined as a modified Rankin Scale score of 0 to 2 (range, 0 [no symptoms] to 6 [death]). Safety outcomes included the incidence of RIPC-related adverse events within 7 days.

RESULTS:

Among 270 randomized patients, a total of 268 (99.3%) participants completed the trial, including 133 in the RIPC group and 135 in the control group (mean [SD] age, 65.5 [16.8] years; 171 [63.8%] men). At 90 days, functional independence was achieved in 81 (60.9%) patients in the RIPC group and 78 (57.8%) patients in the control group (adjusted risk ratio, 1.07 [95% CI, 0.89–1.30]; P=0.46). RIPC-related adverse events occurred in 10 of 133 (7.5%) patients, and no intervention-related adverse events occurred in the control group.

CONCLUSIONS:

Ultra-early RIPC is safe for patients with acute ischemic stroke treated with EVT, but it does not significantly improve the 90-day functional outcomes.

REGISTRATION:

URL: https://www.clinicaltrials.gov; Unique identifier: NCT04581759.

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Effects of blood flow restriction therapy for lower limb dysfunction in stroke patients: a systematic review and meta-analysis

 Is this just a more extensive version of these? Does your doctor have a protocol for anything here? NO? So, COMPLETELY FUCKING INCOMPETENT then!

• leg wraps (9 posts to May 2013)

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Effects of blood flow restriction therapy for lower limb dysfunction in stroke patients: a systematic review and meta-analysis

• 

  Jun Zhang 1

• 

  YuXin Xiao 2

• L

  LiangYu Qiu 3

• G

  Gang Zhang 1

• R

  Rui Wang 1

• X

  XuePing Zhu 1

• C

  Chan Wang 1*

• M

  MingJun Xu 2*

• 1. Department of Acupuncture, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China

• 2. Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China

Abstract

Objective:

To systematically evaluate the efficacy of blood flow restriction training (BFRT) for lower limb dysfunction in stroke patients.

Methods:

Randomized controlled trials published up to October 2025 were retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, Embase, Web of Science, and Cochrane Library. The control group received conventional rehabilitation, while the intervention group received conventional rehabilitation combined with BFRT.

Results:

Eleven studies involving 522 patients were included. The intervention group achieved significantly higher Berg Balance Scale scores [MD = 4.52, 95% CI (0.78, 8.26), p = 0.02] and longer 6-min walk test distances [MD = 9.73, 95% CI (7.26, 12.21), p < 0.00001]. Subgroup analysis showed that when the intervention duration exceeded 4 weeks, the intervention group achieved higher lower-extremity Fugl-Meyer Assessment scores [MD = 4.38, 95% CI (2.00, 6.77), p = 0.0003] and Modified Barthel Index scores [MD = 10.50, 95% CI (6.32, 14.68), p < 0.00001] than the control group. Among patients in the subacute phase, the intervention group also demonstrated higher lower-extremity Fugl-Meyer Assessment scores [MD = 2.63, 95% CI (0.42, 4.83), p = 0.02].

Conclusion:

BFRT improves balance and walking endurance in stroke patients. When delivered for more than 4 weeks, it yields additional benefits in lower limb motor function and activities of daily living, with more pronounced motor improvements observed in the subacute phase. Owing to limitations in sample size, treatment protocol heterogeneity, and methodological quality, these findings require confirmation through large-scale, high-quality studies.

Effect of RICAS (Remote Ischemic Preconditioning on Collaterals of Atherosclerosis Stroke): Rationale and Design

 

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Effect of RICAS (Remote Ischemic Preconditioning on Collaterals of Atherosclerosis Stroke): Rationale and Design

Zi‐Ai Zhao, MD, Yan Lv, MD, and Hui‐Sheng Chen, MD https://orcid.org/0000-0002-7486-1992 chszh@aliyun.comAuthor Info & Affiliations

Journal of the American Heart Association

New online

https://doi.org/10.1161/JAHA.124.038570

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• Nonstandard Abbreviations and Acronyms
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• STATISTICAL ANALYSIS
• DISCUSSION
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Abstract

Background

As a noninvasive, low‐cost, nonpharmacological procedure with excellent properties of safety, remote ischemic conditioning (RIC) has been demonstrated to prevent recurrence of stroke among patients with ischemic stroke of large artery atherosclerosis origin. We hypothesized that the benefit is attributed to the improvement of collaterals by chronic RIC in this population, and we aimed to explore the influence of chronic RIC on collateral status evaluated by digital subtraction angiography in this population.

Methods

The RICAS (Remote Ischemic Preconditioning on Collaterals of Atherosclerosis Stroke) study is a prospective, randomized, blind end point, multicenter study. Eligible patients with ischemic stroke of anterior circulation caused by large artery atherosclerosis, poor collateral compensation, and more than 1 month of symptom onset, are randomly assigned into experimental and control groups with a ratio of 1:1. The patients in the experiment group will receive treatment with RIC (bilateral upper limbs, for a total procedure time of 50 minutes, twice daily) for 1 year as an adjunct to guideline‐based treatment, while patients in the control group only receive guideline‐based treatment. A maximum of 300 patients (150 participants per group) are required to test the superiority hypothesis with 80% power (using a 2‐sided α=0.05) to detect a 15% difference. Subgroup analyses for the primary end point will be performed on 8 prespecified subgroups by age, sex, ischemic event (acute ischemic stroke ore transient ischemic stroke), tandem lesion, history of hypertension, hypercholesterolemia, diabetes, and myocardial infarction. The primary outcome is the proportion of collateral status improvement, which is defined as an increase of ≥1 point on the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology score, as assessed by digital subtraction angiography at 12 months after randomization. The safety outcomes include RIC‐related adverse events.

Conclusions

This study may provide the direct evidence for the potential effect of chronic RIC treatment on the improvement of collateral status.

Registration

URL: https://clinicaltrials.gov. Unique identifier: NCT06170944.

Metabolic Syndrome and Efficacy of Remote Ischemic Postconditioning in Acute Moderate Ischemic Stroke: A Post Hoc Analysis of the RICAMIS Trial

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Metabolic Syndrome and Efficacy of Remote Ischemic Postconditioning in Acute Moderate Ischemic Stroke: A Post Hoc Analysis of the RICAMIS Trial

Yi‐Na Zhang, MD https://orcid.org/0000-0003-0921-0058, Qiong Wu, MD, Yu Cui, PhD https://orcid.org/0000-0002-4925-1500, Nan‐Nan Zhang, MM https://orcid.org/0009-0000-4414-2906, and Hui‐Sheng Chen, MD https://orcid.org/0000-0002-7486-1992 chszh@aliyun.comAuthor Info & Affiliations

Journal of the American Heart Association

New online

https://doi.org/10.1161/JAHA.124.037859

• Abstract
• Nonstandard Abbreviations and Acronyms
• Clinical Perspective
• METHODS
• RESULTS
• DISCUSSION
• CONCLUSIONS
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• Acknowledgments
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Abstract

Background

Metabolic syndrome (METS) is associated with poor outcomes after acute ischemic stroke. This study aimed to investigate the relationship between METS and efficacy of remote ischemic postconditioning (RIPostC) in acute moderate ischemic stroke using the database of the RICAMIS (Remote Ischemic Conditioning for Acute Moderate Ischemic Stroke) trial.

Methods and Results

In the RICAMIS trial, eligible participants were patients with acute moderate ischemic stroke within 48 hours of onset who did not receive reperfusion treatment. A total of 1482 patients were enrolled in this secondary analysis, including the METS (602) and non‐METS (880) group according to the METS definitions of the Chinese Diabetes Society, which was further subdivided into RIPostC and control subgroups. The primary outcome was excellent functional outcome, defined as a modified Rankin Scale score of 0 to 1 at 90 days. The differences in clinical outcomes between the RIPostC subgroup and control subgroup were compared in patients with METS or non‐METS, respectively, and the interaction effects of RIPostC treatment assignment with METS status were evaluated. The baseline characteristics between RIPostC and control subgroups across patients with METS and non‐METS were well balanced, except the difference in Trial of Org 10 172 in Acute Stroke Treatment stroke mechanism in the METS group. Compared with control, RIPostC was associated with high probability of excellent functional outcome in patients with METS (68.8% versus 56.1%; odds ratio [OR], 1.751 [95% CI, 1.248–2.456]; P=0.001), but not in patients without METS (66.6% versus 64.6%; OR, 1.103 [95% CI, 0.833–1.461]; P=0.494). Notably, a significant interaction effect between treatments (RIPostC or control) by different METS status on excellent functional outcome was observed (P=0.039).

Conclusions

The secondary analysis suggests for the first time that RIPostC may provide greater benefit in patients with acute ischemic stroke with METS versus non‐METS.

Nonstandard Abbreviations and Acronyms

AIS

acute ischemic stroke

LAA

large artery atherosclerosis

METS

metabolic syndrome

NIHSS

National Institutes of Health Stroke Scale

RICAMIS

Remote Ischemic Conditioning for Acute Moderate Ischemic Stroke

RIPostC

remote ischemic postconditioning

TOAST

Trial of Org 10172 in Acute Stroke Treatment

Clinical Perspective

What Is New?

•

This is the first report of patients with acute moderate ischemic stroke, within 48 hours of onset, who did not receive reperfusion treatment and in whom remote ischemic postconditioning treatment produced greater probability of excellent clinical outcome in patients with metabolic syndrome compared with patients without metabolic syndrome.

What Are the Clinical Implications?

•

Patients with acute moderate ischemic stroke with metabolic syndrome may get more benefit from remote ischemic postconditioning, which needs to be validated in future trials.(Why?)

Remote ischemic postconditioning (RIPostC), a noninvasive and nonpharmacological procedure performed by intermittently blocking the blood flow of both upper limbs, has been found to be potentially beneficial in acute ischemic stroke (AIS).^{1, 2} The recent RICAMIS (Remote Ischemic Conditioning for Acute Moderate Ischemic Stroke) trial has demonstrated that RIPostC can improve 3‐month functional outcomes in patients with moderate AIS,³ although this finding was not confirmed by the RESIST (Remote Ischemic Conditioning in Patients With Acute Stroke) study.⁴ It is an important clinical concern to identify a suitable population who can benefit from RIPostC.

Metabolic syndrome (METS) represents a clustering of metabolic abnormalities, including 4 core components: dyslipidemia, elevated blood pressure, abnormal blood glucose, and obesity.⁵ Several studies have suggested that METS is associated with poor clinical outcome^{6, 7} and weakens the benefit of recanalization therapy in AIS.^{7, 8} The underlying mechanisms may involve impaired endogenous fibrinolytic capacity, endothelial dysfunction, inflammatory response, and hampered angiogenesis induced by METS.^{9, 10} Furthermore, neuroprotective mechanisms of RIPostC include modulation of microcirculation, endothelial function, oxidative stress, inflammation, neurogenesis, apoptosis, and autophagy.¹¹ Given the overlap of neuroprotective effects of RIPostC with the mechanisms underlying METS‐mediated damage on stroke, we hypothesize that METS may affect the efficacy of RIPostC in AIS. Therefore, this study was designed to investigate the association of METS with the efficacy of RIPostC in the RICAMIS trial.

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A review of remote ischemic conditioning as a potential strategy for neural repair poststroke

And all this earlier research was not enough to realize that the next step was to create protocols on this rather than repeat research? So we had to waste more time and money better spent solving stroke problems?

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  Remote ischemic conditioning (11 posts to July 2018)

   

• leg wraps (7 posts to May 2013)

 

 A review of remote ischemic conditioning as a potential strategy for neural repair poststroke

Wantong Yu1| Changhong Ren1,2| Xunming Ji1,2This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.© 2022 The Authors. CNS Neuroscience & Therapeutics published by John Wiley & Sons Ltd.Abbreviations: AIS, Acute ischemic stroke; Ang, Angiotensin; BDNF, brain-derived neurotrophic factor; CNS, central nervous system; eNOS, endothelial nitric oxide synthase; EPO, erythropoietin; GAP-43, growth-associated protein 43; HIF-1, Hypoxia inducible factor-1; iNOS, inducible nitric oxide synthase; LTD, long-term depression; LTP, long-term potentiation; mTOR, mammalian target of rapamycin; Ngb, neuroglobin; NO, nitric oxide; OPC, oligodendrocyte precursor cell; PSD95, Postsynaptic density protein-95; p- STAT3, signal transducer and activator of transcription 3 phosphorylation; RIC, Remote ischemic condition; STAT3, signal transducer and activator of transcription 3; SYN, Synaptophysin; Treg, regulatory T cell; VEGF, vascular endothelial growth factor; VEGFR, vascular endothelial growth factor receptor 2.1Department of Neurology and Beijing Key Laboratory of Hypoxia Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China2Center of Stroke, Beijing Institute for Brain Disorder, Capital Medical University, Beijing, ChinaCorrespondenceXunming Ji, Center of Stroke, Beijing Institute for Brain Disorder, Capital Medical University, Beijing 100069, China.Email: jixm@ccmu.edu.cnFunding informationNational Natural Science Foundation of China, Grant/Award Number: 81971114 and 81801313 

Abstract

Ischemic stroke is one of the major disabling health-care problem and multiple different approaches are needed to enhance rehabilitation, in which neural repair is the structural basement. Remote ischemic conditioning (RIC) is a strategy to trigger endogenous protect. RIC has been reported to play neuroprotective role in acute stage of stroke, but the effect of RIC on repair process remaining unclear. Several studies have discovered some overlapped mechanisms RIC and neural repair performs. This review provides a hypothesis that RIC is a potential therapeutic strategy on stroke rehabilitation by evaluating the existing evidence and puts forward some remaining questions to clarify and future researches to be performed in the fiel

Remote ischemic conditioning (RIC) with exercise (RICE) is safe and feasible for acute ischemic stroke (AIS) patients

 

And all this earlier research was not enough to realize that the next step was to create protocols on this rather than repeat research? So we had to waste more time and money better spent solving stroke problems?

• leg compressions (16 posts to September 2015)

  Remote ischemic conditioning (11 posts to July 2018)

   

• leg wraps (7 posts to May 2013)

   

Remote ischemic conditioning (RIC) with exercise (RICE) is safe and feasible for acute ischemic stroke (AIS) patients

Yanna Tong^1,2, Hangil Lee³, Wesley Kohls³, Zhenzhen Han^1,2, Honglian Duan^1,2, Zhe Cheng^1,2, Fenghai Li^1,2, Jie Gao^1,2, Jing Liu², Xiaokun Geng^1,2,3* and Yuchuan Ding^3*

• ¹Institute of Neuroscience, Beijing Luhe Hospital, Capital Medical University, Beijing, China
• ²Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
• ³Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United States

Objective: Rehabilitation is essential in reducing stroke disability and should be performed as early as possible. Exercise is an established and effective rehabilitation method; however, its implementation has been limited as its very early use exacerbates cerebral injury and is restricted by patients' unstable conditions and disabilities. Remote ischemic conditioning (RIC) is a passive and accessible therapy in acute phases of stroke and appears to have similar neuroprotective effects as exercise. This study assessed the safety and feasibility of the novel rehabilitation strategy—early RIC followed by exercise (RICE) in acute ischemic stroke (AIS).

Methods: We conducted a single-center, double-blinded, randomized controlled trial with AIS patients within 24 h of stroke onset or symptom exacerbation. All enrolled patients were randomly assigned, at a ratio of 1:1, to either the RICE group or the sham-RICE group (sham RIC with exercise). Each group received either RIC or sham RIC within 24 h after stroke onset or symptom exacerbation, once a day, for 14 days. Both groups started the exercise routine on day 4, twice daily, for 11 total days. The safety endpoints included clinical deterioration, recurrence of stroke, hemorrhagic transformation, complications, and adverse events resulting from RICE during hospitalization. The efficacy endpoints [Modified Rankin Scale (mRS) score, National Institutes of Health Stroke Scale (NIHSS) score, Barthel Index, and walking ability] were evaluated at admission and 90 days after stroke onset.

Results: Forty AIS patients were recruited and completed the study. No significant differences in baseline characteristics were found between the two groups, which included risk factors, stroke severity at admission, pre-morbid disability, and other special treatments. No significant differences were found in the safety endpoints between two groups. Excellent recovery (mRS 0–2) at 3 months was obtained in 55% of the patients with RICE as compared 40% in sham group, but it did not reach a significant level.

Conclusions: RICE was safe and feasible for AIS patients, and seems to be a promising early stroke rehabilitation. The results of this study suggest a need for a future randomized and controlled multicenter trial with a larger sample size to determine the efficacy of RICE.

Cerebral protection by remote ischemic post-conditioning in patients with ischemic stroke: A systematic review and meta-analysis of randomized controlled trials

 

Remote ischemic postconditioning (RIPostC) is the application of a transient and brief ischemic stimulus to a distant site from the organ or texture that is afterward exposed to injury ischemia[8] and has been found to reduce IRI in various animal models.

This might be 

• leg wraps (9 posts to May 2013)

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 If so, then your hospital and doctors are extremely incompetent for not having protocols on this in place already. 

Cerebral protection by remote ischemic post-conditioning in patients with ischemic stroke: A systematic review and meta-analysis of randomized controlled trials

Meng Lu^1†, Yujiao Wang^2†, Xin Yin¹, Yuanyuan Li¹ and Hongyan Li^1*

• ¹Department of Nursing, The First Bethune Hospital of Jilin University, Changchun, China
• ²Department of Neurology, The First Bethune Hospital of Jilin University, Changchun, China

Background: There is evidence that remote limb ischemic postconditioning (RIPostC) can reduce ischemia-reperfusion injury (IRI) and improve the prognosis of patients with ischemic stroke. However, so far, only few relevant clinical studies have been conducted. Therefore, we carried out a meta-analysis of eligible randomized controlled trials to compare the RIPostC group with a control group (no intervention or sham surgery) in patients with ischemic stroke.

Methods: Four English-language publication databases, PubMed, Cochrane, Embase, and Web of Science, were systematically searched up to March 2022. The data were analyzed using Review Manager fixed-effects and random-effects models.

Results: A total of 12 studies were included, and 11 of those were analyzed quantitatively. Compared to controls, The RIPostC group showed significantly reduced NIHHS scores in patients with ischemic stroke, (MD: −1.09, 95% confidence interval [CI]: −1.60, −0.57, P < 0.0001) and improved patients' Montreal Cognitive Assessment (MoCA) scores, (MD: 1.89, 95% CI: 0.78, 3.00, P = 0.0009), Our results showed that RIPostC is safe, (RR = 0.81, 95%CI: 0.61, 1.08, P = 0.15).

Conclusion: Our meta-analysis showed that RIPostC is safe and effective and has a positive cerebral protective effect in patients with ischemic stroke, which is safe and effective, and future large-sample, multicenter trials are needed to validate the cerebral protective effect of RIPostC.

Background

Ischemic stroke is a highly morbid and disabling disease. About two-thirds of patients are left with sequelae including functional impairment of varying degrees (1). Early revascularization therapy such as intravenous thrombolysis and mechanical thrombectomy is an effective treatment for ischemic stroke, but this treatment has a strict time window beyond which the probability of adverse effects will increase, the salvage rate for ischemic penumbra will greatly reduce, and the risk of bleeding will outweigh the therapeutic benefit (2). In recent years, several studies have aimed to explore new neuroprotective strategies. However, few have been successfully translated from basic research to clinical application.

The phenomenon of ischemic preconditioning was first identified in the heart. Ischemic preconditioning provides hope to the study of neuroprotective measures. In 1986, the American scholar Murry performed four ischemia-reperfusion sessions on the anterior descending branch before preparing an infarct model and found that it could lead to a reduction in infarct size (3). In several subsequent studies, it has been confirmed that ischemic preconditioning can reduce myocardial infarct size and coronary vascular injury and improve the clinical prognosis of patients with myocardial infarction (4, 5). Kitagawa et al. showed that ischemic preconditioning of the gerbil brain prior to ischemia had a protective effect on the post-ischemic brain and reduced neuronal death in the C1 region of the hippocampus (6). However, ischemic preconditioning requires intervention before the onset of an ischemic event, which is difficult to achieve in clinical practice because we may not be able to anticipate sudden events.

In 2006, Zhao et al. (7) first found that ischemic post-conditioning attenuated ischemia-reperfusion injury (IRI) after cerebral reperfusion in a rat model of permanent middle cerebral artery occlusion and transient bilateral carotid artery occlusion. Similar to ischemic preconditioning, ischemic post-conditioning is an endogenous mechanism that stimulates endogenous protective mechanisms in the body to reduce IRI to critical vital organs through repeated, transient, non-lethal ischemic treatment of the body. Vinten-Johansen et al. found that post-treatment not only produced similar results to pretreatment, but that post-conditioning reduced infarct size, attenuated vascular dysfunction, and reduced neutrophil accumulation after prolonged reperfusion (8–10). Several studies have confirmed this finding (11–13). Studies have shown that ischemic post-conditioning can inhibit free radical production and initiation of apoptosis during ischemic reperfusion and increase superoxide dismutase and catalase activities in brain tissue (7, 14). Reactive oxygen and nitrogen (ROS/RNS) also play an important role in the mechanism of action of ischemic post-conditioning (15). Although the protective mechanisms are not yet fully elucidated, the protective effect of ischemic post-conditioning on the brain has been confirmed in several studies.

RIPostC is safer than local post-conditioning. RIPostC refers to ischemic post-treatment of non-life-critical organs such as skeletal muscles of the arms and legs to mediate the body's endogenous protective mechanisms, and is a complex, systemic phenomenon (16). RIPostC was first used 30 years ago in patients who suffered a heart attack (17, 18), and it can exert a protective effect on the myocardium through a complex signal transduction including neuronal and humoral (19). Similarly, RIPostC not only protects the myocardium from ischemic injury, but also has a similar protective effect on the brain (20). However, most of these studies have focused on animal models and have achieved ischemic post-conditioning by intermittent occlusion of the carotid and cerebral arteries, which is ethically not possible in humans, as it is associated with high risk. Several clinical studies have investigated the protective effect of post-treatment of RIPostC in patients with ischemic cerebrovascular disease, but the number of available studies is small and the sample size of individual studies is very limited to draw definitive conclusions. Therefore, a systematic evaluation in conjunction with published randomized controlled trials (RCTs) is needed to assess whether RIPostC improves the prognosis and reduces the degree of neurological deficits in patients with ischemic cerebrovascular disease.

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