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Year : 2016  |  Volume : 2  |  Issue : 2  |  Page : 67-71

Rationale for ischemic conditioning to prevent stroke in patients with intracranial arterial stenosis

1 Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, USA
2 Department of Neurology, Medical College of Georgia, Augusta University, Augusta, GA, USA

Correspondence Address:
Sami Al Kasab
Department of Neurology, 96 Jonathan Lucas St., CSB 301.MSC 606, Charleston, SC 29425-6160
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2394-8108.186260

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Intracranial atherosclerotic arterial stenosis (ICAS) is one of the most common causes of stroke worldwide and is associated with particularly a high risk of recurrent stroke. Although aggressive medical management, consisting of dual antiplatelet therapy and intensive control of vascular risk factors, has improved the prognosis of patients with ICAS, subgroups of patients remain at very high risk of stroke. More effective therapies for these high-risk patients are urgently needed. One promising treatment is remote limb ischemic conditioning, which involves producing repetitive, transient ischemia of a limb by inflating a blood pressure cuff with the intention of protecting the brain from subsequent ischemia. In this study, we review the limitations of currently available treatments, discuss the potential mechanisms of action of ischemic conditioning, describe the preclinical and clinical data suggesting a possible role of ischemic conditioning in treating patients with ICAS, and outline the questions that still need to be answered in future studies of ischemic conditioning in subjects with ICAS.

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