SynthesisFrontiers in neurology
Optimizing remote ischemic conditioning for acute ischemic stroke: a systematic review and meta-analysis of treatment duration and reperfusion strategies.
Synthesis in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
4 authors.
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Abstract
Background: Recent large-scale randomized controlled trials (RCTs) regarding remote ischemic conditioning (RIC) for acute ischemic stroke (AIS) have yielded inconsistent results. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of RIC, with a focused analysis on the impact of treatment duration and reperfusion strategies. Methods: We searched PubMed, Embase, the Cochrane Library, and Web of Science from inception to March 30, 2026, for eligible RCTs comparing RIC with control in AIS patients; reference-list screening and supplementary Google Scholar searches were also performed. The primary outcome was functional independence (Modified Rankin Scale score 0-2) at 90 days. The secondary outcome was 90-day mortality. Exploratory subgroup analyses were performed according to treatment duration (longer-duration vs. shorter-duration) and reperfusion context (endovascular thrombectomy [EVT], intravenous thrombolysis [IVT], and non-reperfusion/mixed standard-care contexts). Risk Ratios (RRs) were calculated using a random-effects model. Results: A total of 12 RCTs involving 5,301 patients were included. Overall, RIC was associated with a modest but statistically significant increase in the rate of functional independence at 90 days (RR 1.05, 95% CI 1.01-1.09; Conclusion: RIC appears to be a safe adjunctive therapy for AIS and may offer a modest functional benefit. The available evidence suggests, but does not prove, that longer treatment regimens and use in patients undergoing mechanical thrombectomy may be associated with more favorable outcomes. These subgroup findings should be interpreted cautiously and confirmed in future high-quality trials.
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