Remote ischemic post-conditioning and intravenous thrombolysis in acute ischemic stroke


  • This randomized controlled study provided Class IV evidence that the proportion of patients with a favorable outcome (modified Rankin scale [mRS] 0 or 1) at 90 days is increased by intravenous recombinant tissue plasminogen activator (IV tPA) and remote ischemic post-conditioning (RIPC) in patients with acute ischemic stroke (AIS).

Why this matters

  • IV tPA (alteplase) is the only approved effective drug therapy in the American Heart Association and American Stroke Association guidelines for treating AIS. However, a significant proportion of patients remain without a favorable outcome (mRS 0 or 1).

  • New methods of improving clinical outcomes and reducing ischemia/reperfusion injury is of great importance. This study demonstrated that RIPC in addition to alteplase therapy significantly improved outcomes in patients experiencing AIS, compared with alteplase alone.