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.