Background Remote ischemic conditioning (RIPC) has been proposed as a possible potential treatment for ischemic stroke. However, neuroprotective benefits of pre-procedural administration of RIPC have not been investigated in patients undergoing endovascular intracranial aneurysm (IA) repair procedure.

Objective To evaluate the safety and feasibility of RIPC in patients with an unruptured IA who undergo elective endovascular treatment.

Methods In this single-center, prospective pilot study patients with an unruptured IA undergoing elective endovascular treatment with flow diverters or coiling were recruited. Patients received 3 intermittent cycles of 5 min arm ischemia followed by reperfusion using manual blood cuff inflation/deflation prior to endovascular treatment. Patients were monitored and followed up for RIPC-related adverse events and ischemic brain lesions by diffusion-weighted MRI within 48 hours following endovascular treatment.

Results A total of 7 patients aged 59.86±4.99 years with an unruptured IA successfully completed a total 21 sessions of RIPC and the required procedures. Except for 2 patients who developed skin petechiae over their arm, no other serious procedure-related adverse events were observed as a result of RIPC procedure. On follow-up diffusion-weighted MRI, a total of 19 brain ischemic lesions with an average volume of 257.35±210.54 were found in 4 of 7 patients. The volume of all ischemic brain lesions was 1029.4.

Conclusions We demonstrated safety and feasibility of RIPC in patients undergoing elective aneurysm repair. RIPC was readily applied and quite well tolerated by the patients. Larger sham-controlled clinical trials are required to determine the safety and efficacy of this therapeutic strategy in mitigating ischemic damages following endovascular treatment of IAs.

Disclosures S. Seyedsaadat: None. L. Rangel Castilla: None. D. Kallmes: None.