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NIH Study Reveals Compressing Limb Strategy For Stroke Therapy

The National Institutes of Health (NIH) is currently funding an initiative referred to as Stroke Preclinical Assessment Network (SPAN), looking to pinpoint stroke therapies that have the best promise. With seven labs across the country, they are working together to make this all happen. 

Medical Xpress advised that one of six new approaches being reviewed as a potential treatment is around bouts of compression – relaxing a limb (via a blood pressure-like cuff) – to help prepare an individual’s brain to deal with the inadequate oxygen levels during a stroke. 

Known as remote ischemic conditioning, additional therapies to this are being reviewed in SPAN include: a blood vessel dilator; anti-cancer medication; an immunosuppressive medication to help with rheumatoid arthritis; an immune system modulator used currently for MS; review of uric acid, a body waste product that is seen in high levels for those who suffer gout, but that also works as an antioxidant for decreasing damage around strokes. It’s important to note that all medicines within the line up have been approved already by the Food and Drug Administration (FDA) for other illnesses, and the remote ischemic conditioning procedure is the sole device within the treatments being reviewed. 

The team notes that while the stroke (and other conditions) studies are revealing promising results, they may not translate to enhanced outcomes for patients. One of the goals of SPAN is to improve on the chances that they will.

The current therapies for clot-based (ischemic) stroke are giving the clot a tPA drug within stroke’s onset (four-and-a-half hours into the stroke), a procedure referred to as mechanical thrombectomy, which aims to extract the clot within 6.

5 hours of stroke onset.

And the team is looking to enhance the effectiveness for treatments like mechanical thrombectomy, where some deal with major permanent disability, sometimes death. While this treatment helps some recover fully from a stroke of this type, approximately half of sufferers can become disabled for up to three months after the incident.

Investigators state that remote ischemic conditioning is a non-invasive, side effect-free, and inexpensive treatment that could potentially be administered during the ambulance ride to the hospital; however, at first, it seemed to work well with ischemic strokes, the most common of stroke types, versus hemorrhagic strokes that mark 15% of strokes that occur, and also account for 40% of deaths linked to strokes. For remote ischemic conditioning therapy to work during the ambulance ride, the type of stroke must be identified; there was a concern that if used during a hemorrhagic stroke, it might enhance bleeding.

Having said that, it was revealed that the opposite occurred, which was unexpected to say the least.

In the models, the repetitive and simple technique of ischemic conditioning helped to decrease stroke size and enhance brain flow.

While how the treatment helps with stroke recovery is not completely understood, it does appear to help protect the brain in a variety of ways.

Currently in China, stroke prevention trials larger in scope are under way, using remote ischemic conditioning. There is also a Denmark study using the therapy for 1,500 stork patients in prehospital care.



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