STUDY PROTOCOL article
Front. Neurol.
Sec. Endovascular and Interventional Neurology
Remote Ischemic Conditioning for Safety, Feasibility and Preliminary Efficacy of Patients With Aneurysmal Subarachnoid Hemorrhage After Aneurysm Clipping, Design, and Protocol for an Open-Label, Evaluator Blinding Randomized Controlled Trial
Provisionally accepted
- 1Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- 2Beijing Institute For Brain Disorders, Beijing, China
- 3People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background and rationale: Aneurysmal subarachnoid hemorrhage (aSAH) is a severe cerebrovascular event with a high mortality and disability rate. Compared to interventional surgery, microsurgical clipping is more invasive and has a higher incidence of postoperative complications, including cerebral vasospasm and ischemic cerebral infarction. In recent years, a large number of basic experiments have proved that remote ischemic conditioning (RIC) has multiple pathways of neuroprotective effects, and many large-scale randomized controlled clinical trials have confirmed that remote ischemic conditioning applied to patients with ischemic stroke has the effect of improving prognosis. However, current research has only focused on demonstrating the safety of remote ischemic conditioning for patients with aSAH, and lacks high-level evidence for its effectiveness. Method: We design an open-label, evaluator blinding randomized controlled trial. This study focuses on aneurysmal subarachnoid hemorrhage occurring within 24 hours after microsurgical clipping. All participants will be randomly assigned to the intervention group and the control group at a 1:1 ratio (n = 20), and will receive standard management according to the guidelines. Participants assigned to the intervention group will receive RIC twice a day, once in the morning and once in the afternoon, for 7 consecutive days after the operation. Neurological prognosis will be evaluated at baseline, day 3, day 7, day 30, and day 90.The primary outcome measure is the proportion of patients with a mRS score of 0-2 at 90 ± 7 days after surgery and the incidence rate of RIC adverse events. The secondary measures include the incidence of aSAH complications, the mRS score of patients 30 ± 7 days after surgery, and the mRS score of patients 7 ± 1 day after surgery. Discussion: The study's aim is to explore the safety, feasibility and preliminary efficacy of RIC in aSAH patients after clipping surgery.It serves as a methodological and feasibility foundation for the later multicenter, double-blind REPAIR trial (NCT06711302), which aims to confirm efficacy in a larger population
Keywords: Remote ischemic conditioning, aneurysmal subarachnoid Hemorrhage, Stroke, protocol, Brain
Received: 10 Jul 2025; Accepted: 07 Nov 2025.
Copyright: © 2025 Xu, Jin, Niu, Yin, Yan, Guan and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Aihua Liu, liuaihuadoctor@ccmu.edu.cn
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.