Effects of Remote Ischemic Conditioning on Dynamic Cerebral Autoregulation, Blood Pressure and Heart Rate Variability in Patients With Cerebral Small Vessel Disease (ESCAPE-SVD)

This is an interventional treatment trial for Cerebral Small Vessel Diseases Read More

Inclusion Criteria:

• 1) Regardless of age, sex;

• 2) Patients are diagnosed with cerebral small vessel disease, and neuroimaging shows new subcortical lacunar infarction (in line with one of the following):

  ① MRI examination Diffusion-weighted imaging (DWI) phase shows high signal intensity [Apparent Diffusion Coefficient (ADC) diffusion restriction] lesions < 20 mm diameter in subcortical, basal ganglia or brainstem , with or without corresponding clinical symptoms;

  ② With new clinical symptoms, MRI examination FLAIR sequence shows corresponding FLAIR high signal intensity lesions [diameter < 20 mm]) in subcortical, basal ganglia or pons;

• 3) Remote ischemic conditioning can be started within 7 days from onset;
• 4) Willing to participate and sign the informed consent.

Exclusion Criteria:

• 1) Vascular stenosis > 50% by Transcranial Doppler (TCD);
• 2) Previous history of intracranial hemorrhage or major bleeding in other parts of the body;
• 3) Previous history of atrial fibrillation or myocardial infarction within 6 months;
• 4) Moyamoya disease or hereditary cerebral small vessel disease, such as mitochondrial encephalopathy, CADASIL or Fabry;
• 5) The patients who had clear non-vascular white matter lesions, such as multiple sclerosis, adult white matter dysplasia, metabolic encephalopathy;
• 6) Severe hepatic and renal diseases, cancer or other major diseases related to medical and surgical procedures;
• 7) The patients who had the contraindication of remote ischemic conditioning treatment, such as severe soft tissue injury, fracture or vascular injury in the upper limb; Acute or subacute venous thrombosis, arterial occlusive disease, subclavian steal syndrome, etc;
• 8) Significant coagulation abnormalities;
• 9) Pregnant or lactating women;
• 10) The patients with disturbance of consciousness or agitation who cannot cooperate to dynamic cerebral autoregulation monitoring or beat-to-beat blood pressure monitoring;
• 11) Previous remote ischemic conditioning therapy or similar treatment;
• 12) Unwilling to be followed up or treated for poor compliance;
• 13) He/She is participating in other clinical research or has participated in other clinical research or has participated in this study within 3 months prior to admission;
• 14) Other conditions that the researchers think are not suitable for the group.