Cerebral in situ ischemic postconditioning: From bench to bedside and beyond

Ischemic postconditioning (IPostC) has emerged as a promising therapeutic strategy for mitigating ischemia-reperfusion injury in ischemic tissues. However, its neuroprotective potential following thrombectomy in acute ischemic stroke (AIS) remains underexplored in clinical settings. To address this gap, we conducted a review to evaluate the feasibility, clinical relevance, and safety of IPostC in AIS patients. This review is structured in four parts. First, we assess the translational success of IPostC from preclinical research to clinical applications in non-neurological organs. Second, we examine data from animal models of cerebral ischemia, including rodents and canines, to evaluate the potential applicability of IPostC in the brain. Based on an integrated synthesis of these findings, we argue that clinical translation of IPostC for stroke treatment is both feasible and potentially beneficial. Furthermore, by incorporating insights from related endovascular interventions, we refine the proposed IPostC protocol to support safer and more effective clinical implementation. Finally, we introduce a novel in situ neurointerventional IPostC technique and discuss its potential clinical implications.