Abstract WP054: Remote Ischemic Conditioning for the Acute Treatment of Ischemic and Hemorrhagic Stroke: A Systematic Review and Meta-Analysis

Introduction: Remote ischemic conditioning (RIC), a low-cost, non-invasive therapy involving brief cycles of limb ischemia and reperfusion, may be a neuroprotective adjuvant or alternative to reperfusion therapies in acute ischemic stroke (AIS), and may have therapeutic effects in hemorrhagic stroke (HS). This systematic review and meta-analysis evaluated the efficacy of RIC in AIS and HS, focusing on functional and neurological outcomes, cerebral blood flow (CBF) and markers of cerebrovascular injury. Methods: This review was registered in PROSPERO (CRD42024549594). We searched MEDLINE, Embase, and Web of Science up to July 11, 2025. Eligible studies included RCTs assessing RIC initiated in adults within 96 hours of stroke onset. The primary outcomes were functional (modified Rankin Scale [mRS]) and neurological status (NIH Stroke Scale/Score [NIHSS]) at less than 7, 8-89, and 90 days. Secondary outcomes included CBF, infarct volume, and perihematomal edema. Data were pooled using fixed and random-effects models, generating standardized mean differences (SMDs) and odds ratios (ORs) with study heterogeneity assessed through Cochran’s Q. Results: A total of 32 studies (31 RCTs) with 5,580 participants (36% female) were included – 26 RCTs (N=5,399) in AIS and 5 in HS (N=181). mRS at