Remote Ischemic Conditioning Plus Stenting for Symptomatic Carotid Artery Stenosis

Remote Ischemic Conditioning Plus Stenting for Symptomatic Carotid Artery Stenosis (RICSICAS): A Prospective, Randomized Controlled, Blind Endpoint, Single-Center Study

Remote ischemic conditioning (RIC) has emerged as a promising non-invasive strategy to protect the brain, with evidence suggesting its benefit in patients with carotid artery stenting (CAS). However, the long-term benefit and safety of chronic RIC in this population remain unknown. This trial aims to evaluate whether chronic RIC reduces the incidence of major vascular events and improves clinical outcomes in high-risk patients with carotid artery stenosis who received CAS.

Inclusion Criteria:

• Age ≥ 40 years old;
• Patients with symptomatic moderate to severe stenosis of the internal carotid artery;
• History of ipsilateral cerebral ischemic symptoms within the past 180 days;
• Planned for carotid artery stent;
• Essen Score ≥ 3;
• Modified Rankin Scale score of 0 or 1;
• Signed informed consent.

Exclusion Criteria:

• Uncontrolled severe hypertension (systolic blood pressure > 180 mmHg or diastolic blood pressure > 110 mmHg despite medication)
• Subclavian artery stenosis ≥ 50% or presence of subclavian steal syndrome
• Severe hematological disorders or significant coagulation abnormalities
• Contraindications to remote ischemic conditioning, such as severe soft tissue injury, fracture, or vascular injury in the upper limbs, or peripheral vascular disease in the distal upper limbs
• Severe comorbid conditions with a life expectancy of less than 1 year
• Participation in another clinical trial within the past 3 months or ongoing participation
• Any other circumstances deemed by the investigator as unsuitable for participation in this clinical study.