The effect of Remote Ischemic Condition on Hematoma growth in patients with Intracerebral Hemorrhage: a subgroup analysis from the RESIST trial
- Journal
- Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association (Q1)
- Published
- 8 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Arzu Bilgin-Freiert, Grethe Andersen, Boris Cehov, Martin Faurholdt Gude, Kim Morgenstjerne Ørskov, Niels Hjort, et al.
- PMID
- 42710698
- DOI
- 10.1016/j.jstrokecerebrovasdis.2026.108746
Why clinicians should know about it
- Picked for Neurology (clinical) (top studies of the week, 13 September 2026): Remote ischemic conditioning in intracerebral hemorrhage
- Picked for Rehabilitation (top studies of the week, 13 September 2026): Sub‑study of RCT, remote ischemic conditioning in ICH
Abstract
BACKGROUND: It remains uncertain whether remote ischemic conditioning (RIC) with transient cycles of limb ischemia and reperfusion is an effective supplement to standard-of-care management of intracerebral hemorrhage (ICH). METHODS: This is a predefined sub-study to a randomized clinical trial conducted at four stroke centers in Denmark. RIC was induced by using an inflatable cuff on the upper extremity with a cuff pressure of at least 200 mm Hg and sham cuff pressure of 20 mm Hg. Each treatment application consisted of 5 cycles with 5 minutes of inflation followed by 5 minutes of deflation. Hematoma and edema volumes were manually segmented by blinded assessors. The primary end point was the risk of hematoma expansion (growth exceeding 6 mL or a relative growth of more than 33%). RESULTS: Among 1500 prehospital randomized patients, 165 patients had an ICH. Of them, 87 patients were randomly assigned to RIC and 78 to sham treatment. The median age was 71 (IQR: 60, 77), 73 (44%) were females, and the median onset to randomization was 40 minutes (IQR: 30, 69). The median National Institute of Health Stroke Scale score was 12, and 19 patients (12%) had either hematoma evacuation or an external ventricular drain. The study did not provide evidence for a difference in the adjusted risk of 24-hour hematoma expansion in patients treated with RIC compared to sham with a risk difference of -0.052 (95% CI: -0.20;0.10, p=0.504) nor for a difference in the adjusted 7-day hematoma reabsorption rate with a mean difference of 5.47 mL (95% CI: -4.57;15.52, p=0.280). There was no significant difference in edema size at baseline, 24 hours or 7 days. CONCLUSIONS AND RELEVANCE: RIC initiated in the prehospital setting and continued in the hospital did not reduce hematoma expansion or peri-hematoma edema in patients with ICH. TRIAL REGISTRATION: linicalTrials.gov:NCT03481777.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.