Protective effect of remote ischemic preconditioning on blood pressure control in magnetic resonance-guided focused ultrasound operations

Abstract

Backrgound. Magnetic resonance-guided focused ultrasound (MR-FUS) is a new non-invasive technology for the surgical treatment of extrapyramidal movement disorders for such pathologies as essential tremor, Parkinson’s disease, etc. In these cases, the brain is injured and a zone of ischemia is formed. Arterial hypertension (AH) is one of the most common pathologies, which is often accompanied by neurological diseases. Objective. To investigate the effect of the remote ischemic preconditioning (RIPC) on blood pressure (BP) during MR-FUS surgery. Design – blinded, randomized, controlled, 2-group study with sham preconditioning. Materials and Methods. Patients were randomized into the RIPC group (cuff systolic BP (SBP) >50 mmHg, n=42) and the group with sham RIPC (cuff diastolic BP (DBP), n=39) before surgery in regime 3 cycles each 5 min with 5 min rest between cycles. Results. While there was a decrease in SBP and DBP before and after the operation in the RIPC group, there was an increase (p<0.001) in the sham RIPC group. Using the Difference-in-Difference equation for SBP, SBP was 8.9 (5.9–11.9) mm Hg higher in the sham RIPC group than in the RIPC group (p<0.01). Conclusion. As a result, MR-FUS operations showed a significant decrease in BP during RIPC compared to the imitation, which confirms the angioprotective effect of preconditioning.