Remote Ischemic Preconditioning

Ischemic Preconditioning Ischemic preconditioning is a widely accepted concept, first introduced in 1986 by Murray et al,1 who showed in an animal experiment that multiple brief periods (5 min) of coronary artery occlusion dramatically reduced infarct size because of the subsequent sustained coronary occlusion. Numerous reports have followed and supported the concept. The mechanism of ischemic preconditioning has been extensively investigated and reviewed,2,3 and clinical application of ischemic preconditioning was first reported in 1993 by Yellon et al,4 who studied patients undergoing coronary artery bypass grafting. After putting the patients on cardiopulmonary bypass, they cross-clamped the aorta twice for 3 min with an interval of 2 min. They then performed distal bypass anastomosis with a technique of intermittent cross-clamping under electrically induced ventricular fibrillation. They showed that the myocardial ATP level after the procedure was twice as high as that of the control group.