Objective:

2

To evaluate the efficacy of electro-acupuncture (EA) or transcutaneous electrical acupoint stimulation (TEAS) on perioperative cerebral blood flow (CBF) and neurological function in ischemic stroke (IS) patients undergoing carotid artery stenting (CAS).

Methods:

2

In total

124 consecutive IS patients were randomly allocated to the EA

TEAS

and sham groups (groups A

T

and S; 41

42

and 41 cases

respectively) by softwarederived random-number sequence. Groups A and T received EA and TEAS

respectively

at the Shuigou (GV 26) and Baihui (GV 20)

Hegu (LI4) and Waiguan (TE 5) acupoints. Group S received sham EA. The stimulation was started from 30 min before surgery until the end of the operation. The primary outcome was the CBF at 30 min after surgery

which was measured by transcranial Doppler sonography. The secondary outcomes included hyperperfusion incidence and neurological function. National Institutes of Health Stroke Scale (NIHSS) and General Evaluation Scale (GES) scores were recorded at 1 week

1 month

and 3 months postoperatively.

Results:

2

Mean CBF velocity at 30 min after surgery in groups A and T was much lower than that in Group S (

P

<

0.05); the incidence of hyperperfusion in Groups A and T was also lower than that in group S (

P

<

0.05). Acupuncture was an independent factor associated with reduced incidence of hyperperfusion (OR=0.042; 95% CI: 0.002–0.785;

P

=0.034). NIHSS and GES scores improved significantly at 1 week postoperatively in Groups A and T than in Group S (

P

<

0.05). Relative to Group S

groups A and T exhibited significantly lower incidences of moderate pain

as well as higher incidences of satisfaction with anesthesia

at 1 day postoperatively (

P

<

0.05).

Conclusion:

2

EA or TEAS administered in combination with local anesthesia during CAS can inhibit transient increases in CBF

reduce the incidence of postoperative hyperperfusion

and improve neurological function. (Registration No. ChiCTR-IOR-15007447)