Cardiac Remote Ischemic Preconditioning Before Elective Major Vascular Surgery (CRIPES)
Peripheral Arterial Disease
About this trial
This is an interventional treatment trial for Peripheral Arterial Disease focused on measuring peripheral arterial disease, myocardial infarction
Eligibility Criteria
Inclusion Criteria:
- Eligible patients would be those undergoing elective major vascular surgery at the Minneapolis VA Medical Center for an expanding abdominal aortic aneurysm, obstructive carotid disease, and/or chronic limb ischemia during the study period. All patients must be ≥ 18 years of age and provide written informed consent.
Exclusion Criteria:
- Exclusion criteria include hypertensive crisis, acute coronary syndrome in the preceding 6 weeks, severe valvular heart disease, peripheral arterial disease of the upper extremities, manifested by a systolic blood pressure difference greater than 20 mmHg, pregnant women, patients unable to understand the consent process due to mental illness, advanced malignancy with limited life expectancy (<1 year), and hemodialysis with a fistula in the upper extremity.
Sites / Locations
- Minneapolis VA Medical Center
Arms of the Study
Arm 1
Arm 2
Placebo Comparator
Active Comparator
Control
Preconditioning
Blood pressure cuff inflated in the right or left arm to 40-50 mmHg
The RIPC protocol will consist of three cycles of the following: 5-minute inflation of a blood pressure cuff around the right upper arm to 200 mmHg (or 20 above the systolic blood pressure if baseline BP > 200 mmHg) to allow for external compression of the brachial artery resulting in transient arm ischemia, followed by a 5-minute interval of cuff deflation to allow for reperfusion. The total duration of the protocol is 30 minutes equally divided between ischemia and reperfusion. The protocol is to be applied in the patient room the morning of the operation.