Interest of Remote Ischemic Preconditioning for Prevention of Contrast Medium-induced Nephropathy in High Risk Patients (IPC-Angio)
Nephropathy
About this trial
This is an interventional prevention trial for Nephropathy focused on measuring Transcatheter Aortic Valve Implantation
Eligibility Criteria
Inclusion Criteria:
- Age greater than 18 years, no upper age limit ;
- Patient which may hospitalized for a medical check-up before a percutaneous aortic valve implantation (CTA and coronarography);
- Patient at risk for NPCI defined by a Mehran risk classification system ≥11 (Annexe 2) ;
- Willing to provide free and informed written consent
Exclusion Criteria:
- Pathology of the upper-limbs limiting the use of the cuff (bilateral amputation, arteriovenous fistula);
- Critical renal disease requiring hemodialysis ;
- Person who is not affiliated to a health care system insurance
- Inability to understand the instructions of the study;
- Absolute contraindication to of iodinated contrast medium injection (anaphylactic shock history to contrast media, especially Xenetix, clearance (MDRD) less than 30mL/min/1.73m2) ;
- Pregnancy
- Simultaneous participation in other protocol;
- Person with legal protection, person deprived of liberty.
Sites / Locations
- Rennes University Hospital
Arms of the Study
Arm 1
Arm 2
Experimental
Sham Comparator
Remote ischemic preconditioning
SHAM remote ischemic preconditioning
Remote Ischemic Preconditioning (RIPC) is accomplished by performing 4 cycles of alternating 5-minute inflation and 5-minute deflation of a standard upper-arm blood pressure cuff, to induce transient and repetitive arm ischemia and reperfusion. RIPC will be started just before the CTA, and the time between the last inflation cycle and the beginning of the CTA will be less than 45 minutes.
The SHAM Remote Ischemic Preconditioning ("SHAM" RIPC) will be carried out with the same number of cycles that the RIPC but cuff will be inflated to the diastolic pressure of the subject and the cuff will be deflated to10 mmHg in order to maintain a non- ischemic compression (blind patient protocol).