Effect of Repeated Remote Ischemic Preconditioning on Peripheral Arterial Disease in Patients Suffering from Intermittent Claudication

Balın, Mehmet; Kıvrak, Tarık

doi:10.1155/2019/9592378

Cited by 5 publications

(16 citation statements)

References 35 publications

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“…Widening the inclusion and reducing the exclusion criteria might improve recruitment rates. Specifically, we excluded patients with a history of peripheral arterial vascular disease, although RVOS appears safe in such patients [ 86 , 87 , 88 ]. Another potential strategy to improve recruitment in a future RCT is to set up the study at multiple (>2) sites, although the protocol is highly demanding and participating centres might be unable to deliver the interventions and assessments per protocol.…”

Section: Discussionmentioning

confidence: 99%

Safety and Feasibility Assessment of Repetitive Vascular Occlusion Stimulus (RVOS) Application to Multi-Organ Failure Critically Ill Patients: A Pilot Randomised Controlled Trial

Chhetri

Hunt

Mendis

et al. 2022

JCM

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Muscle wasting is implicated in the pathogenesis of intensive care unit acquired weakness (ICU-AW), affecting 40% of patients and causing long-term physical disability. A repetitive vascular occlusion stimulus (RVOS) limits muscle atrophy in healthy and orthopaedic subjects, thus, we explored its application to ICU patients. Adult multi-organ failure patients received standard care +/- twice daily RVOS {4 cycles of 5 min tourniquet inflation to 50 mmHg supra-systolic blood pressure, and 5 min complete deflation} for 10 days. Serious adverse events (SAEs), tolerability, feasibility, acceptability, and exploratory outcomes of the rectus femoris cross-sectional area (RFCSA), echogenicity, clinical outcomes, and blood biomarkers were assessed. Only 12 of the intended 32 participants were recruited. RVOS sessions (76.1%) were delivered to five participants and two could not tolerate it. No SAEs occurred; 75% of participants and 82% of clinical staff strongly agreed or agreed that RVOS is an acceptable treatment. RFCSA fell significantly and echogenicity increased in controls (n = 5) and intervention subjects (n = 4). The intervention group was associated with less frequent acute kidney injury (AKI), a greater decrease in the total sequential organ failure assessment score (SOFA) score, and increased insulin-like growth factor-1 (IGF-1), and reduced syndecan-1, interleukin-4 (IL-4) and Tumor necrosis factor receptor type II (TNF-RII) levels. RVOS application appears safe and acceptable, but protocol modifications are required to improve tolerability and recruitment. There were signals of possible clinical benefit relating to RVOS application.

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Section: Discussionmentioning

confidence: 99%

Safety and Feasibility Assessment of Repetitive Vascular Occlusion Stimulus (RVOS) Application to Multi-Organ Failure Critically Ill Patients: A Pilot Randomised Controlled Trial

Chhetri

Hunt

Mendis

et al. 2022

JCM

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“…Conceivable side effects of RIC such as thrombosis, arterial plaque rupture, nerve and vascular injury did not occur in any patient in the large phase III studies conducting a RIC protocol [8,9]. Here we describe a repetitive, chronic RIC application for 3 × 5 cycles (each with 5 min ischemia and 5 min reperfusion) on day 1, 3,5,8,10,12,15,17,19,21,24,26. The treatment and follow-up will be supported by two study nurses and a study diary to increase the patient compliance.…”

Section: Study Interventionmentioning

confidence: 99%

“…The mechanism of tissue/organ protection by RIC is mainly based on activation of neuronal efferences, systemic antiinflammatory responses and the release of humoral factors via the bloodstream [3,4]. Additionally, RIC might have a beneficial effect on chronic remodelling processes and angiogenesis which is highly relevant for treatment of PAOD [2,3,5,6].…”

Section: Study Interventionmentioning

confidence: 99%

“…However, only small and heterogenous studies have evaluated the potential effects of RIC on patients with PAOD. Unfortunately, most of these studies employed a single and limited application of RIC [5,6]. Recent studies suggested that daily repeated RIC (chronic RIC; cRIC) might be more effective for cardiovascular protection than a single RIPC application (Chong et al 2019).…”

Section: Introductionmentioning

confidence: 99%

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Repetitive application of remote ischemic conditioning (RIC) in patients with peripheral arterial occlusive disease (PAOD) as a non-invasive treatment option: study protocol for a randomised controlled clinical trial

Hummitzsch

Voelckers

Rusch

et al. 2022

BMC Cardiovasc Disord

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Background The best medical treatment (BMT) for most patients with early stage of peripheral arterial occlusive disease (PAOD) is often limited to gait training and pharmacological therapy besides endovascular surgery. The application of remote ischemic conditioning (RIC) has been described as a promising experimental strategy for the improvement of therapeutic outcome in cardiovascular disease but has not proven beneficial effects in clinical practice and treatment of PAOD yet. Methods Here we describe a prospective, randomized trial for the evaluation of possible effects of repeated application of RIC in patients with PAOD. This monocentric study will enrol 200 participants distributed to an intervention group receiving RIC + BMT and a control group only receiving BMT for four weeks. Patients are at least 18 years of age and have diagnosed PAOD Fontaine stage II b. Pain-free and total walking distance will be measured via treadmill test (primary endpoints). In addition, ankle-brachial index (ABI) and quality of life (QoL) will be assessed using the SF-36 and VascuQoL-6 questionnaire. Moreover, evaluation of markers for atherosclerosis, angiogenic profiling and mononuclear cell characterization will be performed using biochemical assays, proteome profiling arrays and flow cytometry (secondary endpoints). Discussion Our prospective, randomized monocentric trial is the first of its kind to analyse the effects of chronic and repetitive treatment with RIC in patients with PAOD and might provide important novel information on the molecular mechanisms associated with RIC in PAOD patients. Trial registration: Prospectively registered in the German Clinical Trials Register (Deutsche Register Klinischer Studien) Registration number: DRKS00025735; Date of registration: 01.07.2021.

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“…Knowledge of the physiological response to aggression produced by surgical trauma provides effective treatment capacity in the event of complications. Surgical intervention causes endocrine, metabolic, autonomic, immunological, and hematologic changes [1]. Somatic and autonomic afferent nerve impulses generated at the site of injury activate the endocrine response, while the inflammatory and immune response, mediated by hormones, begins to develop.…”

Section: Introductionmentioning

confidence: 99%

Estimation of the Predictive Factors of Myocardial Ischemic Preconditioning in Elective Surgical Patients

Díaz¹,

García²,

Salazar³

et al. 2020

GJAPM

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Introduction: the physiological response to the aggression produced by the surgical trauma provides the effective treatment capacity in case of complications. Surgical intervention causes endocrine, metabolic, autonomic, immunological, and hematological changes.Objective: to estimate the predictive factors of the second window of myocardial ischemic preconditioning in the patients proposed for elective surgical interventions. Material and Methods:A quasi-experimental study was carried out in the period January to December 2019 at the Maria Curie Cancer Hospital in Camagüey with patients who met inclusion and exclusion criteria in preoperative consultation in the research period, to whom preconditioning was applied. Ischemic two hours before surgery. Chi squared and logistic regression was calculated as appropriate.Results: Predictive factors such as essential arterial hypertension odds ratio 16,632, diabetes mellitus 12,157, age 60 years and over with odds ratios of 8,035, heart failure odds ratio 6,433, cerebrovascular disease odds ratio 6,135, and chronic kidney disease were estimated. Odds ratio 5,800 and chronic obstructive pulmonary disease with odds ratio 5,738. Conclusion:the predictive factors of the second window of ischemic preconditioning were independent predictors of risk in elective surgical patients.

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Effect of Repeated Remote Ischemic Preconditioning on Peripheral Arterial Disease in Patients Suffering from Intermittent Claudication

Cited by 5 publications

References 35 publications

Safety and Feasibility Assessment of Repetitive Vascular Occlusion Stimulus (RVOS) Application to Multi-Organ Failure Critically Ill Patients: A Pilot Randomised Controlled Trial

Safety and Feasibility Assessment of Repetitive Vascular Occlusion Stimulus (RVOS) Application to Multi-Organ Failure Critically Ill Patients: A Pilot Randomised Controlled Trial

Repetitive application of remote ischemic conditioning (RIC) in patients with peripheral arterial occlusive disease (PAOD) as a non-invasive treatment option: study protocol for a randomised controlled clinical trial

Estimation of the Predictive Factors of Myocardial Ischemic Preconditioning in Elective Surgical Patients

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