Document Detail


Remote ischemic preconditioning for cerebral and cardiac protection during carotid endarterectomy: results from a pilot randomized clinical trial.
MedLine Citation:
PMID:  20484064     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Remote ischemic preconditioning (RIPC) is a physiological mechanism whereby brief ischemia-reperfusion episodes attenuate damage by subsequent prolonged ischemic insults. It reduces myocardial injury following cardiac and aortic aneurysm surgery. We aimed to determine whether RIPC affects neurological or cardiac injury following carotid endarterectomy (CEA). Patients were preconditioned using 10 minutes of lower limb ischemia-reperfusion. The primary neurological outcome was saccadic latency deterioration. The primary cardiac outcome measure was increased in serum troponin I >0.15 mg/dL. In all, 70 patients were randomized, of whom 55 completed the neurological surveillance protocol. Although there were fewer saccadic latency deteriorations in the RIPC arm, this did not reach statistical significance (32% versus 53%; P = .11). The primary cardiac outcome occurred in 1 patient in each arm (P = .97). There were no adverse events related to the preconditioning protocol. Remote ischemic preconditioning appears safe in patients with CEA. Large-scale trials are required to determine whether RIPC confers clinical benefits.
Authors:
Stewart R Walsh; S A Nouraei; Tjun Y Tang; Umar Sadat; Roger H Carpenter; Michael E Gaunt
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-05-18
Journal Detail:
Title:  Vascular and endovascular surgery     Volume:  44     ISSN:  1938-9116     ISO Abbreviation:  Vasc Endovascular Surg     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-09-16     Completed Date:  2011-01-13     Revised Date:  2012-01-31    
Medline Journal Info:
Nlm Unique ID:  101136421     Medline TA:  Vasc Endovascular Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  434-9     Citation Subset:  IM    
Affiliation:
Cambridge Vascular Unit, Addenbrooke's Hospital, Cambridge, United Kingdom. srwalsh@doctors.org.uk
Data Bank Information
Bank Name/Acc. No.:
ISRCTN/ISRCTN98544942
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MeSH Terms
Descriptor/Qualifier:
Aged
Carotid Stenosis / surgery*
Cerebrovascular Disorders / etiology,  prevention & control*
Endarterectomy, Carotid / adverse effects*
England
Female
Heart Diseases / etiology,  prevention & control*
Humans
Ischemic Preconditioning* / adverse effects
Lower Extremity / blood supply*
Male
Middle Aged
Pilot Projects
Tourniquets
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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