- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03027011
Remote Ischemic Preconditioning on Brain Injury in Carotid Endarterectomy
March 9, 2017 updated by: The Affiliated Hospital of Xuzhou Medical University
Effect of Remote Ischemic Preconditioning on Brain Injury in Carotid Endarterectomy
This is a randomized controlled trial designed to test an intervention (Remote ischemic preconditioning) in patients undergoing carotid endarterectomy (CEA).Remote ischemic preconditioning(RIPC) with transient upper limb ischemia/reperfusion is a novel, simple, cost-free,non-pharmacological and non-invasive strategy.The purpose of this study is to evaluate the effects of Remote Ischaemic Preconditioning on perioperative ischaemic injury in patients undergoing carotid endarterectomy compared to control intervention.The outcomes of interest include neurocognitive function,clinical outcomes,and biomarkers of brain injury.
Study Overview
Status
Unknown
Conditions
Intervention / Treatment
Detailed Description
Remote ischemic preconditioning (RIPC) protocol will be induced during anesthesia by 3 cycles of 5-min upper limb ischemia and 5-min reperfusion using a blood pressure cuff inflated to a pressure 200mmHg
Study Type
Interventional
Enrollment (Anticipated)
40
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Chen Xiuxia, MD
- Phone Number: +86-18052268332
- Email: cxxlxy@sina.com
Study Locations
-
-
Jiangsu
-
Xuzhou, Jiangsu, China, 221000
- Recruiting
- The Affiliated Hospital of Xuzhou Medical University
-
Contact:
- Chen Xiuxia, MD
- Phone Number: +86-18052268332
- Email: cxxlxy@sina.com
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
55 years to 80 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Patients undergoing carotid endarterectomy
- Patients aged 55 years to 80 years
Exclusion Criteria:
- Inability to give informed consent
- Known Deep venous thrombosis (DVT) in arm
- Pre-existing lymphedema or axillary node dissection both arms
- Arteriovenous fistula or graft in both arms
- Left ventricular ejection fraction less than 50%
- Diagnosis of dementia, intellectual disability, or mental illness including depression, anxiety, or schizophrenia
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: Control
Control group without remote ischemic preconditioning
|
Control group without remote ischemic preconditioning
|
Active Comparator: Remote Ischemic Preconditioning(RIPC)
RIPC will be induced during anesthesia by 3 cycles of 5-min upper limb ischemia and 5-min reperfusion using a blood-pressure cuff inflated to a pressure 200mmHg
|
RIPC will be induced during anesthesia by 3 cycles of 5-min upper limb ischemia and 5-min reperfusion using a blood-pressure cuff inflated to a pressure 200mmHg
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
S100-beta biomarker
Time Frame: 48 hours post surgery
|
tested by ELISA
|
48 hours post surgery
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Short - term cognitive function
Time Frame: 1 day before surgery and 1 week post surgery
|
Short - term cognitive function will be tested by mini-mental state examination
|
1 day before surgery and 1 week post surgery
|
Neuron specific enolase (NSE) biomarker
Time Frame: 48 hours post surgery
|
tested by ELISA
|
48 hours post surgery
|
Sleep quality
Time Frame: 1 week post surgery
|
Sleep quality will be test by medical outcomes study sleep scale
|
1 week post surgery
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Chen Xiuxia, MD, The Affiliated Hospital of Xuzhou Medical University
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Murry CE, Jennings RB, Reimer KA. Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium. Circulation. 1986 Nov;74(5):1124-36. doi: 10.1161/01.cir.74.5.1124.
- Przyklenk K, Bauer B, Ovize M, Kloner RA, Whittaker P. Regional ischemic 'preconditioning' protects remote virgin myocardium from subsequent sustained coronary occlusion. Circulation. 1993 Mar;87(3):893-9. doi: 10.1161/01.cir.87.3.893.
- Xia Z, Herijgers P, Nishida T, Ozaki S, Wouters P, Flameng W. Remote preconditioning lessens the deterioration of pulmonary function after repeated coronary artery occlusion and reperfusion in sheep. Can J Anaesth. 2003 May;50(5):481-8. doi: 10.1007/BF03021061. English, French.
- Hougaard KD, Hjort N, Zeidler D, Sorensen L, Norgaard A, Hansen TM, von Weitzel-Mudersbach P, Simonsen CZ, Damgaard D, Gottrup H, Svendsen K, Rasmussen PV, Ribe LR, Mikkelsen IK, Nagenthiraja K, Cho TH, Redington AN, Botker HE, Ostergaard L, Mouridsen K, Andersen G. Remote ischemic perconditioning as an adjunct therapy to thrombolysis in patients with acute ischemic stroke: a randomized trial. Stroke. 2014 Jan;45(1):159-67. doi: 10.1161/STROKEAHA.113.001346. Epub 2013 Nov 7.
- Naylor AR. What is the current status of angioplasty vs endarterectomy in patients with asymptomatic carotid artery disease? J Cardiovasc Surg (Torino). 2007 Apr;48(2):161-80.
- Naylor AR. Where next after SPACE and EVA-3S: 'the good, the bad and the ugly!'. Eur J Vasc Endovasc Surg. 2007 Jan;33(1):44-7. doi: 10.1016/j.ejvs.2006.11.002. Epub 2006 Nov 28.
- Brevoord D, Kranke P, Kuijpers M, Weber N, Hollmann M, Preckel B. Remote ischemic conditioning to protect against ischemia-reperfusion injury: a systematic review and meta-analysis. PLoS One. 2012;7(7):e42179. doi: 10.1371/journal.pone.0042179. Epub 2012 Jul 31.
- Sanderson TH, Reynolds CA, Kumar R, Przyklenk K, Huttemann M. Molecular mechanisms of ischemia-reperfusion injury in brain: pivotal role of the mitochondrial membrane potential in reactive oxygen species generation. Mol Neurobiol. 2013 Feb;47(1):9-23. doi: 10.1007/s12035-012-8344-z. Epub 2012 Sep 26.
- Pundik S, Xu K, Sundararajan S. Reperfusion brain injury: focus on cellular bioenergetics. Neurology. 2012 Sep 25;79(13 Suppl 1):S44-51. doi: 10.1212/WNL.0b013e3182695a14.
- Bhuiyan MI, Kim YJ. Mechanisms and prospects of ischemic tolerance induced by cerebral preconditioning. Int Neurourol J. 2010 Dec;14(4):203-12. doi: 10.5213/inj.2010.14.4.203. Epub 2010 Dec 31.
- Nandagopal K, Dawson TM, Dawson VL. Critical role for nitric oxide signaling in cardiac and neuronal ischemic preconditioning and tolerance. J Pharmacol Exp Ther. 2001 May;297(2):474-8.
- Kitagawa K, Matsumoto M, Tagaya M, Hata R, Ueda H, Niinobe M, Handa N, Fukunaga R, Kimura K, Mikoshiba K, et al. 'Ischemic tolerance' phenomenon found in the brain. Brain Res. 1990 Sep 24;528(1):21-4. doi: 10.1016/0006-8993(90)90189-i.
- Ederle J, Featherstone RL, Brown MM. Percutaneous transluminal angioplasty and stenting for carotid artery stenosis. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD000515. doi: 10.1002/14651858.CD000515.pub3.
- Lim SY, Yellon DM, Hausenloy DJ. The neural and humoral pathways in remote limb ischemic preconditioning. Basic Res Cardiol. 2010 Sep;105(5):651-5. doi: 10.1007/s00395-010-0099-y. Epub 2010 May 7.
- Manchurov V, Ryazankina N, Khmara T, Skrypnik D, Reztsov R, Vasilieva E, Shpektor A. Remote ischemic preconditioning and endothelial function in patients with acute myocardial infarction and primary PCI. Am J Med. 2014 Jul;127(7):670-3. doi: 10.1016/j.amjmed.2014.02.012. Epub 2014 Feb 21.
- Olguner C, Koca U, Kar A, Karci A, Islekel H, Canyilmaz M, Mavioglu O, Kizildag S, Unlu G, Elar Z. Ischemic preconditioning attenuates the lipid peroxidation and remote lung injury in the rat model of unilateral lower limb ischemia reperfusion. Acta Anaesthesiol Scand. 2006 Feb;50(2):150-5. doi: 10.1111/j.1399-6576.2006.00938.x.
- Jiang HW, Chen C, Hao LJ. [Protective effect of limb ischemic preconditioning against liver ischemia/reperfusion injury in the rat]. Zhongguo Ying Yong Sheng Li Xue Za Zhi. 2010 Nov;26(4):502-4. Chinese.
- Cao L, Yuan G, Wang Y, Chang Y, Xu J, Zou D, Wei L. [Limb ischemic preconditioning reduces rabbit hepatic ischemia-reperfusion injury through inhibition the phosphorylation of proteins in the MAPK signal pathway in the late phase]. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2012 Jun;37(6):591-7. doi: 10.3969/j.issn.1672-7347.2012.06.009. Chinese.
- Sun XC, Li WB, Li QJ, Zhang M, Xian XH, Qi J, Jin RL, Li SQ. Limb ischemic preconditioning induces brain ischemic tolerance via p38 MAPK. Brain Res. 2006 Apr 21;1084(1):165-74. doi: 10.1016/j.brainres.2006.02.041. Epub 2006 Apr 21.
- Rehni AK, Shri R, Singh M. Remote ischaemic preconditioning and prevention of cerebral injury. Indian J Exp Biol. 2007 Mar;45(3):247-52.
- Rehni AK, Singh N, Jaggi AS. Possible involvement of insulin, endogenous opioids and calcitonin gene-related peptide in remote ischaemic preconditioning of the brain. Yakugaku Zasshi. 2007 Jun;127(6):1013-20. doi: 10.1248/yakushi.127.1013.
- Vlasov TD, Korzhevskii DE, Poliakova EA. [Ischemic adaptation of the rat brain as a method for protection of endothelium from ischemic reperfusion injury]. Ross Fiziol Zh Im I M Sechenova. 2004 Jan;90(1):40-8. Russian.
- Hahn CD, Manlhiot C, Schmidt MR, Nielsen TT, Redington AN. Remote ischemic per-conditioning: a novel therapy for acute stroke? Stroke. 2011 Oct;42(10):2960-2. doi: 10.1161/STROKEAHA.111.622340. Epub 2011 Aug 11.
- Malhotra S, Naggar I, Stewart M, Rosenbaum DM. Neurogenic pathway mediated remote preconditioning protects the brain from transient focal ischemic injury. Brain Res. 2011 Apr 22;1386:184-90. doi: 10.1016/j.brainres.2011.02.032. Epub 2011 Feb 19.
- Tulu S, Mulino M, Pinggera D, Luger M, Wurtinger P, Grams A, Bodner T, Beer R, Helbok R, Matteucci-Gothe R, Unterhofer C, Gizewski E, Schmutzhard E, Thome C, Ortler M. Remote ischemic preconditioning in the prevention of ischemic brain damage during intracranial aneurysm treatment (RIPAT): study protocol for a randomized controlled trial. Trials. 2015 Dec 29;16:594. doi: 10.1186/s13063-015-1102-6.
- Walsh SR, Nouraei SA, Tang TY, Sadat U, Carpenter RH, Gaunt ME. Remote ischemic preconditioning for cerebral and cardiac protection during carotid endarterectomy: results from a pilot randomized clinical trial. Vasc Endovascular Surg. 2010 Aug;44(6):434-9. doi: 10.1177/1538574410369709. Epub 2010 May 18.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
March 1, 2017
Primary Completion (Anticipated)
December 1, 2017
Study Completion (Anticipated)
December 1, 2017
Study Registration Dates
First Submitted
January 17, 2017
First Submitted That Met QC Criteria
January 18, 2017
First Posted (Estimate)
January 20, 2017
Study Record Updates
Last Update Posted (Actual)
March 10, 2017
Last Update Submitted That Met QC Criteria
March 9, 2017
Last Verified
March 1, 2017
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- XYFY-2017-005
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
IPD Plan Description
IPD will be available when this trial is finished and the article have been published
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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