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Trial registered on ANZCTR
Registration number
ACTRN12611001265965
Ethics application status
Approved
Date submitted
28/11/2011
Date registered
12/12/2011
Date last updated
14/06/2016
Type of registration
Retrospectively registered
Titles & IDs
Public title
Remote Ischaemic Preconditioning for Protection in Vascular Surgery
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Scientific title
Remote Ischaemic Preconditioning for Protection in Vascular Surgery as assessed by Cardiac Troponin T and Clinical Outcomes
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Secondary ID [1]
273481
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Nil
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Universal Trial Number (UTN)
Nil
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Open Abdominal Aortic Aneurysm Repair (or other Intra-Abdominal Vascular Surgery Procedure)
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Endovascular Abdominal Aortic Aneurysm Repair
279270
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Extra-Abdominal Bypass Graft Surgery
279271
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Condition category
Condition code
Cardiovascular
279468
279468
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0
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Diseases of the vasculature and circulation including the lymphatic system
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Cardiovascular
279469
279469
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0
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Coronary heart disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Remote Ischaemic Preconditioning (RIPC) Intervention: Three 5-min cycles of RIPC administered by a blood pressure cuff inflated to 20 mm Hg above systolic blood pressure around the non-dominant arm, with an intervening 5 min of reperfusion between each cycle, during which time the cuff is deflated. This entire 3 x 5 min protocol is to be administered 24 hours prior to surgery, as well as after induction of anaesthesia, immediately prior to the start of the surgical procedure. Therefore, two complete RIPC protocols (6 bouts of 5 min of ischaemia) prior to surgery will be administered.
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Intervention code [1]
283798
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Prevention
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Intervention code [2]
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Treatment: Other
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Comparator / control treatment
Control: Sham application of the blood pressure cuff with no inflation
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Cardiac-related clinical adverse events including (but not limited to) myocardial infarction and arrhythmias. Clinical adverse events will be assessed by standard clinical assessments performed by the primary clinician caring for the patient. If an event is suspected (e.g. MI), standard clinical investigations will be ordered as per usual practice (e.g. for MI - ECG and cardiac Troponin T blood test). All adverse events will be classified according to the Common Terminology Criteria for Adverse Events (CTCAE) and they will be recorded by the study co-ordinator.
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Assessment method [1]
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Timepoint [1]
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Clinical adverse events: Any time peri-operatively, until discharge.
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Primary outcome [2]
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Cardiac Troponin T measured in plasma using a high-sensitivity assay.
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Assessment method [2]
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Timepoint [2]
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Blood samples: 24 hours prior to surgery, immediately pre-surgery, 6, 12, 24, 48, 72, 96 and 120 post-surgery.
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Secondary outcome [1]
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Renal-related clinical adverse events including (but not limited to) renal dialysis. Assessed as per cardiac-related adverse events.
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Assessment method [1]
295021
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Timepoint [1]
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Clinical adverse events: Any time peri-operatively, until discharge.
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Secondary outcome [2]
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Creatinine, urea and electrolytes measured in plasma.
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Assessment method [2]
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Timepoint [2]
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Blood samples: 24 hours prior to surgery, 24 and 48 hours post-surgery.
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Eligibility
Key inclusion criteria
Patients due to undergo elective or urgent major vascular surgery at Dunedin Public Hospital (open AAA repair, EVAR, extra-abdominal bypass graft surgery).
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Minimum age
No limit
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
No exclusion criteria
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Sealed opaque envelopes.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation created by computer software.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
20/11/2011
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Actual
25/10/2011
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Date of last participant enrolment
Anticipated
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Actual
20/06/2013
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
80
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Accrual to date
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Final
85
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Otago
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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University of Otago
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Address [1]
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Department of Surgical Sciences
Dunedin School of Medicine
University of Otago
201 Great King Street
Dunedin 9016
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Country [1]
284272
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New Zealand
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Primary sponsor type
Individual
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Name
Andre van Rij
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Address
Head of Department
Department of Surgical Sciences
Dunedin School of Medicine
University of Otago
PO Box 913
Dunedin 9054
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
283223
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Country [1]
283223
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Lower South Regional Ethics Committee
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Ethics committee address [1]
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Ministry of Health 229 Moray Place Dunedin 9016
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Ethics committee country [1]
286231
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New Zealand
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Date submitted for ethics approval [1]
286231
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Approval date [1]
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05/08/2011
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Ethics approval number [1]
286231
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LRS/11/07/024
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Summary
Brief summary
Ischaemia-Reperfusion Injury is a specific type of tissue damage that unfortunately often occurs following major surgery, such as Vascular Surgery. A technique called Remote Ischaemic Preconditioning (RIPC) is known to provide protection to the heart and other tissues in such a setting. This technique involves interrupting the blood supply to a limb for a brief period, and it is simply performed by intermittently inflating a blood pressure cuff around the arm. There appear to be two phases of protection, early and late. The aim of this project is therefore to investigate the potential of combining these two phases of protection by administering RIPC twice pre-surgery in a vascular surgery group. We hypothesize that this RIPC protocol will reduce the risk of cardiac and renal complications during and following surgery.
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Trial website
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Trial related presentations / publications
http://www.ncbi.nlm.nih.gov/pubmed/27075990 http://www.ncbi.nlm.nih.gov/pubmed/27102874 Thomas KN, Cotter JD, Williams MJ, van Rij AM. Repeated Episodes of Remote Ischemic Preconditioning for the Prevention of Myocardial Injury in Vascular Surgery. Vasc Endovascular Surg. 2016;50(3):140-6. Thomas KN, Cotter JD, Williams MJ, van Rij AM. Diagnosis, Incidence, and Clinical Implications of Perioperative Myocardial Injury in Vascular Surgery. Vasc Endovascular Surg. 2016;50(4):247-55.
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Public notes
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Contacts
Principal investigator
Name
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Prof Andre van Rij
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Address
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Department of Surgical Sciences Dunedin School of Medicine University of Otago PO Box 913 Dunedin 9054
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Country
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New Zealand
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Phone
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+64 3474 0999 ext 58835
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Professor Andre van Rij
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Address
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Department of Surgical Sciences
Dunedin School of Medicine
University of Otago
PO Box 913
Dunedin 9054
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Country
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New Zealand
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Phone
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+64 3474 0999 ext 58835
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Professor Andre van Rij
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Address
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Department of Surgical Sciences
Dunedin School of Medicine
University of Otago
PO Box 913
Dunedin 9054
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Country
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New Zealand
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Phone
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+64 3474 0999 ext 58835
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Repeated Episodes of Remote Ischemic Preconditioning for the Prevention of Myocardial Injury in Vascular Surgery.
2016
https://dx.doi.org/10.1177/1538574416639150
Embase
Remote ischaemic preconditioning versus no remote ischaemic preconditioning for vascular and endovascular surgical procedures.
2023
https://dx.doi.org/10.1002/14651858.CD008472.pub3
N.B. These documents automatically identified may not have been verified by the study sponsor.
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