Evidence map›Paper›PMID 25903752›Full record

Trial reportTrials2015

Preconditioning Shields Against Vascular Events in Surgery (SAVES), a multicentre feasibility trial of preconditioning against adverse events in major vascular surgery: study protocol for a randomised control trial.

Donagh Healy, Mary Clarke-Moloney, Brendan Gaughan, Siobhan O'Daly, Derek Hausenloy, Faisal Sharif, John Newell, Martin O'Donnell, Pierce Grace, John F Forbes and 23 more

Registry-linked trialOpen access · goldAbstract readClinical Trial, Phase IIMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Trials, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02097186 (Preconditioning Shields Against Vascular Events in Surgery), which is not on this map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02097186 naunknown statusnot on this map

Preconditioning Shields Against Vascular Events in Surgery: A Multi-centre Feasibility Trial of Preconditioning Against Adverse Events in Major Vascular Surgery (Preconditioning-SAVES)

TypeinterventionalSponsorMid Western Regional Hospital, IrelandRan2014 to 2017Enrolled400ConditionsAbdominal Aortic Aneurysm, Carotid Atherosclerosis, Critical Lower Limb IschaemiaArmsRemote ischaemic preconditioning
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

33 authors at 11 institutions in 2 countries.

Donagh HealyDepartment of Vascular Surgery, University Hospital Limerick, Saint Nessan's Road, Dooradoyle, Limerick, Ireland. Donagh1@hotmail.com.
Mary Clarke-MoloneyUniversity of Limerick, Castletroy, Limerick, Ireland. Mary.ClarkeMoloney@ul.ie.
Brendan GaughanNational Cardiovascular and Stroke Research Network, Irish Heart Foundation, 50 Ringsend Road, Dublin, Ireland. bgaughan@irishheart.ie.
Siobhan O'DalyNational Cardiovascular and Stroke Research Network, Irish Heart Foundation, 50 Ringsend Road, Dublin, Ireland. sodaly@irishheart.ie.
Derek HausenloyThe Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London, WC1E 6HX, UK. d.hausenloy@ucl.ac.uk.
Faisal SharifNUI Galway, University Road, Galway, Ireland. faisal.sharif@nuigalway.ie.
John NewellHealth Research Board Clinical Research Facility Galway, National University of Ireland, Galway, Geata an Eolais, University Road, Galway, Ireland. john.newell@nuigalway.ie.
Martin O'DonnellHealth Research Board Clinical Research Facility Galway, National University of Ireland, Galway, Geata an Eolais, University Road, Galway, Ireland. martin.odonnell@nuigalway.ie.
Pierce GraceUniversity of Limerick, Castletroy, Limerick, Ireland. pagrace@eircom.net.
John F ForbesUniversity of Limerick, Castletroy, Limerick, Ireland. John.Forbes@ul.ie.
Walter CullenUniversity of Limerick, Castletroy, Limerick, Ireland. walter.cullen@ul.ie.
Eamon KavanaghDepartment of Vascular Surgery, University Hospital Limerick, Saint Nessan's Road, Dooradoyle, Limerick, Ireland. eamon.kavanagh@hse.ie.
Paul BurkeDepartment of Vascular Surgery, University Hospital Limerick, Saint Nessan's Road, Dooradoyle, Limerick, Ireland. peburke1@gmail.com.
Simon CrossWaterford Regional Hospital, Dunmore Road, Waterford, Ireland. simon.cross@hse.ie.
Joseph DowdallWaterford Regional Hospital, Dunmore Road, Waterford, Ireland. joseph.dowdall@hse.ie.
Morgan McMonagleWaterford Regional Hospital, Dunmore Road, Waterford, Ireland. Morgan.McMonagle@hse.ie.
Greg FultonCork University Hospital, Corcaigh, Wilton, Co. Cork, Ireland. Greg.Fulton@hse.ie.
Brian J ManningCork University Hospital, Corcaigh, Wilton, Co. Cork, Ireland. brianj.manning@hse.ie.
Elrasheid A H KheirelseidDepartment of Vascular Surgery, University Hospital Limerick, Saint Nessan's Road, Dooradoyle, Limerick, Ireland. rashmed1111@gmail.com.
Austin LeahyBeaumont Hospital, Beaumont Road, Dublin 9, Ireland. profaustinleahy@beaumont.ie.
Daragh MoneleyBeaumont Hospital, Beaumont Road, Dublin 9, Ireland. daragh.moneley@beaumont.ie.
Peter NaughtonBeaumont Hospital, Beaumont Road, Dublin 9, Ireland. peternaughton74@eircom.net.
Emily BoyleDepartment of Vascular Surgery, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland. emboyle@rcsi.ie.
Seamus McHughDepartment of Vascular Surgery, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland. seamusmchugh@rcsi.ie.
Prakash MadhavenSt. James's Hospital, James Street, Dublin 8, Ireland. pmadhaven@stjames.ie.
Sean O'NeillSt. James's Hospital, James Street, Dublin 8, Ireland. seanoneillsec@stjames.ie.
Zenia MartinSt. James's Hospital, James Street, Dublin 8, Ireland. zeniamartin@gmail.com.
Donal CourtneyGalway University Hospital, Newcastle Road, Galway, Ireland. donal.courtney@hse.ie.
Muhammed TubassamGalway University Hospital, Newcastle Road, Galway, Ireland. muhammed.tubassam@hse.ie.
Sherif SultanGalway University Hospital, Newcastle Road, Galway, Ireland. sheriff.sultan@hse.ie.
Damian McCartanDepartment of Vascular Surgery, Waterford Regional Hospital, Dunmore Road, Waterford, Ireland. damiamccartan@rcsi.ie.
Mekki MedaniDepartment of Vascular Surgery, Waterford Regional Hospital, Dunmore Road, Waterford, Ireland. mekkimedani@rcsi.ie.
Stewart WalshHealth Research Board Clinical Research Facility Galway, National University of Ireland, Galway, Geata an Eolais, University Road, Galway, Ireland. STEWARTREDMOND.WALSH@nuigalway.ie.
Beaumont Hospital · IEUniversity Hospital Waterford · IEUniversity Hospital Limerick · IEUniversity of Limerick · IESt. James's Hospital · IEUniversity Hospital Galway · IECork University Hospital · IEHealth Research Board · IEIrish Heart Foundation · IEOllscoil na Gaillimhe – University of Galway · IEUniversity College London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients undergoing vascular surgery procedures constitute a 'high-risk' group. Fatal and disabling perioperative complications are common. Complications arise via multiple aetiological pathways. This mechanistic redundancy limits techniques to reduce complications that target individual mechanisms, for example, anti-platelet agents. Remote ischaemic preconditioning (RIPC) induces a protective phenotype in at-risk tissue, conferring protection against ischaemia-reperfusion injury regardless of the trigger. RIPC is induced by repeated periods of upper limb ischaemia-reperfusion produced using a blood pressure cuff. RIPC confers some protection against cardiac and renal injury during major vascular surgery in proof-of-concept trials. Similar trials suggest benefit during cardiac surgery. Several uncertainties remain in advance of a full-scale trial to evaluate clinical efficacy. We propose a feasibility trial to fully evaluate arm-induced RIPC's ability to confer protection in major vascular surgery, assess the incidence of a proposed composite primary efficacy endpoint and evaluate the intervention's acceptability to patients and staff. METHODS/

designFour hundred major vascular surgery patients in five Irish vascular centres will be randomised (stratified for centre and procedure) to undergo RIPC or not immediately before surgery. RIPC will be induced using a blood pressure cuff with four cycles of 5 minutes of ischaemia followed by 5 minutes of reperfusion immediately before the start of operations. There is no sham intervention. Participants will undergo serum troponin measurements pre-operatively and 1, 2, and 3 days post-operatively. Participants will undergo 12-lead electrocardiograms pre-operatively and on the second post-operative day. Predefined complications within one year of surgery will be recorded. Patient and staff experiences will be explored using qualitative techniques. The primary outcome measure is the proportion of patients who develop elevated serum troponin levels in the first 3 days post-operatively. Secondary outcome measures include length of hospital and critical care stay, unplanned critical care admissions, death, myocardial infarction, stroke, mesenteric ischaemia and need for renal replacement therapy (within 30 days of surgery). DISCUSSION: RIPC is novel intervention with the potential to significantly improve perioperative outcomes. This trial will provide the first evaluation of RIPC's ability to reduce adverse clinical events following major vascular surgery.

trial registrationwww.clinicaltrials.gov NCT02097186 Date Registered: 24 March 2014.

Indexed as

Acute Kidney InjuryBiomarkersClinical ProtocolsElectrocardiographyFeasibility StudiesHumansIrelandIschemic PreconditioningMyocardial Reperfusion InjuryRegional Blood FlowResearch DesignRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeTroponin IBiomarkersTroponin I

Identifiers

PMID25903752
PMCPMC4414457
OpenAlexW2161477432

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.