Remote ischaemic preconditioning in intermittent claudication

Abstract

Background: Remote ischaemic preconditioning (RIPC) protects tissues against ischaemia-reperfusion (I/R) injury, a common occurrence in several clinical settings.

Aims: To evaluate whether RIPC has a beneficial impact on walking disability in arterial intermittent claudication.

Methods: A total of 20 patients with proven intermittent claudication underwent two treadmill walking tests with a 7-day interval in between; they were randomized according to the order in which they received either RIPC or a control procedure before the first treadmill test, with a crossover at the second test. Patients received three cycles of alternating 5-minute inflation and 5-minute deflation of blood-pressure cuffs on both arms, with inflation to a pressure of 200 mmHg in the RIPC procedure or 10mmHg in the control procedure. Walking distances and limb oxygenation data, assessed with transcutaneous oximetry and near infrared spectroscopy measurements, were obtained during both RIPC and control procedures in all patients.

Results: Similar exercise intensities were achieved after the control and RIPC procedures. Walking distances did not significantly differ after the control and RIPC procedures (204 [141-259]m vs 215 [162-442]m, respectively; P=0.22). Similarly, no difference was observed in terms of transcutaneous oxygen pressure change and near infrared spectroscopy measurements during exercise between the two procedures.

Conclusion: RIPC did not improve walking distance or limb ischaemia variables in patients with peripheral artery disease and intermittent claudication.

Keywords: Artériopathie oblitérante des membres inférieurs; Conditionnement ischémique à distance; Ischaemia-reperfusion; Ischémie-reperfusion; Peripheral artery disease; Remote conditioning.