CClinicalTrials.gg
CompletedNCT03347032Updated Dec 14, 2022

Remote Ischemic Preconditioning for Renal Protection in TAVI

An interventional study of Remote ischemic preconditioning and Control in Aortic Valve Stenosis, Renal Insufficiency and Contrast-induced Nephropathy, sponsored by Henry Ford Health System. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-12-14.

Sponsored by Henry Ford Health System · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
46
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Severe aortic stenosis remains a major cause of morbidity and mortality of the elderly affecting approximately 3% of elderly patients with an increasing number of patients undergoing transcatheter aortic valve interventions. As part of pre-procedural planning these patients undergo CT scans and receive contrast during the procedure. These patients often have baseline renal insufficiency and are high risk of contrast induced nephropathy despite pre-hydration techniques. The purpose of this study is to evaluate the efficacy of this simple and safe procedure in preventing renal injury in this particular population.

02

Conditions studied

  • Aortic Valve Stenosis
  • Renal Insufficiency
  • Contrast-induced Nephropathy
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Adults aged 18 or older presenting with moderate to severe aortic stenosis for a trans-catheter aortic valve intervention

Exclusion criteria

Exclusion Criteria:

  • Patients in cardiogenic shock defined as requiring circulatory or hemodynamic support with a device, vasopressors or inotropes
  • Systemic hypotension (systolic blood pressure \< 90mmHg)
  • Patients currently on hemodialysis
  • Presence of an arteriovenous dialysis fistula or graft or lymphedema in either arm
  • Patients enrolled in other active cardiovascular investigational studies
  • Severe comorbidities with a life expectancy of less than 6 months
  • Pregnant or lactating women
  • Patients unable to provide consent
  • Patients taking the medication glibenclamide for treatment of diabetes
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
46 participants (actual)

Study arms

  • Experimental
    Intervention

    This group will undergo remote ischemic preconditioning with serial inflations of the blood pressure cuff to 200 mmHg followed by deflation for reperfusion for a period of 5 minutes each for a total of 4 cycles.

    Procedure: Remote ischemic preconditioning

  • Sham comparator
    Control

    This group will undergo serial inflations of the blood pressure cuff to 40 mmHg followed by deflation for a period of 5 minutes each for a total of 4 cycles.

    Procedure: Control

Interventions

  • ProcedureRemote ischemic preconditioning

    Serial inflations and deflations as detailed in the arm/group descriptions

  • ProcedureControl

    Serial inflations and deflations as detailed in the arm/group descriptions

05

What researchers measure

Primary outcomes

  1. Renal function as a measured by serum creatinine

    Assess the effects on post procedure renal injury. Lab work will be obtained in the form of a basic metabolic panel evaluating the creatinine level. A baseline basic metabolic panel will be obtained prior to scheduled procedure to evaluate baseline renal function and then 48-72 hours post procedure, the optimal time to see the effects of contrast induced nephropathy to evaluate the degree of acute kidney injury. The baseline and post procedure measurements of renal function will be compared between both arms of the study.

    Time frame: 48-72 hours

Secondary outcomes

  1. Clinical Outcomes

    The patient's electronic medical record will be reviewed at 6 months post procedure. The investigators will be assessing renal function at 6 months if a creatinine (lab) was ordered by the primary provider for any reason.

    Time frame: 6 months

  2. Clinical Outcomes

    The investigators will be reviewing the medical records of participants for evidence of post procedure adverse events including death, MI, stroke and hospital readmission

    Time frame: 6 months

06

Study locations

1 site
  • Henry Ford Hospital
    Detroit, Michigan 48202, United States
07

Registry details

Key details

Study ID
NCT03347032
Lead sponsor
Henry Ford Health System
Responsible party
Brittany Fuller, MD (Co-Investigator, Henry Ford Health System) — Principal investigator
First posted
Nov 20, 2017
Start date
Feb 13, 2018
Primary completion
Dec 30, 2018
Completion
Dec 30, 2018
Last update
Dec 14, 2022

Study contacts

William O'Neill, MD
principal investigator · Henry Ford Health System

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Dec 2022. You cannot join it, but the record below documents what was studied.

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