NCT05084066

Brief Summary

This study aims to evaluate whether remote ischemic preconditioning (RIPC) daily for 28 days reduces the symptoms of intermittent claudication in patients with peripheral artery disease (PAD). The study evaluates the effect of RIPC on patients' total walking distance (TWC), initial claudication distance (ICD), and time to relief of claudication (TRC). In addition, the trial investigates the effect of RIPC on different arterial functional characteristics and low molecular weight metabolites in serum and affected skeletal muscle.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
42

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Jan 2022

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

September 21, 2021

Completed
28 days until next milestone

First Posted

Study publicly available on registry

October 19, 2021

Completed
3 months until next milestone

Study Start

First participant enrolled

January 24, 2022

Completed
1.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 18, 2023

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 18, 2023

Completed
Last Updated

October 10, 2023

Status Verified

October 1, 2023

Enrollment Period

1.2 years

First QC Date

September 21, 2021

Last Update Submit

October 9, 2023

Conditions

Keywords

Intermittent ClaudicationTotal Walking DistanceInitial Claudication DistanceTime to Relief of ClaudicationArterial StiffnessVASCUQOL-6Peripheral Artery Disease

Outcome Measures

Primary Outcomes (1)

  • Change from Baseline Total Walking Distance at 28 Days

    Maximal walking distance performed on a treadmill test

    28 days

Secondary Outcomes (9)

  • Change from Baseline Initial Claudication Distance at 28 Days

    28 days

  • Change from Baseline Time to Relief of Claudication at 28 Days

    28 days

  • Change from Baseline Carotid-Femoral Pulse Wave Velocity at 28 Days

    28 days

  • Change from Baseline Augmentation Index at 28 Days

    28 days

  • Change from Baseline Low Molecular Weight Metabolite Levels in Serum at 28 Days

    28 days

  • +4 more secondary outcomes

Study Arms (2)

Experimental group

EXPERIMENTAL

20 patients with PAD and claudication

Other: Repeated remote ischemic preconditioning

Control group (sham)

SHAM COMPARATOR

20 patients with PAD and claudication

Other: Simulation of repeated remote ischemic preconditioning (sham)

Interventions

An automated device performs four 5-minute episodes of upper limb ischemia in which the cuff pressure in the experimental group remains at 200 mmHg for 5 minutes, causing and ensuring ischemia. Ischemic episodes alternate with 5-minute reperfusion. The intervention lasts a total of 35 minutes. The participant places the device on his upper arm and presses the "Start" button, starting the intervention. The intervention takes place at rest in the patient's home environment daily for 28 days. During the first visit to the research center, the research assistant teaches the participant how to use the device. The device measures the patient's blood pressure at the start of the intervention. If the patient's blood pressure is above 200 mmHg, the device will not perform the intervention.

Experimental group

The automated device simulates the intervention of the experimental group with the difference that the device does not apply pressure to the upper limb and, therefore, no ischemia occurs.

Control group (sham)

Eligibility Criteria

Age18 Years - 80 Years
Sexmale
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Peripheral arterial disease, which causes claudication
  • Patients who have given written informed consent and are undergoing conservative treatment for claudication (continuous treatment for at least three months)
  • Patients with lower limb atherosclerosis Fontaine class IIA or IIB
  • The primary limiter of walking is claudication, not any other condition
  • Ankle-brachial index (ABI) ≤ 0,9 in symptomatic lower limb

You may not qualify if:

  • Female gender
  • Resting blood pressure \> 200 mmHg
  • Fontaine class III or IV
  • eGFR \< 30 ml/min/1,73 m2
  • Home oxygen therapy or severe COPD (GOLD 3-4)
  • Heart failure NYHA III-IV
  • Stable angina pectoris
  • Clinically severe COVID-19 infection in the last three months
  • History of malignancy (within the last five years)
  • Persistent or permanent atrial fibrillation or flutter
  • Acute myocardial infarction in the last three months
  • Residual signs of cerebral infarction that impede movement
  • Significant atherosclerosis of peripheral arteries of the upper limb (symptomatic)
  • History of deep vein thrombosis of the upper limb
  • Diabetic polyneuropathy
  • +2 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Tartu University Hospital

Tartu, Estonia

Location

Related Publications (2)

  • Eerik K, Kasepalu T, Post H, Eha J, Kals M, Bjorck M, Kals J. Effects of Repeated Remote Ischaemic Preconditioning on Arterial Stiffness, Organ Damage, and Oxidative Stress in Patients with Intermittent Claudication: A Sham Controlled Randomised Trial. Eur J Vasc Endovasc Surg. 2025 Jun 24:S1078-5884(25)00575-1. doi: 10.1016/j.ejvs.2025.06.046. Online ahead of print.

  • Eerik K, Kasepalu T, Post H, Eha J, Kals M, Kals J. Editor's Choice - Daily Remote Ischaemic Preconditioning for Intermittent Claudication: A Sham Controlled Randomised Trial. Eur J Vasc Endovasc Surg. 2025 Feb;69(2):295-302. doi: 10.1016/j.ejvs.2024.10.047. Epub 2024 Nov 8.

MeSH Terms

Conditions

Peripheral Arterial DiseaseIntermittent Claudication

Interventions

salicylhydroxamic acid

Condition Hierarchy (Ancestors)

AtherosclerosisArteriosclerosisArterial Occlusive DiseasesVascular DiseasesCardiovascular DiseasesPeripheral Vascular DiseasesSigns and SymptomsPathological Conditions, Signs and Symptoms

Study Officials

  • Jaak Kals, PhD

    University of Tartu

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

September 21, 2021

First Posted

October 19, 2021

Study Start

January 24, 2022

Primary Completion

April 18, 2023

Study Completion

April 18, 2023

Last Updated

October 10, 2023

Record last verified: 2023-10

Data Sharing

IPD Sharing
Will not share

Locations