Please select the eligibility criteria that correspond to the clinical trial below.
Title: Cardiac Remote Ischemic Preconditioning Prior to Elective Major Vascular Surgery
Brief Summary: The investigators have previously shown that elective vascular surgery is a high-risk operation with an anticipated risk of either death or heart attack of 15%. This study is testing whether a protocol of remote ischemic preconditioning (RIPC) applied 24 hours prior to the operation is safe, feasible and reduces the incidence of an adverse, perioperative cardiac complication.


Options:
A: Inclusion Criteria:

1. Patient \> 18 and \<85 years old
2. Patient having a planned surgery for a thoracoabdominal aortic aneurysm by direct approach,
3. Patient with aortic aneurysm requiring supra-visceral aortic clamping and visceral artery reconstruction,
4. Aortic aneurysmal patient with or without distal femoral circulatory assistance,
5. Patient with aortic aneurysm of atheromatous or dissecting etiology,
6. Woman of childbearing potential with effective contraception (estrogen-progestin or intrauterine device or tubal ligation), postmenopausal woman (≥ 12 months of amenorrhea not induced by therapy)
7. Patient who read and understood the newsletter and signed the consent form
8. Patient affiliated with a social security scheme

Exclusion Criteria:

1. Patient with aortic aneurysms requiring supra-visceral aortic clamping but not requiring visceral artery reconstruction (supra-visceral aortic clamping for renal aortic juxtaposition aorta),
2. Patient with thoraco abdominal aortic aneurysms requiring a circulatory arrest (aortic aneurysms affecting the descending thoracic aorta or the aortic arch)
3. Patient requiring emergency aortic surgery
4. Patient under treatment known as interfering with PCI (Nicorandil or oral antidiabetic agents),
5. Pregnant or lactating woman (negative result of baseline blood test)
6. Participation in another interventional study within 28 days before randomization or during this study
7. Person deprived of liberty by an administrative or judicial decision or person subject to a legal measure for the protection of adults,
8. Patient under the protection of justice, patient under guardianship or curatorship.
B: Inclusion Criteria:

* Undergoing elective major vascular surgery at the Minneapolis VA Medical Center for abdominal aortic aneurysm, carotid disease or limb ischemia.
* Age \> 18.
* Provides informed consent.

Exclusion Criteria:

* Hypertensive crisis
* Peripheral arterial disease of the upper extremities
* Arteriovenous (AV) fistula
* Acute Coronary Syndrome (ACS) in the last 6 months
* Severe valvular heart disease
* Pregnant women
* Unable to provide consent
C: Inclusion Criteria:

* patients who are willing to give full informed consent for participation and
* who are undergoing open abdominal aortic aneurysm repair or
* who are undergoing endovascular aortic aneurysm repair or
* who are undergoing lower limb revascularization surgery or
* who are undergoing carotid endarterectomy

Exclusion Criteria:

* patients under age of 18
* patients who are pregnant
* patients with known malignancy during last 5 years
* patients with permanent atrial fibrillation or flutter
* patients with symptomatic upper limb atherosclerosis
* patients who require home oxygen therapy
* patients with eGFR \< 30 ml/min/1.73 m2, measured preoperatively
* patients who have had myocardial infarction during last month
* patients who have had upper limb vein thrombosis
* patients who have undergone vascular surgery in the axillary region
* patients who are not able to follow the study regimen
D: Inclusion Criteria:

* is ≥ 45 years old;
* is undergoing elective major colorectal or upper GI surgery.

Exclusion Criteria

* Diabetic patients that are taking glibenclamide medication
* Patients with upper limb peripheral vascular disease, including those with arteriovenous fistula for dialysis
* Untreated hypertension (defined as two or more readings \>180mmHg systolic on admission for surgery)
* Current participation in any study investigating troponin levels or ischaemic preconditioning
* Unable or lacks capacity to give informed consent to participation

Answer: B