Please select the eligibility criteria that correspond to the clinical trial below.
Title: Preconditioning Shields Against Vascular Events in Surgery: A Multi-centre Feasibility Trial of Preconditioning Against Adverse Events in Major Vascular Surgery (Preconditioning-SAVES)
Brief Summary: Major vascular surgery involves operations to repair swollen blood vessels, clear debris from blocked arteries or bypass blocked blood vessels. Patients with these problems are a high-risk surgical group as they have generalized blood vessel disease. These puts them at risk of major complications around the time of surgery such as heart attacks , strokes and death. The mortality following repair of a swollen main artery in the abdomen is about 1 in 20. This contrasts poorly with the 1 per 100 risk of death following a heart bypass. Simple and cost-effective methods are needed to reduce the risks of major vascular surgery. Remote ischaemic preconditioning (RIPC) may be such a technique. To induce RIPC, the blood supply to muscle in the patient's arm is interrupted for about 5 minutes. It is then restored for a further five minutes. This cycle is repeated three more times. The blood supply is interrupted simply by inflating a blood pressure cuff to maximum pressure. This repeated brief interruption of the muscular blood supply sends signals to critical organs such as the brain and heart, which are rendered temporarily resistant to damage from reduced blood supply. Several small randomized clinical trials in patients undergoing different types of major vascular surgery have demonstrated a potential benefit. This large, multi-centre trial aims to determine whether RIPC can reduce complications in routine practice.


Options:
A: Inclusion Criteria:

* Patients with ruptured abdominal aortic aneurysm offered surgery
* Age \> 18 years

Exclusion Criteria:

* Technical inoperable
B: Inclusion Criteria:

* Age greater than 18 years
* Patient willing to give full informed consent for participation
* Patients undergoing elective carotid endarterectomy or
* Patients undergoing open abdominal aortic aneurysm repair or
* Patients undergoing endovascular abdominal aneurysm repair or
* Patients undergoing surgical lower limb revascularisation (suprainguinal or infrainguinal)

Exclusion Criteria:

* Pregnancy
* Significant upper limb peripheral arterial disease
* Previous history of upper limb deep vein thrombosis
* Patients on glibenclamide or nicorandil (these medications may interfere with RIPC) Patients with an estimated pre-operative glomerular filtration rate \< 30mls/min/1.73m2
* Patients with a known history of myocarditis, pericarditis or amyloidosis
* Patients with an estimated pre-operative glomerular filtration rate \< 30mls/min/1.73m2.
* Patients with severe hepatic disease defined as an international normalised ratio \>2 in the absence of systemic anticoagulation
* Patients with severe respiratory disease (for the trial, defined as patients requiring home oxygen therapy)
* Patients previously enrolled in the trial representing for a further procedure
* Patients with previous axillary surgery
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:

* patients scheduled for total arch replacement
* written informed consent

Exclusion Criteria:

* pre-existing AKI
* peripheral vascular disease affecting the upper limbs
* hybrid total arch replacement
* the history of kidney transplantation

Answer: B