major vascular surgery
Conditions
Interventions
Standard Control group:Within 24–72 hours before surgery, trained nursing staff will perform the intervention by inflating a blood pressure cuff to 50 mmHg. Each inflation will last 5 minutes, followe
Intervention group:24-72 hours prior to surgery, when nurses measure blood pressure, patients with systolic pressure >150 mmHg should be pressurized to 200 mmHg
patients with systolic pressure <150 mmHg should be pressurized to 50 mmHg above their systolic pressure. If systolic pressure exceeds 180 mmHg, administer additional antihypertensive medication until
Sponsors
West China Hospital of Sichuan University
Eligibility
Sex/Gender
All
Age
18 Years to 90 Years
Inclusion criteria
Inclusion criteria: 1. Patients aged 18–90 years admitted to the vascular surgery department. 2. Patients undergoing vascular surgery at moderate to high cardiovascular risk, such as surgeries involving the aorta, carotid artery, lower limb arteries, visceral arteries, or retroperitoneal tumors with vascular involvement (the definition of moderate- to high-risk vascular surgery is based on the 2002 ACC/AHA guidelines; moderate-risk procedures include carotid endarterectomy and abdominal surgery, while high-risk procedures include emergency major surgery in elderly patients, aortic and major branch artery surgery, peripheral vascular surgery, and prolonged procedures with significant fluid shifts or blood loss). 3. Signed informed consent is obtained. 4. No specific requirements regarding patients' preoperative comorbidities, such as hypertension, diabetes, coronary artery disease, etc.
Exclusion criteria
Exclusion criteria: 1. Patients requiring emergency surgery. 2. Patients with upper limb fractures or upper limb vascular disease. 3. Patients with newly diagnosed myocardial infarction or unstable angina within the past month. Myocardial infarction definition: A new event meeting one or more of the following criteria: new or suspected new significant ST-T wave changes or new left bundle branch block; pathological Q waves on electrocardiogram; imaging evidence of new myocardial necrosis or new regional wall motion abnormalities; presence of intracoronary thrombus confirmed by coronary angiography or autopsy. Unstable angina definition: Evidence of myocardial ischemia without myocardial necrosis, characterized by typical ischemic chest pain (e.g., occurring at rest, with minimal exertion, worsening, or new-onset symptoms), potential ST-segment depression or dynamic T-wave changes on electrocardiogram, and normal levels of myocardial injury biomarkers such as serum troponin. 4. Patients with newly diagnosed stroke within the past month. Stroke definition: Acute onset of focal neurological dysfunction in the brain, retina, or spinal cord, lasting more than 24 hours, or of any duration with imaging (CT or MRI) or autopsy evidence of focal infarction or hemorrhage, or presenting with relevant clinical symptoms such as unilateral weakness, numbness, or vision loss; diplopia; speech disturbances; ataxia; and non-positional vertigo.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Major Adverse Cardiovascular and Cerebrovascular Events within 30 Days Postoperatively (MACCE); | — |
Secondary
| Measure | Time frame |
|---|---|
| Acute Kidney Injury ;all-cause mortality;myocardial infarction;heart failure; a rise in troponin levels to more than twice the upper limit of normal;stroke;systemic embolism;30-day overall complication rate;Health-related quality of life at 30 days, assessed using the EQ-5D-5L questionnaire;Time to return to normal activities (days);Postoperative length of stay (days);ICU length of stay (days);Procedure-related adverse events: Including skin bruising at the cuff site and limb ischemia.; | — |
Countries
China
Contacts
Public ContactJiarong Wang
West China Hospital, Sichuan University
Outcome results
None listed