Effect of Remote Ischemic Preconditioning on Complications After Elective Abdominal Aortic Aneurysm Repair: A Meta-Analysis With Randomized Control Trials

Abstract

Objective:

This meta-analysis was to evaluate the effect of remote ischemic preconditioning (RIP) on complications after abdominal aortic aneurysm repair.

Methods:

A literature search was conducted in Google scholar, PubMed, Embase, and Web of Science databases up to February 2019. The pooled risk difference (RD) as well as their 95% confidence interval (CI) were calculated by RevMan 5.3 software.

Results:

A total of 249 patients receiving abdominal aortic aneurysm repair with RIP and 248 receiving abdominal aortic aneurysm repair without RIP in 7 included studies were reanalyzed in this meta-analysis. The results showed that RIP cannot significantly reduce the postoperative mortality (RD = −0.01, 95% CI: −0.07 to 0.06, P = .87), myocardial infarction (RD = −0.01, 95% CI, −0.09 to 0.07, P = .79), and renal impairment (RD = 0.06, 95% CI: −0.41 to 0.30, P = .89) and renal failure (RD = 0.04, 95% CI: −0.03 to 0.10, P = .30). Moreover, the pooled estimate indicated that the RIP significantly increased the risk of arrhythmia after abdominal aortic aneurysm repair surgery (RD = 0.08, 95% CI: 0.01 to −0.16, P = .03). Nevertheless, sensitivity analyses indicated unreliable results for risk of arrhythmia.

Conclusion:

There is no evidence that RIP reduces mortality after abdominal aortic aneurysm repair. Moreover, the current evidence is not robust enough to prove the effect of RIP on kidney- and cardiac-related complications.