Effect of delayed remote ischemic preconditioning on major cardiovascular and cerebrovascular events in major vascular surgery: the protocol of DRIPC randomized controlled trial

Introduction Although endovascular therapy has become the mainstream approach for major vascular surgery, patients undergoing such procedures are still classified as high-risk according to clinical guidelines. Remote ischemic preconditioning (RIPC) is a promising perioperative intervention strategy that has demonstrated acceptable safety and efficacy. Existing research indicates that delayed remote ischemic preconditioning (DRIPC) offers superior protective effects compared to preconditioning performed within 24 h before surgery. However, there is currently a lack of Level I evidence regarding the efficacy and safety of DRIPC in the perioperative period for vascular surgery patients. This study aims to provide high-level evidence on the effectiveness and safety of this intervention in a clinical setting. Methods and analysis The trial is a single-center, prospective, double-blind, randomized controlled clinical trial. A total of 1,054 patients will be recruited. The primary endpoints of the study include major adverse cardiac and cerebrovascular events (MACCE) within 30 days postoperatively. Ethics and dissemination This study has been approved by the Ethics Committee of West China Hospital of Sichuan University (approval number:2025-1846). The results will be submitted to a major clinical journal for peer review and publication. Clinical Trial registration identifier ChiCTR2600116987