Remote Ischemic Preconditioning for Aute Type A Aortic Dissection Surgery

Exclusion Criteria11

• Traumatic or iatrogenic aortic dissection;
• Previous open cardiac or thoracic aortic surgery;
• Severe preoperative dysfunction of vital organs, such as persistent deep coma, abdominal compartment syndrome, or circulatory failure;
• Severe comorbidities, including myocardial infarction within the past 7 days, stroke within the past 2 months; end-stage renal disease (eGFR \<30 ml/min/1.73 m²); end-stage liver disease (total bilirubin \>342 μmol/L or INR \>2.0);
• Evidence of ischemia in the limb planned for intervention, such as decreased skin temperature, pain, pallor, with or without sensory disturbance, paralysis, or diminished/absent pulses; or severe deformity or prior arteriovenous surgery at the intervention site;
• Peripheral arterial disease involving the limbs, Raynaud phenomenon, active phlebitis, or a history of deep vein thrombosis of the lower extremities;
• Current use of sulfonylurea oral hypoglycemic agents or nicorandil;
• Life expectancy \<1 year (e.g., advanced malignancy);
• Participation in another clinical trial without having reached its primary endpoint;
• Pregnancy or lactation; immunodeficiency (e.g., HIV positivity, history of organ transplantation); known bleeding disorders, coagulation abnormalities, or sickle cell anemia; active or uncontrolled infection;
• Other severe physical or psychiatric disorders, or laboratory abnormalities, which in the investigator's judgment may increase risk or interfere with study outcomes, rendering the patient unsuitable for enrollment.