Remote Ischemic PreConditioning (RIPC)

Exclusion Criteria

• •1. Dissecting or mycotic brain aneurysm. Fusiform or atherosclerotic intracerebral aneurysms may be eligible for the trial if endovascular treatment is planned with a goal of exclusion of the aneurysm from the circulation.
• •2. Planned endovascular vessel sacrifice as the primary modality for aneurysm treatment.
• •3. Known history of life-threatening allergic reaction to any medication.
• •4. Soft tissue, orthopedic, or vascular injury which, in the judgment of the investigator, would preclude arm ischemic conditioning (e.g. superficial wounds, venous, arterial ulcers, gangrene).
• •5. History of peripheral vascular disease or deep vein thrombosis in either arm.
• •6. Women who are pregnant, or have a positive urine or blood (β-hCG) pregnancy test.
• •7. Women who are breastfeeding.
• •8. Any clinically significant psychiatric or psychological disease, which would preclude the patient from completing the protocol.
• •9. Pre-morbid (estimated) modified Rankin scale score of greater than 2. A subject is not excluded if they have a pre-morbid modified Rankin scale of greater than 2 but the disability does not interfere with the subject's ability to complete an MRI and the cognitive evaluations.
• •10. Previous serious traumatic brain injury that would preclude the patient from completing the protocol or preclude MRI analysis of small strokes.
• •11. Patients with peripherally inserted central catheters, hemodialysis shunts, arteriovenous fistulae or grafts in the treatment limb, or lymphedema.
• •12. Patients with known Human Immunodeficiency Virus (HIV) infection.
• •13. Patients who are unable to have an MRI scan for any reason.
• •14. Participation in a clinical trial with an investigational drug within 30 days preceding this study. Previous participation in any clinical trial investigating ischemia following endovascular aneurysm treatment, participation in another trial involving RIPC, or prior receipt of RIPC.
• •15. Severe or unstable concomitant condition disease or chronic condition, which, in the opinion of the investigator, could affect assessment of the safety or efficacy of study intervention.
• •16. Any other medical condition that the site investigator deems would put the patient at excessive risk of participation in the study or an expected life expectancy less than 1 year or that would result in inability to collect clinical outcomes at 30 days.
• •17. Systolic blood pressure above 200mm Hg.
• •18. Cannot tolerate inflation of the tourniquet on their arm consistent with blood pressure cuff.