CompaRison of FEmorofemoral Bypass and Left-Heart ByPass Techniques in Open Thoracoabdominal AortIc Aneurysm Repair (REPAIR)
Comparison of Femorofemoral Bypass and Left-Heart Bypass Techniques in Open Thoracoabdominal Aortic Aneurysm Repair: A Study Protocol for Multicenter, Two-Arm, Open-Label, Randomized, ParalleI-Controlled Non-Inferiority Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Su-Wei Chen, Doctor
- Phone Number: +86 155 2461 2655
- Email: 15524612655@163.com
Study Locations
-
-
Beijing Municipality
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Beijing, Beijing Municipality, China, 100013
- Recruiting
- Beijing Anzhen Hospital
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Contact:
- Su-Wei Chen, Doctor
- Phone Number: +86 155 2461 2655
- Email: 15524612655@163.com
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Computed tomography angiography (CTA) confirmed as ATAAD according to the 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease;
- Adult patients (≥18 years old);
- Indications for TAAAR are available and requiring cardiopulmonary bypass;
- Signed informed consent and availability for follow-up.
Exclusion Criteria:
- History of chronic renal failure, chronic heart failure, Coronary heart disease with established surgical indications, hepatocirrhosis, and hepatic insufficiency;
- History of severe cerebral infarction (with cerebral infarction sequels);
- Inflammatory aortic diseases, such as Takayasu arteritis and Behçet's disease, etc;
- History of infectious aortic diseases;
- History of malignancy or previous radiotherapy;
- Pregnant or feeding women, or anyone planning to reproduce during the test period;
- Participating in any other clinical trial;
- Having other causes not eligible for operation.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: femoro-femoral cardiopulmonary bypass
Thoracoabdominal aortic aneurysm repair is performed under fCPB.
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This procedure is performed under fCPB via femoral artery and vein, inferior vena cava outside the pericardial cavity is alternative choice.
Two clamps were used to occlude the distal aortic arch beyond the left subclavian artery and the proximal descending aorta at the same time.
A triple occlusion technique could also be adopted when the aneurysm neck was located high.
The proximal abdominal aorta was clamped at the diaphragmatic level after the proximal anastomosis was completed, then intercostal artery reconstruction was performed using the arterial tube method.
The clamp is deployed at the bilateral iliac bifurcation, the branches of the four-branched graft were anastomosed sequentially in the order of the right renal artery, superior mesenteric artery, celiac trunk, and left renal artery.
Finally, the distal end of the four-branched graft was anastomosed to the distal abdominal aorta.
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Active Comparator: left heart bypass
Thoracoabdominal aortic aneurysm repair is performed under LHB.
|
This procedure is performed under LHB via the left inferior pulmonary vein and femoral artery.
Two clamps were used to occlude the distal aortic arch beyond the left subclavian artery and the proximal descending aorta at the same time.
A triple occlusion technique could also be adopted when the aneurysm neck was located high.
The proximal abdominal aorta was clamped at the diaphragmatic level after the proximal anastomosis was completed, then intercostal artery reconstruction was performed using the arterial tube method.
The clamp is deployed at the bilateral iliac bifurcation, the branches of the four-branched graft were anastomosed sequentially in the order of the right renal artery, superior mesenteric artery, celiac trunk, and left renal artery.
Finally, the distal end of the four-branched graft was anastomosed to the distal abdominal aorta.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Major adverse events
Time Frame: Thirty days and 12 months after the operation
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Major adverse events include surgical mortality, renal replacement treatment, stroke, and spinal cord injury.
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Thirty days and 12 months after the operation
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Blood Product Transfusion Volume
Time Frame: Surgical day and postoperative 1 to 3 days
|
volume of blood products transfused from surgical day to postoperative 3 day, including red blood cells, fresh frozen plasma, apheresis platelets and recombinant activated coagulation factor VII
|
Surgical day and postoperative 1 to 3 days
|
|
Duration of Mechanical Ventilation
Time Frame: Surgical day, postoperative 1 to 3 days, and discharge day / postoperative 30 days.
|
time interval between mechanical ventilation and extubation after operation.
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Surgical day, postoperative 1 to 3 days, and discharge day / postoperative 30 days.
|
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Early Mortality
Time Frame: Postoperative 6 to 12 months
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Death occurring after discharge or within 1 year of follow-up
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Postoperative 6 to 12 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2023ZD0504403
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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