- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01253252
Endoprosthesis Treatment Effects on Human Abdominal Aorta Aneurysms (AAA) Metabolic Activity (AAAendo)
Endoprosthesis Treatment Effects on Human Abdominal Aorta Aneurysms(AAA)Metabolic Activity
Study Overview
Status
Conditions
Detailed Description
Background:
Abdominal Aorta Aneurysm(AAA) is a frequently occurring atherothrombotic disease, linked to male gender and aging. Due to the current aging of the population, the incidence of rupture may be increasing. The clinical evaluation of AAA usually includes a morphological assessment(size and localization) for diagnosis, open surgery or endovascular prosthesis (EVAR) may be indicated to prevent the onset of a rupture which is often lethal. Unfortunately, the durability of endovascular repair of AAA remains uncertain and the rupture risk or endoleaks onset requires continuous surveillance and the conventional imaging by CT scan often fails to predict this negative progression.
Our hypothesis is that the therapeutic efficacity of endovascular surgery in the AAA is linked to the restoration of effective compartmentalization between the blood and the outer wall (removal of the thrombosis interface and blood pressure constraint). Thus, success of EVAR must be followed by the disappearance of adventitial inflammation visualized by metabolic activity in FDG-PET (18FDG uptake) and a normalization of biological markers of the injury. Conversely, the inefficacy of endovascular therapy should result in the persistence of an inflammatory metabolic activity in relation to the saccular endoleak and a persistent elevation of plasma biomarkers.
Primary objective:
The general aim of this pilot study is to assess the effect of endoprosthesis treatment on PET scan functional imaging of AAA.
Materials and method:
Seven French Hospitals will recruit 50 patients presenting a large AAA scheduled for EVAR (Endovascular prosthesis) within one month. A 18FDG PET scan will be added to their conventional follow up (CT scan, usual blood sampling, ECG…) i.e. within one month before endovascular surgery (inclusion visit), at one month and 6 month of follow-up.
Furthermore, biological markers of the inflammation, proteolysis and coagulation potentially related to morphology and evolution of AAA will be investigated by the U698 (National Institute for Medical Research) Unit, implementing already existing database from others cohorts of patients with AAA, including biological samples conserved both by the Nancy clinical investigation center and the (U698) National Institute for Medical Research Unit.
Study duration for a patient: 26 months
Perspectives:
This pilot study will help to assess the effect of EVAR in terms of it functional inflammatory response and determine the required sample size for a future project. Since aneurysm expansion rate varies widely among patients and even for one single patient over time, studying metabolic adventitial immuno-inflammatory activity using 18FDG PET imaging will provide new major informations about the efficacity of endovascular therapy in AAA. Plasma assays will help to identify intermediate biological markers of aneurysm evolutivity after endovascular therapy. Those complementary functional and biological criteria are of paramount importance to improve therapeutic management and prognosis of AAA.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Dijon, France, 21 000
- Le Bocage - Dijon's Hospital
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Lille, France, 59037
- Cardiologic Hospital
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Nancy, France, 54500
- Brabois Hospital
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Nantes, France, 44 093
- Institut du Thorax, Nantes's Hospital
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Paris, France, 75018
- Bichat Claude Bernard Hospital
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Paris, France, 75908
- Georges Pompidou European Hospital
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Rouen, France, 76031
- CH.NICOLLE's Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Large AAA scheduled for endovascular surgery within one month
- Written informed consent
Exclusion Criteria:
- Evolutive neoplasm
- Chronic liver disease
- Connective tissue diseases: rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, Crohn's disease, polymyositis/dermatomyositis, mixed connective tissue disease
- Crohn's disease
- Evolutive tuberculosis
- Contraindication to CT scan
- Pregnancy and breastfeeding
- Women of child bearing potential
- Patient unable to understand the study aims
- Patient unable to comply with scheduled visit
- Participation in other investigational studies.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: Specific procedure
A [18F] Fluorodeoxyglucose PET Scan Imaging will be added to their conventional follow up (CT scan, usual blood sampling, ECG…) i.e. within one month before endovascular surgery (inclusion visit), at one month and 6 month of follow-up. Furthermore, blood sampling for biological investigations (biological markers of the inflammation, proteolysis and coagulation potentially related to morphology and evolution of AAA) will be done. |
Positron Emission Tomography (PET) is a nuclear medicine imaging technique which produces a 3-dimensional image of functional processes in the body. The system detects pairs of gamma rays emitted indirectly by a positron-emitting radionuclide, which is introduced into the body on a biologically active molecule. Images of tracer concentration in 3-dimensional space are then reconstructed by computer analysis. The biologically active molecule chosen for PET is 18-fluorodeoxyglucose. The concentrations of tracer imaged then give tissue metabolic activity, in terms of regional glucose uptake. The dose of 18FDG that is recommended for adults in a standard exploration varies from 200 to 500 MBq according to the weight of the patient and the camera used. No allergic or other incident has been observed after several thousands of examinations.
Computed tomography (CT) is a medical imaging method employing tomography created by computer processing.
Digital geometry processing is used to generate the PET's three-dimensional space image.
A venous blood sample of a total of 30 ml for measurement of enzymes associated with the development of aneurysms (= biomarkers).
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
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Difference of 18FDG PET scan signal (mean and maximal aortic standardized uptake measurements) visualized before and after endoprosthesis implantation for AAA treatment.
Time Frame: 3 Pet scan will be performed: within one month before surgery and after 1 and 6 months of follow-up
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3 Pet scan will be performed: within one month before surgery and after 1 and 6 months of follow-up
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Secondary Outcome Measures
Outcome Measure |
Time Frame |
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Correlation between therapeutic efficacity of endovascular treatment and AAA injury biological markers.
Time Frame: Blood samplings will be performed 5 times: within one month before endoprosthesis implantation and after one month, six months, one year and 2 years of follow-up
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Blood samplings will be performed 5 times: within one month before endoprosthesis implantation and after one month, six months, one year and 2 years of follow-up
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Relationship between efficacity of endovascular surgery and morphology of the AAA as assessed by CT scan.
Time Frame: CT scan will be performed within one month before endoprosthesis implantation and at one month, six months, one year and two years of follow-up
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CT scan will be performed within one month before endoprosthesis implantation and at one month, six months, one year and two years of follow-up
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Patrick ROSSIGNOL, MD, phD, Nancy's Hospital, Plurithematic Clinical Investigation Centre
- Study Director: Jean-Baptiste MICHEL, MD, PhD, Institut National de la Santé Et de la Recherche Médicale (INSERM) U698 FRANCE
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2007-A01424-49
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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