Assessment of Renal Artery Fibromuscular Dysplasia: From Diagnosis to Treatment (DysArt)

August 12, 2022 updated by: Assistance Publique Hopitaux De Marseille
This is a prospective multicenter study based on the validation of diagnostic criteria and predictive factors of treatment efficacy for renal artery stenosis in renal artery dysplasia. This is considered as a rare disease and patients are usually treated in specialized centers involved in a national network. Marseille is a center specialized in FMD and a member of the network that is very active across the country. In order to rapidly recruit patients the investigators propose a multicenter study. All patients included will benefit from an invasive angiography with trans stenotic gradient assessment at rest. In case of bilateral stenosis the investigators will randomly omit data from one side and consider the data from the contralateral artery for further analysis, to avoid statistical interdependency. Patients who require angioplasty and who have unilateral stenosis (unilateral FMD lesion or bilateral but with one non significant stenosis based on duplex ultrasound European recommendations for atherosclerotic renal artery stenosis) will be included in the second part of the study. These patients will in addition benefit from a trans stenotic pressure assessment under vasodilation and intravascular renal artery ultrasound. Patients with severe bilateral renal artery stenosis will not be included in the analysis to assess predictive criteria for treatment efficacy on hypertension, treatment of these patients will followed the current best clinical practice. These patients will be followed during 6 to 8 month to assess potential complication of the pressure assessment renal artery stenosis, but their data will be included to assess the value of FFR and IVUS to guide the procedure. Patients with unilateral stenosis will be followed up 6 month after angioplasty in order to assess hypertension and to look for potential complications.

Study Overview

Status

Completed

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

41

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Marseille, France, 13354
        • Assistance Publique Hopitaux de Marseille

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

16 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Adult patients
  • hypertension based on ambulatory BP 24H measurements (12h mean daytime BP ≥135 or 85 mmHg)
  • renal artery stenosis due to multifocal FMD of the main renal artery or accessory artery with a diameter ≥ 5mm (defined using CT scan or duplex ultrasound),
  • if clinical and para-clinical information suggest that the hypertension might be caused by the renal stenosis and will require intravascular revascularization because of:
  • Recent onset of hypertension
  • Resistant hypertension (hypertension treated by 3 hypertensive drugs including one diuretic) based on ambulatory BP measurements (12h mean daytime BP ≥135 or 85 mmHg)
  • Hypertension for patients with poor compliance to medications or medication side effects.
  • Acute flash pulmonary edema
  • Delayed onset of hypertension with a decrease in kidney size or recent onset of renal failure especially after a renin-angiotensin system blocker

Exclusion Criteria:

  • Patients with other causes of secondary hypertension
  • Patients with renal artery stenosis from other causes than FMD higher than 30%
  • Patients with unifocal FMD or intimal FMD
  • Multifocal FMD of an accessory renal artery with a diameter < than 5 mm.
  • Patient with involvement of a collateral artery of the main renal artery
  • Renal artery dissection
  • Patients with creatinine clearance (MDRD) lower that 40ml/min/1.73m2.
  • Patients with an aneurysm with a diameter more than twice the diameter of the concerned artery
  • Patients without a social security number
  • Pregnant patients
  • Patients who refuse to participate in the study
  • Patients for whom the invasive measure are not possible

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Diagnostic
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
MAXIMAL VELOCITY
Time Frame: 24 months
duplex ultrasound parameters
24 months
ratio between maximal speed in the renal artery and in the aorta
Time Frame: 24 MONTHS
duplex ultrasound parameters
24 MONTHS
resistance index
Time Frame: 24 MONTHS
duplex ultrasound parameters
24 MONTHS
systolic ascension time
Time Frame: 24 MONTHS
duplex ultrasound parameters
24 MONTHS

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
stenosis length
Time Frame: 24 months
MDCT anatomical parameters
24 months
arterial diameter
Time Frame: 24 MONTHS
MDCT anatomical parameters
24 MONTHS
number of the stenosis
Time Frame: 24MONTHS
MDCT anatomical parameters
24MONTHS
Distance Ostium / main stenosis
Time Frame: 24 MONTHS
MDCT anatomical parameters
24 MONTHS

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

November 1, 2015

Primary Completion (Actual)

February 2, 2020

Study Completion (Actual)

February 2, 2020

Study Registration Dates

First Submitted

October 22, 2015

First Submitted That Met QC Criteria

October 26, 2015

First Posted (Estimate)

October 27, 2015

Study Record Updates

Last Update Posted (Actual)

August 16, 2022

Last Update Submitted That Met QC Criteria

August 12, 2022

Last Verified

August 1, 2022

More Information

Terms related to this study

Other Study ID Numbers

  • 2015-A01244-45
  • 2015-14 (assistance publique hopitaux de marseille)

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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