- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03945045
A Study of the IJV or the SCV Approach for Ultrasound-guided Implantation of TIVAD
A Randomized Observational Study of the Internal Jugular Vein or the Subclavian Vein Approach for Ultrasound-guided Implantation of Totally Implantable Vascular Access Device(TIVAD)
Study Overview
Status
Intervention / Treatment
Detailed Description
A totally implantable venous access device (TIVAD) provides reliable, long-term vascular access and improves cancer patients' quality of life. The use of TIVADs is associated with important complications as infection and venous thrombosis, and studies have shown that several factors are associated, such as cancer types, catheter types, and the location of the catheter tips. Whether subclavian vein(SCV)or internal jugular vein(IJV) is a better site for TIVAD percutaneous access were also widely studied, and there is no definite consensus generated yet.
A meta-analysis published in 2016 by Wu et al reviewed 12 studies comparing the internal jugular vein (IJV) with the subclavian vein (SCV) as the percutaneous access site found no differences of TIVAD-related infection and catheter-related thrombotic rate. In the secondary outcome, IJV was associated with reduced risks of total major mechanical complications such as catheter dislocation and malfunction. Of 12 studies included, only 3 were randomized trial and there was no consistency between groups of using ultrasound guidance throughout TIVAD insertion. To be further, there is no description of how close to IJV-SCV junction does IJV group were inserted. Hence, a large well-designed RCT is warranted before the IJV site can be recommended.
To compare IJV and SCV as the implantation site of TIVAD and its associated thrombotic or occlusion rate, our study plans to enroll 240 patients with cancer who require central line TIVADs and randomizes them with 1:1 ratio to receive the TIVAD implantation at SCV or IJV. After the implantation, the patients will be regularly followed through phone contact and chart review for 2 years, and any symptomatic thrombosis or occlusion will be found during chemotherapy injection or regular push-pull heparin saline flush every 6 weeks as our hospital care protocol. To detect any asymptomatic thrombosis, the patients will also receive screening vascular ultrasound at 2 weeks, 2 months, and 6 months postoperatively. The study primary endpoints include any infection, asymptomatic thrombosis found by screen ultrasound, and clinically symptomatic thrombosis or occlusion and major mechanical failure/dislocation of TIVAD.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Taipei, Taiwan
- National Taiwan University Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion: 240 cancer patients, 20~99 years old.
Exclusion:
- Breast cancer, mediastinal tumor above 6 cm, head and neck cancer with/without surgical/radiological treatment, lung tumor above 6 cm,
- ECOG (Eastern Cooperative Oncology Group)performance status>=2, can't tolerate sit-upright or standing postoperative chest plain film,
- Allergy to prophylactic antibiotic,
- History of previous TIVAD or Hickman catheter implantation. Recent 2 weeks Central venous catheter insertion.
- End stage renal disease.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: PREVENTION
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: SCV
TIVAD implanted through subclavian vein under real-time ultrasound guidance
|
Subclavian vein approach for Ultrasound-guided Implantation of TIVAD
Other Names:
|
EXPERIMENTAL: IJV
TIVAD implanted through internal jugular vein under real-time ultrasound guidance
|
internal jugular vein approach for Ultrasound-guided Implantation of TIVAD
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
infection (blood stream or local wound)
Time Frame: 2 years
|
|
2 years
|
asymptomatic venous thrombosis
Time Frame: 2 years
|
|
2 years
|
symptomatic venous thrombosis with positive confirmatory image tests
Time Frame: 2 years
|
both positive symptoms and positive confirmative image tests should be met. Positive symptom noted by the patient or caregiver, such as
Positive confirmatory image tests as
|
2 years
|
TIVAD catheter occlusion
Time Frame: 2 years
|
Failure or difficult to infuse fluid or withdraw blood from TIVAD.
Difficult to withdraw blood from TIVAD in certain body position is not counted.
|
2 years
|
major mechanical failure, dislocation of TIVAD.
Time Frame: 2 years
|
|
2 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Intolerable pain or foreign body sensation of TIVAD
Time Frame: 2 years
|
|
2 years
|
Collaborators and Investigators
Investigators
- Principal Investigator: CHENG-YUAN HSIEH, MD, National Taiwan University Hospital
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
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
- 201807144RINC
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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