- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04062734
Endovascular Treatment of Aorto-iliac Disease Using in Situ Fenestration (PREFISIT)
Study Overview
Status
Detailed Description
ISF are mainly described at the level of the aortic arch. Different means are reported to perforate the graft: the mechanical (needles, transjugular intra hepatic access needles or guidewires) or physical (laser and radiofrequency catheters).
ISF could be an alternative in the endovascular treatment of aorto iliac disease including both occlusive and aneurysmal pathologies. In this cases, when a narrow distal aorta is present conventional technique as CERAB, bifurcated endograft are challenging. In situ fenestrations allows conversion of an aorto-uni-iliac endograft into a bifurcated endograft, thereby avoiding crossover femorofemoral bypass and its complications.
The aim of the study was to report the results of ISF technique at the level of the abdominal aorta.
Inclusion criteria will be: a surgical abdominal aortic aneurysm (AAA) with an unsuitable anatomy for a standard endograft, aorto-iliac occlusion with narrow distal aorta (<14mm).
All patients had a preoperative CT scan to assess the anatomy of the abdominal aorta.
All patients received an oral antiplatelet agent(aspirin(75-250md/dl) or clopidogrel (75md/dl) and a statin before the procedure.
In situ fenestration technique The procedure was performed under general anesthesia and guided with a mobile C-arm (Siemens). The less diseased and tortuous iliac axis was used to introduce the endograft and the contralateral side as used for the in situ fenestration.
Whenever possible, the procedure was carried out percutaneously with the preclosure technique using Proglide vascular devices for the two common femoral artery retrograde punctures.
The first step consisted in placing an endograft from a retrograde femoral access. The endograft was deployed in a standard fashion. The distal security wire was not released to maintain the control on the distal part of the endograft and keep the graft straight while performing the fenestration. A transjugular intrahepatic access needle was introduced in a 9F Flexor introducer through a contralateral femoral access. When the top of the introducer was at the level of the aortic bifurcation, the dilatator of the introducer was removed, and the introducer was pushed up to the endograft. Contact between the introducer and the endograft was ensured by observing a slight deformation of the endograft while pushing the introducer.
The needle was advanced and the endograft is punctured at the level of the aortic bifurcation. The hole created was secondary enlarged using cutting or high pressure balloon. A long sheath is advanced intro the fenestration to control the success of the technique.
A kissing stent using balloon expandable covered stents is finally performed to stabilize the repair.
Control angiography confirm the patency of the stents and the absence of early endoleak in case of endovascular treatment of abdominal aortic aneurysm.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
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Boulogne-Billancourt, France, 92100
- Service de Chirurgie Vasculaire, Hôpital Ambroise Paré
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Underwent in situ fenestration treatment between 2014 and 2019
Exclusion Criteria:
- Patient aged < 40 years or > 90 years
- Under guardianship
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Primary Patency
Time Frame: at 1 month
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Evaluate primary patency at 1 month after in situ fenestration by CT angiography.
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at 1 month
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Primary Patency
Time Frame: at 1 month
|
Evaluate primary patency at 1 month after in situ fenestration by doppler ultrasound.
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at 1 month
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Secondary Patency
Time Frame: at 6 and 12 month
|
Evaluate secondary patency at 6 and 12 month after in situ fenestration by CT angiography.
|
at 6 and 12 month
|
Secondary Patency
Time Frame: at 6 and 12 month
|
Evaluate secondary patency at 6 and 12 month after in situ fenestration by doppler ultrasound.
|
at 6 and 12 month
|
Technical success
Time Frame: at baseline
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Technical success was achieved when the perforation of the endograft was performed with the needle.
Technical success will be measured as a ratio between the number of successfull perforation and the number of attempts.
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at baseline
|
Collaborators and Investigators
Investigators
- Principal Investigator: Raphaël COSCAS, MD, PhD, Service de Chirurgie Vasculaire, Hôpital Ambroise Paré
- Study Director: Jérémie JAYET, MD, Service de Chirurgie Vasculaire, Hôpital Ambroise Paré
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
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
- 19RCS-PREFISIT
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
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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