- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05134246
Carotid Revascularization for Radiation Induced Carotid Artery Stenosis (CRICS)
September 25, 2022 updated by: Xuanwu Hospital, Beijing
Outcomes of Carotid Revascularization for Patients With Radiation Induced Carotid Artery Stenosis in China
Cervical radiotherapy (RT) has greatly reduced the mortality of patients with malignant head and neck tumors, which, however, causes a higher risk of carotid artery stenosis, namely, radiation-induced carotid artery stenosis (RICS) and results in a significant increased risk of ischemic stroke.
The systematic review and meta-analysis conducted by our team showed carotid endarterectomy (CEA) can yield better results for these patients than carotid artery stenting (CAS), which was contrary to most previous clinical guidelines.
A large-scale prospective study is needed to verify the results.
We will conduct a prospective registry of RICS patients treated with CEA to evaluate both short-term safety and long-term efficacy outcomes in a Chinese population.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Study Type
Observational
Enrollment (Anticipated)
75
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Tao Wang, MD
- Phone Number: 18810302298
- Email: wangtao_dr@sina.com
Study Contact Backup
- Name: Liqun Jiao, MD
- Phone Number: 13911224991
- Email: liqunjiao@sina.cn
Study Locations
-
-
Beijing
-
Beijing, Beijing, China, 100005
- Recruiting
- Xuanwu Hospital, Capital Medical University
-
Contact:
- Tao Wang, MD
- Phone Number: 18810302298
- Email: wangtao_dr@sina.com
-
Sub-Investigator:
- Xiao Zhang, MD
-
-
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
18 years and older (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Sampling Method
Non-Probability Sample
Study Population
Patients diagnosed with RICS and fulfilled the above eligible criteria in tertiary medical centers in China, will be enrolled consecutively.
Description
Inclusion Criteria:
- Patients with carotid stenosis who had a history of radiotherapy for head and neck cancer. (The median interval between the completion of radiation therapy and development of carotid artery stenosis detected on imaging (or vascular intervention) was no less than 1 years to avoid non-related situations. The target area of the radiotherapy included at least the ipsilateral neck, including part of the carotid system. The internal carotid stenosis was confirmed by angiography, Duplex, 3D angio-CTA or angio-MRI, and stenosis was defined as > 50% based on North American Symptomatic Carotid Endarterectomy Trial criteria), with or without symptom. Patients with a transient ischaemic attack (TIA) or stroke within 6 months were defined as symptomatic. TIA was defined as a transient episode of neurological dysfunction (focal weakness/ language disturbance/transient monocular blindness/ requiring assistance to walk) caused by focal brain or retinal ischemia that lasts for at least 10 min but resolves within 24 h.)
Exclusion Criteria:
- The patients treated for restenosis.
- Intracranial arteriovenous malformation or aneurysm
- Severe stenosis or occlusion of the ipsilateral intracranial artery
- Unstable angina, myocardial infarction (MI), or congestive heart failure in the last 6 months
- Uncorrectable coagulation abnormalities
- Uncontrolled diabetes mellitus defined as glucose > 300 mg/dL (16.67 mmol/L)
- Pregnant or in the perinatal period
- Severe concomitant disease with poor prognosis (life expectancy < 2 years)
- Intolerance or allergies to any of the study medications, such as aspirin or clopidogrel
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
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Carotid endarterectomy (CEA)
Patients who are treated with CEA.
|
Surgeons follow the contemporary guideline combined with their experience and preference in order to ultimately select what is best suited for the patient and choose between CEA and CAS.
Patients will receive 100 mg of aspirin or 75 mg of clopidogrel daily starting from at least 72 h prior to the CEA procedure and continued receiving the medication indefinitely.
General anesthesia is recommended for CEA, although the use of standard or eversion endarterectomy, and a shunt or patch, is left to the discretion of the surgeon.
|
Carotid artery stenting (CAS)
Patients who are treated with CAS.
|
Surgeons follow the contemporary guideline combined with their experience and preference in order to ultimately select what is best suited for the patient and choose between CEA and CAS.
Patients will be given 100 mg of aspirin plus 75 mg of clopidogrel daily for at least 3 days before the CAS procedure and for 90 days after the procedure.
They will receive a daily dose of 100 mg aspirin or 75 mg clopidogrel thereafter.
For the CAS procedure, local anaesthesia and predilation prior to stent placement are recommended.
Use of an embolic protection device is mandatory for all patients who undergo CAS.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Stroke or death within 1 month
Time Frame: Within 1-month post-procedure
|
A composite of any stroke or death occurring within 1-month post-procedure.
|
Within 1-month post-procedure
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Stroke within 1 month
Time Frame: Within 1-month post-procedure
|
Stroke within 1 month
|
Within 1-month post-procedure
|
Death within 1 month
Time Frame: Within 1-month post-procedure
|
Death within 1 month
|
Within 1-month post-procedure
|
Cranial nerve injury
Time Frame: Within 1-month post-procedure
|
Number of participants who suffered from cranial nerve injury
|
Within 1-month post-procedure
|
Carotid artery restenosis
Time Frame: Within 1-year post-procedure
|
Number of participants who suffered from carotid artery restenosis (> 50%) detected by ultrasonography, CTA, or DSA
|
Within 1-year post-procedure
|
Functional outcome
Time Frame: Within 1-month and 1-year post-procedure
|
Functional outcome indicated by NIHSS (National Institutes of Health Stroke Scale: 0-42; higher scores indicate worse outcome) or mRS (modified Rankin Scale: 0-6; higher scores indicate worse outcome)
|
Within 1-month and 1-year post-procedure
|
Other major complications
Time Frame: Within 1-month post-procedure
|
Other major complications, such as myocardial infarction, incision hematoma, pulmonary infection, etc.
|
Within 1-month post-procedure
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Study Chair: Liqun Jiao, MD, Xuanwu Hospital, Beijing
- Principal Investigator: Tao Wang, MD, Xuanwu Hospital, Beijing
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 (ACTUAL)
January 5, 2020
Primary Completion (ANTICIPATED)
December 31, 2026
Study Completion (ANTICIPATED)
December 31, 2027
Study Registration Dates
First Submitted
November 11, 2021
First Submitted That Met QC Criteria
November 22, 2021
First Posted (ACTUAL)
November 24, 2021
Study Record Updates
Last Update Posted (ACTUAL)
September 27, 2022
Last Update Submitted That Met QC Criteria
September 25, 2022
Last Verified
September 1, 2022
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CRICS
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
UNDECIDED
IPD Plan Description
Please contact the PI.
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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.
Clinical Trials on Radiation-induced Carotid Artery Stenosis
-
Heinrich-Heine University, DuesseldorfRecruitingCarotid Artery Plaque | Carotid Artery Diseases | Carotid Artery Stenosis Asymptomatic | Carotid Artery StenosisGermany
-
Xuanwu Hospital, BeijingChanghai Hospital; Peking Union Medical College Hospital; The Second Hospital... and other collaboratorsRecruitingCarotid Artery Stenting | Carotid Endarterectomy | Best Medical Treatment | Carotid Artery Stenosis AsymptomaticChina
-
Washington University School of MedicineNational Heart, Lung, and Blood Institute (NHLBI); Cedars-Sinai Medical Center and other collaboratorsRecruitingCarotid Atherosclerosis | Asymptomatic Carotid Artery Stenosis | Carotid Artery AtheromaUnited States
-
Aesculap AGEnrolling by invitationCarotid Artery Stenosis | Iliac Artery Stenosis | Femoral Artery StenosisGermany
-
Centre Hospitalier St AnneHôpitaux Universitaires Paris Ile-de-Franc OuestNot yet recruiting
-
Mayo ClinicRecruitingPatients With Any Degree of Carotid Artery Stenosis and Vulnerable Features in the Carotid Artery PlaqueUnited States
-
University of BolognaActive, not recruiting
-
W.L.Gore & AssociatesCompleted
-
Oslo University HospitalCompletedCarotid Artery Stenoses
-
4th Military Clinical Hospital with Polyclinic,...Medical Research Agency, PolandNot yet recruitingStroke | Carotid Artery Stenting | Carotid Artery StenosisPoland
Clinical Trials on Carotid endarterectomy (CEA)
-
University of PoitiersUniversity of Roma La SapienzaCompletedStroke | Carotid Artery Stenosis | Carotid Artery Thrombosis
-
Medical University of ViennaRecruitingCarotid Artery StenosisAustria
-
Thomas G. Brott, M.D.National Institute of Neurological Disorders and Stroke (NINDS)RecruitingCarotid StenosisUnited States, Canada, Israel, Spain, Australia
-
Rutgers, The State University of New JerseyUniversity of Alabama at Birmingham; National Institute of Neurological Disorders...CompletedMyocardial Infarction | Stroke | Atherosclerosis | Carotid Stenosis | Cerebral InfarctionUnited States, Canada
-
Xuanwu Hospital, BeijingUnknownStroke | Carotid Stenosis | SurgeryChina
-
Centre Hospitalier St AnneHôpitaux Universitaires Paris Ile-de-Franc OuestNot yet recruiting
-
University Hospital OstravaRecruitingIn-Stent Carotid Artery RestenosisCzechia
-
Perouse MedicalEclevar MedtechCompletedStroke | Artery Stenosis | Artery Stenosis, Carotid | Occlusion of ArteryFrance
-
University of Campinas, BrazilUnknownCarotid Endarterectomy | Percutaneous Transluminal Angioplasty | Cognitive Aspects | Diffusion Weighted MRIBrazil
-
CAMC Health SystemCompletedStenoses, Carotid ArteryUnited States