Blood Flow Quantification Near Stented SFA Lesions Using Ultrasound Velocimetry (EchoPIV in SFA)
2021年6月21日 更新者：Rijnstate Hospital
Feasibility of Ultrasound Particle Image Velocimetry to Quantify Flow Near Stented SFA Lesions
Peripheral arterial disease (PAD) in the lower extremity is the third leading cause of atherosclerotic cardiovascular morbidity.
Endovascular treatment has become the principal surgical strategy in femoro-popliteal lesions.
Stent placement induces significant changes in the arterial geometry and thereby in the hemodynamic environment.
Visualization of local blood flow patterns (around stents) is challenging, but clinically relevant.
Blood flow has a significant influence on the development of atherosclerosis and therefore stent patency.
In vivo blood flow characterization might enable the recognition, prediction and explanation of (in-stent) restenosis.
This study will therefore aim to investigate the feasibility of a novel ultrasound technique (echoPIV) to quantify spatiotemporal blood flow near stented femoral artery lesions.
Furthermore, the blood flow information obtained during the echoPIV measurements will be used as patient-specific boundary conditions in a computational fluid dynamics (CFD) simulation.
The tested hypothesis is that blood flow quantification using echoPIV is feasible in and around stents in the femoral artery and that it will improve CFD simulations.
調査の概要
状態
完了
条件
研究の種類
観察的
入学 (実際)
20
連絡先と場所
このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。
研究場所
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Gelderland
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Arnhem、Gelderland、オランダ
- Rijnstate Hospital
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参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
18年歳以上 (大人、高齢者)
健康ボランティアの受け入れ
いいえ
受講資格のある性別
全て
サンプリング方法
非確率サンプル
調査対象母集団
Patients with peripheral arterial disease who have been treated with a stent placement in the superficial femoral artery.
説明
Inclusion Criteria:
- Scheduled endovascular treatment of a lesion in the SFA through placement of a bare metal or a covered stent
- A recently (<6 weeks) treated lesion in the SFA through placement of a bare metal or a covered stent
Exclusion Criteria:
- Hypersensitivity to the active substance(s) or any of the excipients in SonoVue
- Right-to-left cardiac shunt
- Severe pulmonary hypertension (pulmonary artery pressure > 90mmHg)
- Uncontrolled systemic hypertension
- Adult respiratory distress syndrome
- Severe pulmonary disease (e.g. COPD GOLD 3/4, adult respiratory distress syndrome)
- Clinically unstable cardiac disease (recent or ongoing myocardial infarction, unstable angina at rest, recent percutaneous coronary intervention, clinically worsening cardiac symptoms, severe cardiac arrythmia's, endocarditis, etc.)
- Prosthetic valves
- Loss of renal function (GFR < 31 ml/min), end-stage renal disease
- End-stage liver disease Sepsis
- Hypercoagulable status, recent thrombosis
- Congestive heart failure (class III or IV)
- Hypersensitivity to iodinated contrast media
- Pregnancy
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか？
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
|---|---|
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PAD patients
The entire cohort exists of patients recently treated with an endovascular stent placement in the superficial femoral artery (SFA).
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Patients will undergo high-frame-rate contrast-enhanced ultrasound measurements, within 6 to 8 weeks after the endovascular procedure, at the vascular center of Rijnstate hospital.
Prior to these measurements a venous cannula will be placed to ensure venous access for the contrast administration.
Patients will undergo a CTA scan of the lower extremities at the Radiology dept. of Rijnstate hospital the same day as the echoPIV measurements.
This CTA scan serves as a reference for the vessel geometry and stent location.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Qualitative assessment vector velocity fields
時間枠：6 to 8 weeks after the procedure (stent placement of SFA)
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Vector velocity fields derived from the echoPIV data will be used to calculate and visualize the velocity profile.
In order to answer the question regarding feasibility of echoPIV the quality of the vector velocity fields will be assessed using three different metrics of which the first one is a qualitative assessment by different observers.
Recordings of the contrast-enhanced ultrasound with an overlay of the vector velocity profiles will be reviewed on different topics following a scoring rubrics.
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6 to 8 weeks after the procedure (stent placement of SFA)
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Contrast-to-background ratio
時間枠：6 to 8 weeks after the procedure (stent placement of SFA)
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The contrast-to-background ratio (CBR) is the second metric to assess the outcomes of the echoPIV measurements.
The CBR is a quantitative measure for the contrast levels and therefore for the quality of the contrast-enhanced US image.
The higher the CBR level (in dB) the higher the intensity of the contrast which is needed for sufficient PIV analysis.
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6 to 8 weeks after the procedure (stent placement of SFA)
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Vector correlation
時間枠：6 to 8 weeks after the procedure (stent placement of SFA)
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The vector correlation is the third metric to assess the outcomes of the echoPIV measurements.
The vector correlation demonstrates the tracking performance of the PIV algorithm.
The vector correlation provides a unitless value between 0 and 1 in which 0 indicates poor tracking of the microbubble contrast and 1 indicates perfect tracking of the microbubble contrast.
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6 to 8 weeks after the procedure (stent placement of SFA)
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Vorticity
時間枠：6 to 8 weeks after the procedure (stent placement of SFA)
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Multiple blood flow parameters will be derived from the echoPIV data.
The first one is the vorticity, or the curl of the velocity.
The vorticity represents the rotation of particles inside the flow field.
This measure can potentially be used to define regions with disturbed blood flow, as a high value (in rad/s) indicates the occurence of a recirculation.
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6 to 8 weeks after the procedure (stent placement of SFA)
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Vector complexity
時間枠：6 to 8 weeks after the procedure (stent placement of SFA)
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The second blood flow parameters derived from the echoPIV data is the vector complexity.
Vector complexity is a measure of multi-directional flow, ranging from 0 till 1. a value of 1 means complex flow with all velocity vectors pointing in all directions, whereas a value of 0 means laminar flow with all velocity vectors pointing in the same direction.
This measure can potentially be used to indicate regions with disturbed blood flow.
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6 to 8 weeks after the procedure (stent placement of SFA)
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Correlation echoPIV and CFD
時間枠：6 to 8 weeks after the procedure (stent placement of SFA)
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Velocity profiles obtained with echoPIV will be compared to outcomes of a computational fluid dynamics (CFD) simulation model of the femoral artery.
Multiple points along the imaged vessel will be selected in both the echoPIV and the CFD data to extract the temporal velocity profile.
This profile will be compared point-by-point after which the correlation between both outcomes/techniques will be obtained.
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6 to 8 weeks after the procedure (stent placement of SFA)
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協力者と研究者
ここでは、この調査に関係する人々や組織を見つけることができます。
スポンサー
捜査官
- 主任研究者：Michel MPJ Reijnen, PhD、Dept. of Surgery, Rijnstate Hospital Arnhem
出版物と役立つリンク
研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始 (実際)
2018年8月8日
一次修了 (実際)
2019年8月30日
研究の完了 (実際)
2019年8月30日
試験登録日
最初に提出
2021年6月10日
QC基準を満たした最初の提出物
2021年6月21日
最初の投稿 (実際)
2021年6月22日
学習記録の更新
投稿された最後の更新 (実際)
2021年6月22日
QC基準を満たした最後の更新が送信されました
2021年6月21日
最終確認日
2021年6月1日
詳しくは
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