Brain Lesions After Transcatheter Aortic Valve Replacement
2021年12月27日 更新者：Mao Chen、West China Hospital
The Brain lEsions after TrAnscatheter aorTic ValvE Replacement (BETTER) registry is a prospective, observational, multi-center registry aiming to assess the presence of new brain microbleeds assessed on susceptibility-weighted imaging at 3 enrolling sites, in China (West China Hospital, Sichuan University), UK (St Thomas' Hospital) and Denmark (Rigshospitalet, University of Copenhagen).
The main study arm is planned to include 100 patients with symptomatic severe aortic stenosis undergoing transfemoral TAVR of any devices and 50 isolated bioprosthetic SAVR patients treated during the enrollment period as a control arm.
研究概览
详细说明
"Silent" stroke post-TAVR presents as asymptomatic brain ischemic lesions detected on diffusion-weighted magnetic resonance imaging (DW-MRI), with an incidence ranging from 60% to 100% in different studies.
On the contrary, hemorrhagic lesions are not systematically studied given the poor visualization of small hemorrhage (i.e.
microbleeds) on traditional T1, T2 or DW-MRI sequences.
We have previously identified an incidence of new brain microbleeds early after TAVR of 100% with the routine use of susceptibility-weighted imaging (SWI).
We hypothesize that new brain microbleeds are prevalent in patients with aortic stenosis after either TAVR or SAVR.
The key objective of this registry is to evaluate the incidence, distribution and clinical impact of new brain microbleeds after transfemoral TAVR in patients with symptomatic severe aortic stenosis, in comparison with SAVR.
研究类型
观察性的
注册 (预期的)
150
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习联系方式
- 姓名：Tian-Yuan Xiong, MBBS, PhD
- 电话号码：+86-028-85423582
- 邮箱：xiongtianyuan@wchscu.cn
参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
60年 及以上 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
取样方法
非概率样本
研究人群
Patients with symptomatic severe aortic stenosis (>60 years old) being scheduled for either transfemoral TAVR or isolated SAVR at enrolling sites will be invited to participate in the study
描述
Inclusion Criteria:
- Symptomatic severe aortic stenosis (>60 years old) being scheduled for either transfemoral TAVR or isolated SAVR
Exclusion Criteria:
- Patients who have been diagnosed with brain cancer, brain haemorrhage, brain abscess, aneurysm, cerebral palsy, encephalitis, nervous system infection, head or neurological injury, or trauma, stroke
- Contraindications for a magnetic resonance imaging (MRI) scan (i.e. metallic implants, claustrophobia, MR-incompatible pacemakers or prosthetic heart valves)
- Unremovable dental prostheses that are deemed to affect MRI quality
- Severe coronary artery disease that is unrevascularized
- Prior stroke within the last 12 months
- Expected non-compliance concerning follow-up examinations
- Have participated in other clinical trials
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
队列和干预
团体/队列 |
干预/治疗 |
|---|---|
|
TAVR arm
Symptomatic severe aortic stenosis undergoing transfemoral TAVR of any devices
|
Brain MRI will be scheduled within three days before the procedure and within seven days after the procedure, as well as at 1-year follow-up.
MRI will be preferably performed using a 3.0-Tesla system unless patients are pacemaker-dependent after the procedure.
In such case, a 1.5-Tesla system will be used.
The MRI protocol consists of standardized conventional diffusion-weighted MRI (DW-MRI), T2-FLAIR (fluid-attenuated recovery inversion) and SWI (susceptibility-weighted imaging) parameters.
其他名称：
|
|
SAVR arm
Symptomatic severe aortic stenosis undergoing isolated bioprosthetic surgical aortic valve replacement
|
Brain MRI will be scheduled within three days before the procedure and within seven days after the procedure, as well as at 1-year follow-up.
MRI will be preferably performed using a 3.0-Tesla system unless patients are pacemaker-dependent after the procedure.
In such case, a 1.5-Tesla system will be used.
The MRI protocol consists of standardized conventional diffusion-weighted MRI (DW-MRI), T2-FLAIR (fluid-attenuated recovery inversion) and SWI (susceptibility-weighted imaging) parameters.
其他名称：
|
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
The incidence of new brain microbleeds detected on MRI
大体时间：Post-procedurally (up to 7 days) and 6 months
|
Microbleeds (including the number and size) on SWI after TAVR or SAVR during the index hospitalization and their evolution at the follow-up
|
Post-procedurally (up to 7 days) and 6 months
|
|
The incidence of new brain embolisms detected on MRI
大体时间：Post-procedurally (up to 7 days) and 6 months
|
Ischemic infarcts (including the number and size) on DW-MRI after TAVR or SAVR during the index hospitalization and their evolution at the follow-up
|
Post-procedurally (up to 7 days) and 6 months
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Changes in the neurological and cognitive status of the patients (see description for specific assessments)
大体时间：Post-procedurally (up to 7 days), 6 months and 1 year
|
NIH Stroke Scale (NIHSS) and Montreal Cognitive Assessment (MoCA, cognitive impairment = score <23/30) for overall cognitive status, and tests for five individual cognitive domains (Attention: Digit Symbol-Coding test [DSST]; Memory: Hopkins Verbal Learning Test-Revised [HVLT-R], Brief Visual Memory Test-Revised [BVMT-R]; Executive Function: Stroop Color-Word Association Test [SCWT], Category and Verbal Fluency [both semantic and phonemic]; Visuospatial Function: BVMT-R).
The change of score in each assessment will be calculated.
|
Post-procedurally (up to 7 days), 6 months and 1 year
|
其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Perfusion changes on transcranial doppler during TAVR or SAVR (if obtained)
大体时间：Intra-procedurally
|
Baseline perfusion will be obtained before femoral puncture in TAVR and the start of cardiopulmonary bypass in SAVR, until completion of eventual postimplantation maneuvers in TAVR and the stop of cardiopulmonary bypass in SAVR
|
Intra-procedurally
|
合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (预期的)
2022年1月1日
初级完成 (预期的)
2023年1月1日
研究完成 (预期的)
2024年1月1日
研究注册日期
首次提交
2021年9月8日
首先提交符合 QC 标准的
2021年9月22日
首次发布 (实际的)
2021年10月4日
研究记录更新
最后更新发布 (实际的)
2022年1月13日
上次提交的符合 QC 标准的更新
2021年12月27日
最后验证
2021年12月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.