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CompletedNCT04489277Updated Aug 6, 2020

Silent Brain Infarction After Endovascular Arch Procedures

An observational study in Aortic Arch Aneurysm, sponsored by Medical University of Vienna. Completed at 2 sites in 2 countries. Open to participants aged 18 Years to 100 Years. Per ClinicalTrials.gov, last updated 2020-08-06.

Sponsored by Medical University of Vienna · Observational

Study type
Observational
Model
Cohort
Time perspective
Other
Enrollment
91
Ages
18 Years to 100 Years
Sex
All
01

Study summary

This is the largest study to evaluate incidence and distribution of silent cerebral infarction (SBI) following endovascular repair for disease of the aortic arch. Also, it is the first cohort to include total endovascular arch repair and devices flushed with carbon dioxide (CO2) to prevent gaseous cerebral embolization.

Read the detailed description

Introduction. Poor data exist concerning the rate of silent cerebral ischemic events following endovascular treatment of the aortic arch. The objective of this work was to quantify these lesions using the STEP registry.

Methods. This multicentre retrospective cohort study included consecutive patients treated with an aortic endoprosthesis deployed in Ishimaru zone 0 to 3 and brain diffusion-weighted magnetic resonance imaging (DW-MRI) within 7 days after the procedure. DW-MRI was performed to identify the location and number of new silent brain infarctions (SBI), microbleeds ans general outcome of the patients.

02

Conditions studied

  • Aortic Arch Aneurysm

Keywords

  • Thoracic endovascular aortic repair
  • Silent cerebral infarction
  • Stroke
  • Magnetic resonance imaging
  • DW-MRI
  • Aortic arch disease
03

Who can participate

Ages eligible
18 Years to 100 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Probability sample

Study population

Consecutive patients, who received routine postoperative DW-MRI within 7 days after endovascular aortic arch repair between September 2018 and January 2020 at the University Hospital Hamburg-Eppendorf (Hamburg, Germany) and Marie Lannelongue Hospital (Paris, France) were identified.

Inclusion criteria

  • Included patients underwent a proximal endograft deployment in Ishimaru zone 0 to 3

Exclusion criteria

Exclusion Criteria:

  • Missing preoperative computed tomography angiography (CTA) scan of the chest and any circumstances that precluded the DW-MRI to be performed in the appropriate time window, such as a medical condition or an MRI contraindication
04

Study design

Observational model
Cohort
Time perspective
Other
Enrollment
91 participants (actual)
Target follow-up
17 Months
Patient registry
Yes

Groups and cohorts

  • Patients with Silent Brain Infarction

    treated with an aortic endoprosthesis deployed in Ishimaru zone 0 to 3 and brain diffusion-weighted magnetic resonance imaging (DW-MRI) within 7 days after the procedure with silent brain infarction

    Device: Endovascular Arch Procedures

  • Patients without Silent Brain Infarction

    treated with an aortic endoprosthesis deployed in Ishimaru zone 0 to 3 and brain diffusion-weighted magnetic resonance imaging (DW-MRI) within 7 days after the procedure without silent brain infarction

    Device: Endovascular Arch Procedures

Interventions

  • DeviceEndovascular Arch Procedures

    Endovascular Arch Procedures (TEVAR, Branch endografts, Fenestrated endografts)

05

What researchers measure

Primary outcomes

  1. frequency of silent cerebral infarcts on DW-MRI

    Primary outcomes were the frequency of silent cerebral infarcts on DW-MRI after endovascular arch procedures, and to identify the number, the distribution, and predictors of these lesions.

    Time frame: 7 days

Secondary outcomes

  1. perioperative ischemic stroke

    Secondary outcomes were perioperative ischemic stroke defined as a brain infarction of ischemic etiology which occurs during surgery or within 30 days after surgery, TIA, hemorrhagic stroke, 30-day mortality, spinal cord ischemia, length of stay and discharge disposition.

    Time frame: 30 days

06

Study locations

2 sites
  • Marie Lannelongue Hospital (Paris, France)
    Paris, France
  • University Hospital Hamburg-Eppendorf (Hamburg, Germany)
    Hamburg, Germany
07

References and documents

Publications

  • Charbonneau P, Kolbel T, Rohlffs F, Eilenberg W, Planche O, Bechstein M, Ristl R, Greenhalgh R, Haulon S; STEP collaborators. Silent Brain Infarction After Endovascular Arch Procedures: Preliminary Results from the STEP Registry. Eur J Vasc Endovasc Surg. 2021 Feb;61(2):239-245. doi: 10.1016/j.ejvs.2020.11.021. Epub 2020 Dec 22. PubMed 33358103 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT04489277
Lead sponsor
Medical University of Vienna
Collaborators
Fondation Hôpital Saint-Joseph, Universitätsklinikum Hamburg-Eppendorf, Vascular Surgical Research Group, Imperial College, London, UK, Sanger Heart and Vascular Institute, Charlotte, NC, Loyola University Medical Center, Maywood, IL, UAB School of Medicine, Birmingham, AL, Heidelberg University Hospital, Heidelberg, Germany, University Hospital of Freiburg, Freiburg, Germany, Stanford University, Massachusetts General Hospital, Baylor Research Hospital, Dallas, TX, Emory University Hospital, Atlanta, GA, University Hospital of Mainz, Mainz, Germany, Diakonie Hospital Jung-Stilling, Siegen, Germany, Mayo Clinic, Rochester, MN, Sentara Vascular/Eastern Virginia Medical School, Norfolk, VA, Maastricht University Medical Centre, Maastricht, Netherlands, I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Italy, Memorial Care Long Beach Heart & Vascular Institute, Long Beach, CA
Responsible party
Wolf Eilenberg (Professor Stephan Haulon, Proessor Tilo Kölbel, Fondation Hôpital Saint-Joseph) — Principal investigator
First posted
Jul 28, 2020
Start date
Sep 1, 2018
Primary completion
Jan 31, 2020
Completion
Jan 31, 2020
Last update
Aug 6, 2020

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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