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RecruitingNCT04785443HYPOCAAVIUpdated Mar 19, 2026

Contribution of ICG Angiography in the Detection of Parathyroids and the Prevention of Hypoparathyroidism Post Total Thyroidectomy

A Phase 3 interventional study of ICG and Control group in Thyroid Diseases, sponsored by University Hospital, Brest. Recruiting at 1 site in France. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-03-19.

Sponsored by University Hospital, Brest · Phase 3, Interventional, and Prevention

Phase
Phase 3
Study type
Interventional
Enrollment
242
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

  • Hypoparathyroidism is the most common complication after a total thyroidectomy surgery. It becomes permanent after 6 months.
  • Untreated permanent hypoparathyroidism is a source of numerous complications in general and therefore requires lifelong replacement therapy resulting in a significant deterioration in quality of life.
  • The intraoperative use of indocyanine green (ICG) angiography has recently been described as a reliable means of detecting parathyroidism and predicting the risk of postoperative hypoparathyroidism.
  • This use could prove to be a way to preserve parathyroid in vivo and thus reduce post-operative hypoparathyroidism rates.
Read the detailed description

Hypoparathyroidism is the most common complication after a total thyroidectomy surgery. It is most often transient but can sometimes be permanent when it persists for more than 6 months after surgery. The rates are variable, of the order of 32% for transient hypoparathyroidism and 1% for definitive hypoparathyroidism. Untreated permanent hypoparathyroidism is the source of many complications in general and therefore requires lifelong replacement therapy. The result is a significant deterioration in quality of life.

The mechanisms responsible for hypoparathyroidism during thyroidectomy are direct damage to the parathyroid glands, involuntary excision of these glands, and devascularization of these glands.

The detection of parathyroid glands and the prevention of hypoparathyroidism after thyroidectomy therefore represents a major challenge.

The intraoperative use of indocyanine green angiography has recently been described as a reliable means of detecting parathyroid and predicting the risk of postoperative hypoparathyroidism.

In addition, prior studies and intraoperative observations suggest that indocyanine green angiography during thyroid surgery may be a means of preserving parathyroid in vivo and thus reducing post-operative hypoparathyroidism rates.

02

Conditions studied

  • Thyroid Diseases

Keywords

  • Hypocalcemia
  • Hypoparathyroidism
  • Angiography
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Patient having to undergo a total thyroidectomy
  • Signed consent
  • Patient beneficiary of a social security regimen

Exclusion criteria

Exclusion Criteria:

  • Minor patient under 18 years old
  • Major patient protected by law or unable to give informed consent
  • Pregnant or breastfeeding woman
  • Thyroidectomy totalization
  • History of thyroid or parathyroid surgery
  • Participation refusal
  • Known allergy to ICG
  • Woman of child-bearing age not using adequate method of contraception
04

Study design

Phase
Phase 3
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
242 participants (estimated)

Study arms

  • Experimental
    ICG group

    Patient receiving 2 or 3 intraoperative injections of indocyanine green.

    Drug: ICG

  • Other
    Control group

    Patient benefiting from the traditional surgical act

    Procedure: Control group

Interventions

  • DrugICG

    During thyroidectomy surgery, the patient will received 2 or 3 injections of 5 mg as a bolus. The first one during the dissection of the first lobe, then during the dissection of the second lobe and finally if needed, a 3rd injection will be done at the end of the dissection. Patients will then be followed during 6 months.

  • ProcedureControl group

    During thyroidectomy surgery, patients are treated according to traditional surgery with detection of parathyroids with the naked eyes. Patients will then be followed during 6 months.

05

What researchers measure

Primary outcomes

  1. Compare the frequency of albumin-corrected hypocalcemia (blood sugar below 2 mmol/L, a sign associated with hypoparathyroidism) postoperatively between the ICG group and the control group.

    Frequency of albumin-corrected hypocalcemia (≤2 mmol/L) within 48 hours postoperatively.

    Time frame: Day 2

Secondary outcomes

  1. Evaluate the contribution of ICG angiography in the modification of the rate of definitive hypoparathyroidism after total thyroidectomy.

    Occurrence (yes/no) of albumin-corrected (\<2mmol/L) postoperative hypocalcemia at D8, M1 and M6

    Time frame: Day 8, Month 1 and Month 6

  2. Determine the contribution of indocyanine green angiography (ICG) during the total thyroidectomy procedure for in vivo detection and preservation of parathyroid glands.

    Modification (yes/no) of the surgical procedure by improving the detection of parathyroids or their vascularization during thyroidectomy with the use of indocyanine green angiography.

    Time frame: Day 0

  3. To evaluate the contribution of indocyanine green angiography in the prediction of postoperative hypocalcemia.

    Intraoperative parathyroid vitality score (0=devascularized parathyroid gland to 2 = vascularized thyroid gland) when using indocyanine green angiography.

    Time frame: Day 0

  4. To determine the interest of indocyanine green angiography (ICG) in the prediction of hypoparathyroidism after total thyroidectomy.

    Occurrence (yes/no) of hypo parathormone at D1 and D2 postoperatively (\<10ng/L).

    Time frame: Day 1 and Day 2

  5. Compare the frequency of postoperative hypocalcemia, according to its grade (mild, moderate and deep), between the ICG group and the control group.

    Frequency of mild (asymptomatic and \>1.7mmol/l), moderate (symptomatic and \>1.7mmol/l) and profound (\<1.7mmol/l) hypocalcemia within 48 hours postoperatively.

    Time frame: D1 and D2

  6. Evaluate the tolerance of indocyanine green.

    Occurrence of an adverse event related to the injection of indocyanine green.

    Time frame: Day 1, Day 2, Day 10

06

Study locations

1 of 1 sites recruiting
  • CHRU de Brest
    Brest, 29609, France
    • Jean-Christophe LECLERE · Contact
    • Gael POTARD · Sub investigator
    • Julien PREVOT · Sub investigator
    Recruiting
07

References and documents

Individual participant data

Plan to share: Yes — All collected data that underlie results in a publication.

Supporting information: Study protocol

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT04785443
Lead sponsor
University Hospital, Brest
Responsible party
Sponsor
First posted
Mar 5, 2021
Start date
Jun 22, 2021
Primary completion
Jun 22, 2026 (estimated)
Completion
Jun 22, 2027 (estimated)
Last update
Mar 19, 2026

Study contacts

Jean-Christophe LECLERE, PhD
Contact
jean-christophe.leclere@chu-brest.fr
0298223630 ext. +33
Jean-Christophe LECLERE, PhD
principal investigator · CHRU de Brest

Oversight

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

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