Magnetic Resonance Imaging of Aortic Aneurysm Instability

Aortic Aneurysm Clinical Trial

Official title:

Magnetic Resonance Imaging of Aortic Aneurysm Instability

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00794092
• Other study ID #: 2007/R/CAR/15
• Status: Completed
• Phase: Phase 2/Phase 3
• Start date: November 2008
• Est. completion date: June 2010

Study information

• Verified date: June 2021
• Source: University of Edinburgh
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Abdominal aortic aneurysm (AAA) is a progressive enlargement of the aorta, the largest blood vessel in the body. It is at risk of bursting when it is usually fatal. Currently the risk of the AAA bursting is estimated from its diameter. In this study, the investigators hope to develop a new type of aneurysm scan involving Magnetic Resonance Imaging (MRI). It is hoped that this scan will be better at determining which AAAs are at risk of bursting and therefore require an operation to prevent this.

Description:

Abdominal aortic aneurysms (AAA) have a prevalence of ~5% and when ruptured carry a mortality rate of ~90%. The pathophysiology of AAA encompasses a range of poorly understood biomechanical and biological processes. Currently the diameter of the aneurysm is used as a surrogate for the risk of rupture and patients with an aneurysm diameter greater than 55 mm are considered for elective surgical repair. However, this reliance on a single surrogate measure is too simplistic and does not take into account other physical and biological aspects of the AAA. We propose to evaluate the role of inflammation, proteolysis and neovascularisation in patients with AAA disease. We will compare novel magnetic resonance imaging techniques with blood and tissue measures of inflammation (c-reactive protein, cytokines, macrophage and leucocyte density), proteolytic activity (matrix metalloproteinases, tissue inhibitors of metalloproteinases) and neovascularisation (vessel density, endothelial progenitor cells). By comparing findings between patients with symptomatic and asymptomatic disease, this study will inform our understanding of the disease process as well as potentially identify risk markers of AAA instability that could be used to follow-up patients with asymptomatic disease.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 29
• Est. completion date: June 2010
• Est. primary completion date: June 2010
• Accepts healthy volunteers: No
• Gender: All
• Age group: 40 Years and older

Eligibility

Inclusion Criteria:

• AAA measuring >40mm in AP diameter on ultrasound scanning

• Age >40 years (patients younger than this with AAA may have a connective tissue disorder and a different aetiology to their disease)

• Considered to be suitable for standard infra-renal open surgical repair

Exclusion Criteria:

• Patients who are not deemed to be fit for open surgical repair

• Patients who are deemed to be suitable for a stent graft performed by the radiologists rather than the standard operation

• Contraindication to MRI scanning identified from MRI Safety Questionnaire (see attached)or claustrophobia

• Age <40 years

• Patients requiring emergent repair such that there is insufficient time available to complete the protocol

• Patients refusing to give consent

• Patients unable to give consent

• Pregnant women (contrast is teratogenic in animals)

• Intercurrent illness (may confound the results)

• Patients with a systemic inflammatory disorder or underlying malignancy

• Patients who require an emergency operation such that there is insufficient time to complete the study protocol

• Renal dysfunction (Creat >250 or eGFR<25)

• Hepatic dysfunction (Child's grade B or C)

Related Conditions & MeSH terms

• Aneurysm
• Aortic Aneurysm

Intervention

Drug:
• Sinerem administration
Single dose

Locations

Country	Name	City	State
United Kingdom	University of Edinburgh/Royal Infirmary of Edinburgh	Edinburgh	Midlothian

Sponsors (2)

Lead Sponsor	Collaborator
University of Edinburgh	British Heart Foundation

Country where clinical trial is conducted

United Kingdom, 

References & Publications (1)

Richards JM, Semple SI, MacGillivray TJ, Gray C, Langrish JP, Williams M, Dweck M, Wallace W, McKillop G, Chalmers RT, Garden OJ, Newby DE. Abdominal aortic aneurysm growth predicted by uptake of ultrasmall superparamagnetic particles of iron oxide: a pil — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in signal intensity in a Region of Interest on MRI scanning		24 hours after administration of Sinerem