Acute Mesenteric Ischemia Clinical Trial
— FARAMISOfficial title:
Plasma i-FABP as Predictor for Irreversible Bowel Ischemia After Interventional Re-vascularization in Patients With Acute Mesenteric Ischemia
In the FARAMIS study, we aim to investigate the longitudinal course of intestinal plasma
fatty acid binding protein (i-FABP) in patients with acute mesenteric ischemia (AMI)
undergoing primary percutaneous angiographic intervention.
The investigators postulate that patients with fully re-established intestinal blood flow
and vital intestines will display a significant drop of plasmatic i-FABP within 24 hours,
while patients requiring subsequent intestinal resection due to irreversible bowel necrosis
will not.
If true, patients requiring laparotomy and bowel resection could be identified and patients
in whom angiographic intervention led to successful cure of disease would not be exposed to
potentially perilous surgery.
Status | Recruiting |
Enrollment | 24 |
Est. completion date | June 2017 |
Est. primary completion date | June 2017 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - Presence of acute mesenteric ischemia due to stenosis of the superior mesenteric artery, thromboembolization of the superior mesenteric artery, non-occlusive mesenteric ischemia or acute portal vein thrombosis (as confirmed by CT scan) - The vascular anatomy is suitable for percutaneous revascularization - A primary endovascular re-vascularisation approach is intended based on an interdisciplinary decision by the visceral surgeon, the vascular surgeon and interventional radiologist. This therapeutic decision is made independently of the proposed FARAMIS study. - A peripheral or central line is present to perform repeated blood collections Exclusion Criteria: - Clinically or imaging results indicating that perforation of the bowel is present or suspected - Hemodynamic instability (shock) - Pre-existing severe liver or kidney damage (defined as spontaneous international normalized ratio >2 or creatinine >2 mg/dl.) - Anemia with hemoglobin concentration < 7g/dl - Pediatric patients |
Observational Model: Cohort, Time Perspective: Prospective
Country | Name | City | State |
---|---|---|---|
Germany | University Hospital Regensburg | Regensburg |
Lead Sponsor | Collaborator |
---|---|
University Hospital Regensburg | William Cook Europe |
Germany,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Levels of i-FABP, interleukine 6 and 8 | Association of increased levels of i-FABP, interleukine 6 and 8 with extension of intestinal necrosis according to the pathology report and occurrence of organ failure | 72 hours | No |
Primary | Post-interventional course of plasmatic i-FABP as reliable predictor for successful bowel revascularization | Subjects will be observed for 72 hours after percutaneous revascularization. Patients will then be divided into two groups: patients not requiring surgery and not dying from intestinal necrosis will be allocated to group A. Subjects who undergo surgery without signs of necrotic segments will also be attributed to group A. Patients in whom intestinal necrosis is confirmed by surgery or autopsy will belong to group B. To evaluate whether the post-interventional course of plasmatic i-FABP is a reliable predictor for successful revascularization, the minimum level of i-FABP at the time points 5, 30 and 120 Minutes is divided by the baseline (= before intervention) level of i-FABP. This ratio (R) reflects the decrease (or increase) of i-FABP after revascularization. ROC-analysis will be carried out and the area under the curve will be determined for different R-values. |
72 hours | No |
Secondary | Baseline level of i-FABP as predictor of bowel necrosis | 72 hours | No |
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