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Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT06260475
Other study ID # IUA - 246-18
Secondary ID
Status Not yet recruiting
Phase
First received
Last updated
Start date March 1, 2024
Est. completion date December 31, 2024

Study information

Verified date February 2024
Source Universidade do Porto
Contact n/a
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

This study aims to evaluate the clinical, imaging results of endovascular revascularization of the aorto-iliac sector in comparison with aortobifemoral bypass and the hybrid approach, in patients with atherosclerotic disease of the iliac sector classified as type C and D by the TransAtlantic Inter-Society Consensus (TASC II


Description:

Open surgery repair with Aortobifemoral Bypass (ABF) remains the gold standard revascularization technique in patients with lifestyle-limiting intermittent claudication (IC) and chronic limb-threatening ischemia due to extensive Aortoiliac Occlusive Disease (AIOD), particularly in Trans-Atlantic Inter-Society Consensus II (TASC-II) type D lesions The ABF procedure has proven safe, effective, and durable, particularly considering its high long-term patency rates (85%-90% at five years and 75%-80% at ten years) despite its significant peri-operative associated morbidity (1). On the other hand, endovascular treatment (EVT) offers an attractive alternative with durable results (four- or 5-year primary and secondary patency rates ranged from 60% to 86% and 80% to 98%, respectively), especially in less extensive AIOD, while also providing less perioperative morbidity, making it generally preferable for patients with more severe comorbid conditions. Thus, surgical approaches to extensive AIOD have changed considerably over the last years, primarily due to increased EVT, particularly with the uncovered aortoiliac stenting (AIS). While TASC II provides an anatomical framework to compare therapeutic techniques, the advancement of endovascular techniques has led to many trials suggesting that endovascular management of TASC II C and D lesions is a potential alternative treatment to open strategies. It is attractive for patients with high surgical risk, given the substantially less perioperative morbidity and mortality compared to ABF This study aims to evaluate the clinical, imaging results of endovascular revascularization of the aorto-iliac sector in comparison with aortobifemoral bypass and the hybrid approach, in patients with atherosclerotic disease of the iliac sector classified as type C and D by the TransAtlantic Inter-Society Consensus (TASC II).


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 500
Est. completion date December 31, 2024
Est. primary completion date August 31, 2024
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Patients with peripheral arterial/atherosclerotic disease of the aorto-iliac sector undergoing direct, hybrid or endovascular surgical correction with TransAtlantic Inter-Society Consensus (TASC II) type D classification(12). - Age >18 years old Exclusion Criteria: - Synchronous aortoiliac aneurysmatic/ectasic disease (aorta AP diameter >25 mm)

Study Design


Intervention

Procedure:
Aortobifemoral bypass
Open surgery with aortic and iliac reconstruction
aortoiliac stenting
Endovascular reconstruction of aortic and iliac arterial obstruction: Balloon angioplasty may be performed initially to dilate the narrowed segment of the iliac artery. Subsequently, a stent delivery system is advanced over the wire and positioned across the lesion. The stent is deployed under fluoroscopic guidance to expand and scaffold the diseased artery, restoring blood flow. Vascular - iliac dedicated Stent - any brand

Locations

Country Name City State
Portugal Centro Hospitalar Universitário de São João, EPE Porto
Portugal Faculdade de Medicina da Universidade do Porto Porto

Sponsors (9)

Lead Sponsor Collaborator
Universidade do Porto Centro Hospitalar de Vila Nova de Gaia/Espinho, Centro Hospitalar do Porto, Clinical Centre of Serbia, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro, University of Bari, University of Nis, University of Padova, University of Trieste

Country where clinical trial is conducted

Portugal, 

References & Publications (2)

Groot Jebbink E, Holewijn S, Slump CH, Lardenoije JW, Reijnen MMPJ. Systematic Review of Results of Kissing Stents in the Treatment of Aortoiliac Occlusive Disease. Ann Vasc Surg. 2017 Jul;42:328-336. doi: 10.1016/j.avsg.2017.01.009. Epub 2017 Apr 6. — View Citation

Jongkind V, Akkersdijk GJ, Yeung KK, Wisselink W. A systematic review of endovascular treatment of extensive aortoiliac occlusive disease. J Vasc Surg. 2010 Nov;52(5):1376-83. doi: 10.1016/j.jvs.2010.04.080. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Other Intensive care unit instay Intensive care unit instay - days) until 30 days
Other acute kidney injury (AKI) AKI according to Riffle criteria until 30 days
Primary Major Amputation Amputation above the ankle through study completion, an average of 3 years
Primary Cardiovascular Death Death from cardiovascular disease through study completion, an average of 3 years
Primary acute myorcardial infartion According to the 4th definition of Myocardial infarction through study completion, an average of 3 years
Secondary Major Adverse Limb Events Amputation above the ankle, arterial thrombosis of the limb, binary restenosis through study completion, an average of 3 years
Secondary Major adverse cardiovascular events acute myocardial infarction; acute heart faillure, cardiovascular death, coronary reintervention through study completion, an average of 3 years
Secondary Death Diagnosed by a physician through study completion, an average of 3 years
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