Evaluation of Contrast-Enhanced Ultrasound to Detect Endoleaks After Endovascular Aortic Aneurysm Repair
NCT ID: NCT01005212
Last Updated: 2024-04-12
Study Results
Results available
Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.
View full resultsBasic Information
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Recruitment Status
COMPLETED
Total Enrollment
20 participants
Study Classification
OBSERVATIONAL
Study Start Date
2008-01-31
Study Completion Date
2010-09-30
Brief Summary
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This study will be a cross-sectional survey of interobserver variability associated with contrast enhanced ultrasound (CEUS) to detect endoleaks using computed tomographic angiography (CTA) as the practice standard. The investigators will enroll 40 consecutive patients undergoing endovascular abdominal aortic aneurysm repair (EVAR). At the first follow-up visit after the procedure, participants will undergo two abdominal ultrasound examinations with and without contrast, and one CTA. Analyses will be conducted to examine interobserver variability in the detection and characterization of endoleaks using contrast-enhanced ultrasound (CEUS). Other endpoints include examination of sensitivity and specificity of CEUS compared to CTA, and characterization of the number and types of endoleaks detected.
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Detailed Description
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Conditions
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Endoleaks
Study Design
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Observational Model Type
CASE_ONLY
Study Time Perspective
PROSPECTIVE
Interventions
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Definity
An intravenous line will be placed and 1.3 mL of the ultrasound contrast agent DEFINITY® will be added to 50 mL sterile saline. Flow will be initiated at 4.0 mL/minute and adjusted for optimal imaging. A maximum of 1.3 mL or one vial of ultrasound contrast will be used per patient per session according to the manufacturer's guidelines.
Intervention Type
DRUG
Eligibility Criteria
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Inclusion Criteria
1. Age 18 years of age or greater;
2. Diagnosed with abdominal aortic aneurysm and has undergone or is scheduled to undergo endovascular repair procedure.
3. Has not completed the first scheduled post-treatment follow-up exam
4. Voluntary participation and signature of IRB-approved informed consent.
2. Diagnosed with abdominal aortic aneurysm and has undergone or is scheduled to undergo endovascular repair procedure.
3. Has not completed the first scheduled post-treatment follow-up exam
4. Voluntary participation and signature of IRB-approved informed consent.
Exclusion Criteria
1. Inability to consent (includes non-English speaking patients)
2. Has already completed the first scheduled post-treatment follow-up exam.
3. Clinical instability;
4. Pregnancy / breast feeding;
5. Known allergy to perflutren;
6. Known or suspected right-to-left, bi-directional, or transient right-to-left cardiac shunts (based on manufacturer recommendations for use);
7. Recent heart attack (\<6 months), unstable angina or uncontrolled cardiopulmonary disease
8. Clinically unstable or recent worsening congestive heart failure (based on FDA warning)
9. Serious ventricular arrhythmias or at high risk for arrhythmias
10. Respiratory failure (based on FDA warning)
11. Severe emphysema, pulmonary emboli or other conditions that compromise pulmonary arterial vasculature (based on FDA warning)
12. Any reason judged by the investigators to hamper inclusion.
2. Has already completed the first scheduled post-treatment follow-up exam.
3. Clinical instability;
4. Pregnancy / breast feeding;
5. Known allergy to perflutren;
6. Known or suspected right-to-left, bi-directional, or transient right-to-left cardiac shunts (based on manufacturer recommendations for use);
7. Recent heart attack (\<6 months), unstable angina or uncontrolled cardiopulmonary disease
8. Clinically unstable or recent worsening congestive heart failure (based on FDA warning)
9. Serious ventricular arrhythmias or at high risk for arrhythmias
10. Respiratory failure (based on FDA warning)
11. Severe emphysema, pulmonary emboli or other conditions that compromise pulmonary arterial vasculature (based on FDA warning)
12. Any reason judged by the investigators to hamper inclusion.
Minimum Eligible Age
18 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
No
Sponsors
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Lantheus Medical Imaging
INDUSTRY
Sponsor Role
collaborator
The Methodist Hospital Research Institute
OTHER
Sponsor Role
collaborator
E. Peden, MD
OTHER
Sponsor Role
lead
Responsible Party
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E. Peden, MD
Sponsor-Investigator/Principal Investigator
Responsibility Role
SPONSOR_INVESTIGATOR
Principal Investigators
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Eric Peden, MD
Role: PRINCIPAL_INVESTIGATOR
Houston Methodist Hosptial
Locations
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Houston Methodist Hospital; Department of Cardiovascualr Surgery
Houston, Texas, United States
Site Status
Houston Methodist Hospital; Department of Cardiovascular Surgery
Houston, Texas, United States
Site Status
Countries
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United States
References
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Baum RA, Carpenter JP, Cope C, Golden MA, Velazquez OC, Neschis DG, Mitchell ME, Barker CF, Fairman RM. Aneurysm sac pressure measurements after endovascular repair of abdominal aortic aneurysms. J Vasc Surg. 2001 Jan;33(1):32-41. doi: 10.1067/mva.2001.111807.
Reference Type
BACKGROUND
Baum RA, Carpenter JP, Stavropoulous SW, Fairman RM. Diagnosis and management of type 2 endoleaks after endovascular aneurysm repair. Tech Vasc Interv Radiol. 2001 Dec;4(4):222-6. doi: 10.1016/s1089-2516(01)90012-5.
Reference Type
BACKGROUND
Bargellini I, Napoli V, Petruzzi P, Cioni R, Vignali C, Sardella SG, Ferrari M, Bartolozzi C. Type II lumbar endoleaks: hemodynamic differentiation by contrast-enhanced ultrasound scanning and influence on aneurysm enlargement after endovascular aneurysm repair. J Vasc Surg. 2005 Jan;41(1):10-8. doi: 10.1016/j.jvs.2004.10.037.
Reference Type
BACKGROUND
Bendick PJ, Bove PG, Long GW, Zelenock GB, Brown OW, Shanley CJ. Efficacy of ultrasound scan contrast agents in the noninvasive follow-up of aortic stent grafts. J Vasc Surg. 2003 Feb;37(2):381-5. doi: 10.1067/mva.2003.17.
Reference Type
BACKGROUND
Bromley PJ, Kaufman JA. Abdominal aortic aneurysms before and after endograft implantation: evaluation by computed tomography. Tech Vasc Interv Radiol. 2001 Mar;4(1):15-26. doi: 10.1053/tvir.2001.23090.
Reference Type
BACKGROUND
Carrafiello G, Recaldini C, Lagana D, Piffaretti G, Fugazzola C. Endoleak detection and classification after endovascular treatment of abdominal aortic aneurysm: value of CEUS over CTA. Abdom Imaging. 2008 May-Jun;33(3):357-62. doi: 10.1007/s00261-007-9268-3.
Reference Type
BACKGROUND
Chuter TA, Faruqi RM, Sawhney R, Reilly LM, Kerlan RB, Canto CJ, Lukaszewicz GC, Laberge JM, Wilson MW, Gordon RL, Wall SD, Rapp J, Messina LM. Endoleak after endovascular repair of abdominal aortic aneurysm. J Vasc Surg. 2001 Jul;34(1):98-105. doi: 10.1067/mva.2001.111487.
Reference Type
BACKGROUND
Dill-Macky MJ, Wilson SR, Sternbach Y, Kachura J, Lindsay T. Detecting endoleaks in aortic endografts using contrast-enhanced sonography. AJR Am J Roentgenol. 2007 Mar;188(3):W262-8. doi: 10.2214/AJR.05.0532.
Reference Type
BACKGROUND
Deaton DH, Makaroun MS, Fairman RM. Endoleak: predictive value for aneurysm growth at 3 years. Ann Vasc Surg. 2002 Jan;16(1):37-42. doi: 10.1007/s10016-001-0129-1. Epub 2002 Jan 16.
Reference Type
BACKGROUND
Eskandari MK, Yao JS, Pearce WH, Rutherford RB, Veith FJ, Harris P, Bernhard VM, Becker GJ, Morasch MD, Chrisman HB, Ryu RK, Matsumura JS. Surveillance after endoluminal repair of abdominal aortic aneurysms. Cardiovasc Surg. 2001 Oct;9(5):469-71. doi: 10.1016/s0967-2109(01)00044-8. No abstract available.
Reference Type
BACKGROUND
Giannoni MF, Palombo G, Sbarigia E, Speziale F, Zaccaria A, Fiorani P. Contrast-enhanced ultrasound imaging for aortic stent-graft surveillance. J Endovasc Ther. 2003 Apr;10(2):208-17. doi: 10.1177/152660280301000208.
Reference Type
BACKGROUND
Giannoni MF, Fanelli F, Citone M, Cristina Acconcia M, Speziale F, Gossetti B. Contrast ultrasound imaging: the best method to detect type II endoleak during endovascular aneurysm repair follow-up. Interact Cardiovasc Thorac Surg. 2007 Jun;6(3):359-62. doi: 10.1510/icvts.2006.137265. Epub 2007 Jan 8.
Reference Type
BACKGROUND
Henao EA, Hodge MD, Felkai DD, McCollum CH, Noon GP, Lin PH, Lumsden AB, Bush RL. Contrast-enhanced Duplex surveillance after endovascular abdominal aortic aneurysm repair: improved efficacy using a continuous infusion technique. J Vasc Surg. 2006 Feb;43(2):259-64; discussion 264. doi: 10.1016/j.jvs.2005.09.045.
Reference Type
BACKGROUND
Heilberger P, Schunn C, Ritter W, Weber S, Raithel D. Postoperative color flow duplex scanning in aortic endografting. J Endovasc Surg. 1997 Aug;4(3):262-71. doi: 10.1177/152660289700400305.
Reference Type
BACKGROUND
Hiatt MD, Rubin GD. Surveillance for endoleaks: how to detect all of them. Semin Vasc Surg. 2004 Dec;17(4):268-78. doi: 10.1053/j.semvascsurg.2004.09.003.
Reference Type
BACKGROUND
Jaakkola P, Hippelainen M, Farin P, Rytkonen H, Kainulainen S, Partanen K. Interobserver variability in measuring the dimensions of the abdominal aorta: comparison of ultrasound and computed tomography. Eur J Vasc Endovasc Surg. 1996 Aug;12(2):230-7. doi: 10.1016/s1078-5884(96)80112-2.
Reference Type
BACKGROUND
Jones WB, Taylor SM, Kalbaugh CA, Joels CS, Blackhurst DW, Langan EM 3rd, Gray BH, Youkey JR. Lost to follow-up: a potential under-appreciated limitation of endovascular aneurysm repair. J Vasc Surg. 2007 Sep;46(3):434-40; discussion 440-1. doi: 10.1016/j.jvs.2007.05.002.
Reference Type
BACKGROUND
McWilliams RG, Martin J, White D, Gould DA, Rowlands PC, Haycox A, Brennan J, Gilling-Smith GL, Harris PL. Detection of endoleak with enhanced ultrasound imaging: comparison with biphasic computed tomography. J Endovasc Ther. 2002 Apr;9(2):170-9. doi: 10.1177/152660280200900206.
Reference Type
BACKGROUND
Muthu C, Gordon M, Buckenham T, Lewis D. The case for lifelong follow-up after endovascular aneurysm repair. N Z Med J. 2005 Nov 11;118(1225):U1729. No abstract available.
Reference Type
BACKGROUND
Napoli V, Bargellini I, Sardella SG, Petruzzi P, Cioni R, Vignali C, Ferrari M, Bartolozzi C. Abdominal aortic aneurysm: contrast-enhanced US for missed endoleaks after endoluminal repair. Radiology. 2004 Oct;233(1):217-25. doi: 10.1148/radiol.2331031767.
Reference Type
BACKGROUND
Resch T, Ivancev K, Brunkwall J, Nyman U, Malina M, Lindblad B. Distal migration of stent-grafts after endovascular repair of abdominal aortic aneurysms. J Vasc Interv Radiol. 1999 Mar;10(3):257-64; discussion 265-6. doi: 10.1016/s1051-0443(99)70027-8.
Reference Type
BACKGROUND
Rydberg J, Lalka S, Johnson M, Cikrit D, Dalsing M, Sawchuk A, Shafique S. Characterization of endoleaks by dynamic computed tomographic angiography. Am J Surg. 2004 Nov;188(5):538-43. doi: 10.1016/j.amjsurg.2004.07.011.
Reference Type
BACKGROUND
Sawhney R, Kerlan RK, Wall SD, Chuter TA, Ruiz DE, Canto CJ, LaBerge JM, Reilly LM, Yee J, Wilson MW, Jean-Claude J, Faruqi RM, Gordon RL. Analysis of initial CT findings after endovascular repair of abdominal aortic aneurysm. Radiology. 2001 Jul;220(1):157-60. doi: 10.1148/radiology.220.1.r01jl22157.
Reference Type
BACKGROUND
Singh K, Jacobsen BK, Solberg S, Bonaa KH, Kumar S, Bajic R, Arnesen E. Intra- and interobserver variability in the measurements of abdominal aortic and common iliac artery diameter with computed tomography. The Tromso study. Eur J Vasc Endovasc Surg. 2003 May;25(5):399-407. doi: 10.1053/ejvs.2002.1856.
Reference Type
BACKGROUND
Singh K, Jacobsen BK, Solberg S, Kumar S, Arnesen E. The difference between ultrasound and computed tomography (CT) measurements of aortic diameter increases with aortic diameter: analysis of axial images of abdominal aortic and common iliac artery diameter in normal and aneurysmal aortas. The Tromso Study, 1994-1995. Eur J Vasc Endovasc Surg. 2004 Aug;28(2):158-67. doi: 10.1016/j.ejvs.2004.03.018.
Reference Type
BACKGROUND
Tillich M, Hausegger KA, Tiesenhausen K, Tauss J, Groell R, Szolar DH. Helical CT angiography of stent-grafts in abdominal aortic aneurysms: morphologic changes and complications. Radiographics. 1999 Nov-Dec;19(6):1573-83. doi: 10.1148/radiographics.19.6.g99no091573.
Reference Type
BACKGROUND
Wanhainen A, Bergqvist D, Bjorck M. Measuring the abdominal aorta with ultrasonography and computed tomography - difference and variability. Eur J Vasc Endovasc Surg. 2002 Nov;24(5):428-34. doi: 10.1053/ejvs.2002.1748.
Reference Type
BACKGROUND
White GH, Yu W, May J, Chaufour X, Stephen MS. Endoleak as a complication of endoluminal grafting of abdominal aortic aneurysms: classification, incidence, diagnosis, and management. J Endovasc Surg. 1997 May;4(2):152-68. doi: 10.1177/152660289700400207.
Reference Type
BACKGROUND
White GH, May J, Petrasek P, Waugh R, Stephen M, Harris J. Endotension: an explanation for continued AAA growth after successful endoluminal repair. J Endovasc Surg. 1999 Nov;6(4):308-15. doi: 10.1583/1074-6218(1999)0062.0.CO;2.
Reference Type
BACKGROUND
Other Identifiers
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1007-0202
Identifier Type: OTHER
Identifier Source: secondary_id
Pro00001211
Identifier Type: -
Identifier Source: org_study_id
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