Medico-economic Evaluation of Preoperative Cerebral Oximetry Monitoring During Carotid Endarterectomy

NCT ID: NCT01415648

Last Updated: 2023-11-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

TERMINATED

Clinical Phase

PHASE3

Total Enrollment

879 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-04-30

Study Completion Date

2016-04-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

In France, in 2007, 17 000 patients underwent carotid endarterectomy. The risk of having an ipsilateral postoperative stroke after carotid endarterectomy remains at 1-1.5%. There is no consensus concerning the best cerebral monitoring and hemodynamic optimisation during carotid cross-clamping.

The objective of this prospective, multicentric, double-blinded and randomized study is to evaluate the interest of continuous cerebral oximetry monitoring by INVOS™ cerebral oximeter to direct the hemodynamic optimisation during carotid endarterectomy and reduce the new-onset of postoperative radiological (MRI) ischemic lesions. A cost/effectiveness analysis will be conducted to estimate the impact of this monitoring versus standard care on direct and indirect postoperative costs during 120 days.

A substudy will evaluate the effect of this monitoring on neurocognitive outcome and on a serum marker of brain injury, protein S-100B

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

After consent, patients will be randomized in two groups: one group with continuous per operative cerebral oximetry monitoring associated with hemodynamic optimisation algorithm (excluding norepinephrine) if cerebral oximetry decrease more than 15% under the preoperative baseline; the second group is continuously monitored with cerebral oximeter but this latter is blinded to the medical team, the alarm switch off , and patients are managed with the standard care of the centre.

All patients have a preoperative and a postoperative diffusion cerebral MRI to detect new onset of cerebral ischemic lesion. The amount and the volume of cerebral ischemic lesions will be scored to compare groups.

Quality of life as well as direct (medical and nonmedical) and indirect costs were collected using questionnaires during the 120 postoperative days.

A substudy including 200 patients will be conducted to compare the two groups concerning postoperative protein S-100B level and a composite score of neurocognitive tests (measured pre- and postoperatively) The trial will be conducted according to GCP

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Internal Carotid Stenosis

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

open NIRS

continuous per operative cerebral oximetry monitoring (using INVOS™ cerebral oximeter) associated with hemodynamic optimisation algorithm (excluding norepinephrine) if cerebral oximetry decrease more than 15% under the preoperative baseline

Group Type EXPERIMENTAL

cerebral oximetry monitoring using INVOS™ and hemodynamic optimisation

Intervention Type OTHER

continuous per operative cerebral oximetry monitoring associated with hemodynamic optimisation algorithm (excluding norepinephrine) if cerebral oximetry decrease more than 15% under the preoperative baseline

Blinded NIRS

Continuously monitored with cerebral oximeter but this latter is blinded to the medical team, the alarm switch off , and patients are managed with the standard care of the centre

Group Type SHAM_COMPARATOR

standard cerebral monitoring and hemodynamic optimisation

Intervention Type OTHER

the patient is continously monitored with cerebral oximeter but this latter is blinded to the medical team, the alarm switch off , and patients are managed with the standard care of the centre.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

cerebral oximetry monitoring using INVOS™ and hemodynamic optimisation

continuous per operative cerebral oximetry monitoring associated with hemodynamic optimisation algorithm (excluding norepinephrine) if cerebral oximetry decrease more than 15% under the preoperative baseline

Intervention Type OTHER

standard cerebral monitoring and hemodynamic optimisation

the patient is continously monitored with cerebral oximeter but this latter is blinded to the medical team, the alarm switch off , and patients are managed with the standard care of the centre.

Intervention Type OTHER

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

INVOS™

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Patients (male-female) over 18 y.o.
* Presenting an internal carotid stenosis requiring surgery
* Mini Mental State Examination \>24 during preoperative examination

Exclusion Criteria

* Severe renal failure or requiring dialysis
* Liver failure or cirrhosis (Child class ≥ B) or prothrombin activity\<50%
* Heart failure (NYHA ≥ III), left ventricular ejection fraction \< 40%, acute coronary syndrome,
* Associated surgery
* Pregnancy
* Contraindication to MRI
* History of allergy to modified gelatine or starch
* History of allergy to adhesive part of electrode
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Ministry of Health, France

OTHER_GOV

Sponsor Role collaborator

Nantes University Hospital

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Yann Le Teurnier, MD

Role: PRINCIPAL_INVESTIGATOR

Nantes University Hospital

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Besancon University Hospital "Hôpital Jean Minjoz"

Besançon, , France

Site Status

Bordeaux University Hospital "Haut Lévêque"

Bordeaux, , France

Site Status

Bordeaux University Hospital "Hôpital Pellegrin"

Bordeaux, , France

Site Status

Brest University Hospital "La Cavale Blanche"

Brest, , France

Site Status

Caen University Hospital "Côte de Nacre"

Caen, , France

Site Status

Dijon University Hospital "Le Bocage"

Dijon, , France

Site Status

Le Mans Hospital

Le Mans, , France

Site Status

Hospital de Marie Lannelongue Plessis Robinson

Le Plessis-Robinson, , France

Site Status

Lyon University Hospital "Hôpital Edouard Herriot"

Lyon, , France

Site Status

Marseille University Hospital "Hôpital de la Timone"

Marseille, , France

Site Status

Nantes University Hospital

Nantes, , France

Site Status

"Nouvelles Cliniques Nantaises"

Nantes, , France

Site Status

Nice University Hospital "Saint-Roch"

Nice, , France

Site Status

"Groupe Hospitalier Saint-Joseph"

Paris, , France

Site Status

"Hôpital Européen Georges Pompidou"

Paris, , France

Site Status

Reims University Hospital "Robert Debré"

Reims, , France

Site Status

Rennes University Hospital "Pontchaillou"

Rennes, , France

Site Status

Strasbourg University Hospital

Strasbourg, , France

Site Status

Toulouse University Hospital

Toulouse, , France

Site Status

Countries

Review the countries where the study has at least one active or historical site.

France

References

Explore related publications, articles, or registry entries linked to this study.

Le Teurnier Y, Rozec B, Degryse C, Levy F, Miliani Y, Godet G, Daccache G, Truc C, Steinmetz E, Ouattara A, Cholley B, Malinovsky JM, Portier D, Dupont G, Liutkus D, Viard P, Pere M, Daumas-Duport B, Magras PA, Vourc'h M; EMOCAR Study Group. Optimization of cerebral oxygenation based on regional cerebral oxygen saturation monitoring during carotid endarterectomy: a Phase III multicenter, double-blind randomized controlled trial. Anaesth Crit Care Pain Med. 2024 Aug;43(4):101388. doi: 10.1016/j.accpm.2024.101388. Epub 2024 May 4.

Reference Type DERIVED
PMID: 38710323 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

2010-A01167-32

Identifier Type: OTHER

Identifier Source: secondary_id

STIC/10/02

Identifier Type: -

Identifier Source: org_study_id