Angioplasty of Distal Lesions for Carriers of Inoperable Post-embolic HTP

NCT ID: NCT02844036

Last Updated: 2017-10-23

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

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

33 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-06-30

Study Completion Date

2017-10-31

Brief Summary

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Currently, the standard treatment for proximal thromboses lesions responsible for post-embolic pulmonary hypertension, is the surgical thromboendarterectomy. When the ravages are judged too distal or the patient is judged inoperable for a curative surgical gesture, there is no evidence of any therapeutic option, exept for K anti-vitamins for recurrent embolism. Prognosis is then pejorative with a 60% mortality at 5 years.

This study propose an alternative treatment for these patients in therapeutic "dead end". This is about applying arterial thrombosis technique to the pulmonary circulation.

Detailed Description

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Conditions

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Pulmonary Hypertension

Keywords

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Distal Lesions Post-embolic HTP Angioplasty

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Patients with a pulmonary hypertension

Pulmonary hypertension group 4 of Dana point, chronic thromboses lesions, thromboembolic.

Group Type EXPERIMENTAL

Percutaneous angioplasty

Intervention Type PROCEDURE

Balloon angioplasty

Intervention Type PROCEDURE

Right heart catheterization

Intervention Type PROCEDURE

Echocardiography

Intervention Type PROCEDURE

A six-minute walking test

Intervention Type OTHER

Functional respiratory investigations

Intervention Type PROCEDURE

Pulmonary tomography or pulmonary angiography

Intervention Type PROCEDURE

Biological parameters

Intervention Type OTHER

Interventions

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Percutaneous angioplasty

Intervention Type PROCEDURE

Balloon angioplasty

Intervention Type PROCEDURE

Right heart catheterization

Intervention Type PROCEDURE

Echocardiography

Intervention Type PROCEDURE

A six-minute walking test

Intervention Type OTHER

Functional respiratory investigations

Intervention Type PROCEDURE

Pulmonary tomography or pulmonary angiography

Intervention Type PROCEDURE

Biological parameters

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients over 18 years
* Patients with a pulmonary hypertension diagnosed by right catheterisation, with a mean arterial pressure \>30 mmHg and arterial pulmonary resistance \> 3 UW.
* Patients with group 4 (Dana point) pulmonary hypertension, thromboembolic.
* Chronic thrombosis visible to scanner, pulmonary IRM angiogram or to pulmonary angiogram.
* Patient's file refused by the reference center multidisciplinary coordination meetings for surgical thromboendartériectomy or refusal from the patient to be operate.
* Absence of counter-argument to the femoral venous or jugular way.
* Normal kidney function or moderatly degraded (clearance\>30 mL) or dialysed renal failure
* Persons affiliated to national social security
* Signed free consent by patients

Exclusion Criteria

* Pulmonary hypertension pos-embolic operated by thromboendarteriectomy
* Pulmonary hypertension Group 1 of Dana Point, meaning idiopathic, familial, post-anorectics, associate with a congenital heart disease associated to a scleroderma, associated to a chronic hemolytic disease
* Pulmonary hypertension Group 2 of Dana Point, associated with a left cardiovascular disease
* Pulmonary hypertension Group 3 of Dana Point, associated to a respiratory disease
* Pulmonary hypertension Group 5 of Dana Point, of unclear or multifactorial mechanism
* Hypersensitivity to HEXABRIX, to iodinated contrast product or one of its components
* Obvious thyrotoxicosis
* Protected major persons
* Pregnant or breastfeeding women
* Persons deprived of liberty
* Persons in emergency situations.
* No consent signed or approoved
* Persons no affiliated to national social security
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Grenoble

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Hélène Bouvaist, Doctor

Role: PRINCIPAL_INVESTIGATOR

Grenoble Hospital University

Locations

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UniversityHospitalGrenoble

La Tronche, , France

Site Status

Countries

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France

References

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Mizoguchi H, Ogawa A, Munemasa M, Mikouchi H, Ito H, Matsubara H. Refined balloon pulmonary angioplasty for inoperable patients with chronic thromboembolic pulmonary hypertension. Circ Cardiovasc Interv. 2012 Dec;5(6):748-55. doi: 10.1161/CIRCINTERVENTIONS.112.971077. Epub 2012 Nov 27.

Reference Type BACKGROUND
PMID: 23192917 (View on PubMed)

Sugimura K, Fukumoto Y, Satoh K, Nochioka K, Miura Y, Aoki T, Tatebe S, Miyamichi-Yamamoto S, Shimokawa H. Percutaneous transluminal pulmonary angioplasty markedly improves pulmonary hemodynamics and long-term prognosis in patients with chronic thromboembolic pulmonary hypertension. Circ J. 2012;76(2):485-8. doi: 10.1253/circj.cj-11-1217. Epub 2011 Dec 15.

Reference Type BACKGROUND
PMID: 22185711 (View on PubMed)

Fukumoto Y, Shimokawa H. Recent progress in the management of pulmonary hypertension. Circ J. 2011;75(8):1801-10. doi: 10.1253/circj.cj-11-0567. Epub 2011 Jul 11.

Reference Type BACKGROUND
PMID: 21747194 (View on PubMed)

Feinstein JA, Goldhaber SZ, Lock JE, Ferndandes SM, Landzberg MJ. Balloon pulmonary angioplasty for treatment of chronic thromboembolic pulmonary hypertension. Circulation. 2001 Jan 2;103(1):10-3. doi: 10.1161/01.cir.103.1.10.

Reference Type BACKGROUND
PMID: 11136677 (View on PubMed)

Jais X, D'Armini AM, Jansa P, Torbicki A, Delcroix M, Ghofrani HA, Hoeper MM, Lang IM, Mayer E, Pepke-Zaba J, Perchenet L, Morganti A, Simonneau G, Rubin LJ; Bosentan Effects in iNopErable Forms of chronIc Thromboembolic pulmonary hypertension Study Group. Bosentan for treatment of inoperable chronic thromboembolic pulmonary hypertension: BENEFiT (Bosentan Effects in iNopErable Forms of chronIc Thromboembolic pulmonary hypertension), a randomized, placebo-controlled trial. J Am Coll Cardiol. 2008 Dec 16;52(25):2127-34. doi: 10.1016/j.jacc.2008.08.059.

Reference Type BACKGROUND
PMID: 19095129 (View on PubMed)

Diggle PJ, Liang KY, Zeger SL. Analysis of longitudinal data. New York: Oxfiord University Press, 2000.

Reference Type BACKGROUND

Twisk JWR. Applied longitudinal analysis for epidemiology. Cambridge: Cambridge University Press, 2003.

Reference Type BACKGROUND

Mayer E, Jenkins D, Lindner J, D'Armini A, Kloek J, Meyns B, Ilkjaer LB, Klepetko W, Delcroix M, Lang I, Pepke-Zaba J, Simonneau G, Dartevelle P. Surgical management and outcome of patients with chronic thromboembolic pulmonary hypertension: results from an international prospective registry. J Thorac Cardiovasc Surg. 2011 Mar;141(3):702-10. doi: 10.1016/j.jtcvs.2010.11.024.

Reference Type BACKGROUND
PMID: 21335128 (View on PubMed)

Pepke-Zaba J, Jansa P, Kim NH, Naeije R, Simonneau G. Chronic thromboembolic pulmonary hypertension: role of medical therapy. Eur Respir J. 2013 Apr;41(4):985-90. doi: 10.1183/09031936.00201612. Epub 2013 Feb 8.

Reference Type BACKGROUND
PMID: 23397304 (View on PubMed)

de Perrot M, McRae K, Shargall Y, Pletsch L, Tan K, Slinger P, Ma M, Paul N, Moric J, Thenganatt J, Mak S, Granton JT. Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: the Toronto experience. Can J Cardiol. 2011 Nov-Dec;27(6):692-7. doi: 10.1016/j.cjca.2011.09.009. Epub 2011 Oct 21.

Reference Type BACKGROUND
PMID: 22018451 (View on PubMed)

Inami T, Kataoka M, Shimura N, Ishiguro H, Yanagisawa R, Taguchi H, Fukuda K, Yoshino H, Satoh T. Pulmonary edema predictive scoring index (PEPSI), a new index to predict risk of reperfusion pulmonary edema and improvement of hemodynamics in percutaneous transluminal pulmonary angioplasty. JACC Cardiovasc Interv. 2013 Jul;6(7):725-36. doi: 10.1016/j.jcin.2013.03.009. Epub 2013 Jun 14.

Reference Type BACKGROUND
PMID: 23769649 (View on PubMed)

Other Identifiers

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38RC13.440

Identifier Type: -

Identifier Source: org_study_id