Evaluation of the Severity of Right to Left Shunt in PFO Patients After Systemic Embolism

NCT ID: NCT04610463

Last Updated: 2020-10-30

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-09-25

Study Completion Date

2023-12-31

Brief Summary

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The aim of the project is to identify new risk indicators of PFO. The evaluation of the R-L shunt is based on the newly developed precise measurement technique. Moreover, this measurement of R-L shunt is feasible in a case when R-L shunt is present only intermittently. Multicentric study with 150 patients.

Detailed Description

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The aim of the proposed project is to identify new risk indicators of PFO. The evaluation of the R-L shunt is based on the newly developed precise measurement technique. Moreover, this measurement of R-L shunt is feasible in a case when R-L shunt is present only intermittently.

Detection and quantification of R-L shunt will be realized by the original INNTHERM® ® system (Innova Medical s.r.o., Velká Dobrá). This system is based on the principle of thermodilution.

The basic assumption of our study is the hypothesis, that the size of the R-L shunt (and especially its maximum size during intra-abdominal pressure increase) is a risk factor for the development of paradoxical embolism (from pulmonary to systemic circulation). The most critical consequence of paradoxical embolism is the development of ischemic stroke.

Such measurement with an unequivocal accuracy has never been done so far, due a lack of technology precise enough.

Precise quantification of R-L shunt will allow a more accurate prediction of high-risk patients, especially after correlation with commonly used methods. PFO is now an indication for implantation of percutaneous occlusion device only in case of secondary prevention of stroke, i.e. in a group of patients who have had an ischemic stroke.

Prospectively, precise and better identification of a risk group of these patients could lead to cost reduction of treatment. This cost reduction is crucial for young working-age patients who can be treated before a major irreversible brain injury occurs.

A parameter applicable in primary prevention saves the cost of ischemic stroke treatment and other systemic embolism; additionally it will contribute to cost reduction during aftercare treatment.

Conditions

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Patent Foramen Ovale Embolism

Keywords

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Patent foramen ovale Systemic Embolism Cardiac Shunt Right to left shunt Hemodynamics

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Standard

Subjects indicated for patent foramen ovale closure to prevent a relapse of systemic embolism

Group Type OTHER

Cardiac flow measurement

Intervention Type DIAGNOSTIC_TEST

Catheterized hemodynamics evaluation - a measurement of systemic flow and pulmonary flow, R-L shunt, L-R shunt using the INNTHERM® system, prior to PFO closure using a common PFO-occluder (within one catheterization intervention).

Interventions

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Cardiac flow measurement

Catheterized hemodynamics evaluation - a measurement of systemic flow and pulmonary flow, R-L shunt, L-R shunt using the INNTHERM® system, prior to PFO closure using a common PFO-occluder (within one catheterization intervention).

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

1. Male and female patients aged ≥18 and \< 60 years
2. Cryptogenic stroke or Systemic embolization due to paradoxical embolization via Patent Foramen Ovale
3. The patient indicated for occlusion of PFO with catheter occluder

Exclusion Criteria

1. Inability to perform spiroergometry
2. Inability to perform Transesophageal echocardiography (TEE)
3. Inability to perform proper Valsalva maneuver
4. Inability to understand and/or signed informed consent form
5. Contraindication of Patent Foramen Ovale occlusion by any medical reason or patient refusal
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital Hradec Kralove

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Fakultní nemocnice Brno

Brno, , Czechia

Site Status NOT_YET_RECRUITING

I. interní kardioangiologická klinika, Fakultní nemocnice Hradec Králové

Hradec Králové, , Czechia

Site Status RECRUITING

Fakultní nemocnice Ostrava

Ostrava, , Czechia

Site Status NOT_YET_RECRUITING

Všeobecná fakultní nemocnice v Praze

Prague, , Czechia

Site Status NOT_YET_RECRUITING

Institut klinické a experimentální medicíny (IKEM)

Prague, , Czechia

Site Status RECRUITING

Nemocnice Na Homolce

Prague, , Czechia

Site Status NOT_YET_RECRUITING

Countries

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Czechia

Central Contacts

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Josef Šťásek

Role: CONTACT

Phone: +420495832248

Email: [email protected]

Johana Krempová

Role: CONTACT

Phone: +420601087319

Email: [email protected]

Facility Contacts

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Martin Poloczek

Role: primary

Josef Šťásek

Role: primary

Marian Branny

Role: primary

Tomáš Kovárník

Role: primary

Michael Želízko

Role: primary

Martin Mates

Role: primary

Other Identifiers

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MEASURE-PFO

Identifier Type: -

Identifier Source: org_study_id