Evaluation of Acute Lower Limb Ischemia

NCT ID: NCT05138679

Last Updated: 2023-10-31

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

Total Enrollment

700 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-12-01

Study Completion Date

2023-08-31

Brief Summary

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The primary objective of this study is to evaluate the effect of different treatment modalities on clinical outcome of patients suffering from acute lower limb ischemia (ALI). Depending on clinical presentation, anatomical as well as technical considerations, different treatment options are available for revascularisation of affected limbs. Using an observational, international, multicentric study design (min. patient number of 500), the defined primary endpoint of the study, amputation-free survival 90 days after the diagnosis of ALI, will be evaluated.

Detailed Description

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Recently published clinical guidelines highlighted that the available evidence on the management of acute lower limb ischemia (ALI) is mostly outdated and includes only small patient cohorts. Depending on the patient's characteristics, the duration of ischemic symptoms as well as the cause of ALI and the anatomical lesion, different treatment options are available and need to be compared regarding clinical outcome.

With the knowledge about the heterogeneity of patients suffering from ALI, a multicentre observational study design has the potential to give results on influence of several factors (patient related factors, treatment related factors) on clinical outcome of patients with lower extremity ALI. In contrast, a randomized controlled trial would not be feasible as heterogeneity of patients would lead to limitations in the recruitment of patients.

The primary objective of this study is to evaluate the effect of different treatment modalities on clinical outcome of patients suffering from acutle lower limb ischemia. Depending on clinical presentation, anatomical as well as technical considerations, different treatment options are available for revascularisation of affected limbs. Using an observational, international, multicentric study design (min. patient number of 500), the defined primary endpoint of the study, amputation-free survival 90 days after the diagnosis of ALI, will be evaluated.

The secondary objectives of this study are the identification of factors having an effect on the primary endpoint . These factors are:

* Demographic data (age, gender, Body Mass Index,
* Cardiovascular risk factors (diabetes, arterial hypertension, dyslipidemia, smoking history)
* COVID-19 anamnesis (infectious status; vaccination status)
* Pre-existing diseases (Arterial fibrillation, chronic kidney disease, hemodialysis, coronary artery disease, COVID infection in medical history, pulmonary disease)
* Risk factors for ALI (peripheral arterial disease, aortic aneurysm or dissection, arterial embolization in medical history, malignant disease, peripheral arterial aneurysm, previous stroke, thrombophilia, revascularization procedure on ipsilateral limb)
* Pre-existing medication (antiplatelet, oral anticoagulation, statins)
* Clinical presentation (Rutherford ischemia classification, Cause of ALI, anatomical level of arterial occlusion, diagnostic imaging modality)
* Details on performed intervention (time of ischemia, periprocedural heparin administration, type of procedure, technical details on performed procedure, compartment syndrome with need for fasciotomy)
* Outcome parameters (Survival, Rutherford ischemia classification, residual sensory or motor deficit, impaired walking distance, need for reintervention, major bleeding periprocedural, access site complications, organ failure) 30 and 90 days after diagnosis of ALI.

Conditions

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Acute Limb Ischemia

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Acute lower limb ischemia

Patients with acute lower limb ischemia (older than 18 years)

Revascularization

Intervention Type PROCEDURE

Endovascular or surgical restoration of arterial blood flow.

Primary major amputation

Intervention Type PROCEDURE

Primary below- or above knee major amputation without prior revascularization.

Best medical treatment

Intervention Type OTHER

Conservative treatment of acute lower limb ischemia - without prior revascularization.

Interventions

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Revascularization

Endovascular or surgical restoration of arterial blood flow.

Intervention Type PROCEDURE

Primary major amputation

Primary below- or above knee major amputation without prior revascularization.

Intervention Type PROCEDURE

Best medical treatment

Conservative treatment of acute lower limb ischemia - without prior revascularization.

Intervention Type OTHER

Other Intervention Names

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Surgical embolectomy Peripheral bypass Catheter directed thrombolysis Catheter guided aspiration Catheter guided atherectomy Percutaneous transluminal angioplasty

Eligibility Criteria

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Inclusion Criteria

* Acute lower limb ischemia (Rutherford Categories I-III)

Exclusion Criteria

* No informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical University Innsbruck

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Florian K Enzmann, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Vascular Surgery, Medical University of Innsbruck

Alexandra Gratl, MD

Role: PRINCIPAL_INVESTIGATOR

Department of Vascular Surgery, Medical University of Innsbruck

Locations

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Medical University of Innsbruck, Department of Vascular Surgery

Innsbruck, , Austria

Site Status

Department of General Surgery, Division of Vascular Surgery, Medical University of Vienna

Vienna, , Austria

Site Status

Department of Vascular and Endovascular Surgery, Hospital Ottakring

Vienna, , Austria

Site Status

Department of Cardio-Vascular Surgery, Clinic Floridsdorf and Karl Landsteiner Institute for Cardio-Vascular Research

Vienna, , Austria

Site Status

University Hospital Merkur

Zagreb, , Croatia

Site Status

Department of Vascular Surgery, Hospital of Antibes Juan-les-Pins

Antibes, , France

Site Status

Department of Vascular Surgery, Bordeaux University Hospital

Bordeaux, , France

Site Status

Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris

Boulogne-Billancourt, , France

Site Status

Department of Vascular and Endovascular Surgery, Brest University Hospital

Brest, , France

Site Status

Department of Vascular Surgery, Henri Mondor University Hospital

Créteil, , France

Site Status

Department of Vascular Surgery, University Hospital of Dijon

Dijon, , France

Site Status

Vascular Surgery Department, Hospices Civils de Lyon

Lyon, , France

Site Status

Department of Vascular Surgery, University Hospital of Nancy

Nancy, , France

Site Status

CHU Nantes, l'institut du thorax, service de chirurgie cardio-vasculaire

Nantes, , France

Site Status

University Hospital of Nice, Université Côte d'Azur

Nice, , France

Site Status

Department of Vascular and Thoracic Surgery, Bichat Hospital, Paris, Université de Paris

Paris, , France

Site Status

Department of Vascular Surgery, Ambroise Paré University Hospital, Boulogne-Billancourt and Simone Veil Health Sciences Medical School, Versailles-Saint-Quentin-en-Yvelines University and Paris-Saclay University

Paris, , France

Site Status

Vascular Surgery Department, Georges Pompidou European Hospital, APHP, Paris University

Paris, , France

Site Status

Department of Vascular Surgery, CHU de Reims

Reims, , France

Site Status

Department of Vascular Surgery and Kidney Transplantation, University Hospitals of Strasbourg

Strasbourg, , France

Site Status

European Vascular Center Aachen-Maastricht, University Hospital Aachen, RWTH Aachen University

Aachen, , Germany

Site Status

University Hospital Cologne

Cologne, , Germany

Site Status

Division of Vascular and Endovascular Surgery Department for Visceral-, Thoracic and Vascular Surgery Medical Faculty Carl Gustav Carus and University Hospital Carl Gustav Carus Dresden Technische Universität Dresden

Dresden, , Germany

Site Status

Department of Vascular- and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf

Düsseldorf, , Germany

Site Status

Department of Vascular and Endovascular Surgery, University Hospital Münster

Münster, , Germany

Site Status

Department of Vascular and Endovascular Surgery, Heart and Vascular Center, Semmelweis University

Budapest, , Hungary

Site Status

University Hopspital Chișinău

Chisinau, , Moldova

Site Status

Amsterdam University Medical Center, Department of Surgery

Amsterdam, , Netherlands

Site Status

University Medical Center Utrecht, Department of Vascular Surgery

Utrecht, , Netherlands

Site Status

Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia

Belgrade, , Serbia

Site Status

Institute for Cardiovascular Disease, Belgrade

Belgrade, , Serbia

Site Status

Clinic for Vascular Surgery, Clinical Center Niš

Niš, , Serbia

Site Status

Department of Cardiovascular Surgery, Inselspital, University of Bern

Bern, , Switzerland

Site Status

Department of Vascular Surgery, Kantonsspital Winterthur

Winterthur, , Switzerland

Site Status

Bristol Centre for Surgical Research, Bristol NIHR Biomedical Research Centre, University of Bristol

Bristol, , United Kingdom

Site Status

Department of Vascular Surgery, University Hospital Wales

Cardiff, , United Kingdom

Site Status

NHS Lothian

Edinburgh, , United Kingdom

Site Status

Countries

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Austria Croatia France Germany Hungary Moldova Netherlands Serbia Switzerland United Kingdom

References

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Behrendt CA, Bjorck M, Schwaneberg T, Debus ES, Cronenwett J, Sigvant B; Acute Limb Ischaemia Collaborators. Editor's Choice - Recommendations for Registry Data Collection for Revascularisations of Acute Limb Ischaemia: A Delphi Consensus from the International Consortium of Vascular Registries. Eur J Vasc Endovasc Surg. 2019 Jun;57(6):816-821. doi: 10.1016/j.ejvs.2019.02.023. Epub 2019 May 22.

Reference Type BACKGROUND
PMID: 31128987 (View on PubMed)

Bjorck M, Earnshaw JJ, Acosta S, Bastos Goncalves F, Cochennec F, Debus ES, Hinchliffe R, Jongkind V, Koelemay MJW, Menyhei G, Svetlikov AV, Tshomba Y, Van Den Berg JC, Esvs Guidelines Committee, de Borst GJ, Chakfe N, Kakkos SK, Koncar I, Lindholt JS, Tulamo R, Vega de Ceniga M, Vermassen F, Document Reviewers, Boyle JR, Mani K, Azuma N, Choke ETC, Cohnert TU, Fitridge RA, Forbes TL, Hamady MS, Munoz A, Muller-Hulsbeck S, Rai K. Editor's Choice - European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Acute Limb Ischaemia. Eur J Vasc Endovasc Surg. 2020 Feb;59(2):173-218. doi: 10.1016/j.ejvs.2019.09.006. Epub 2019 Dec 31. No abstract available.

Reference Type BACKGROUND
PMID: 31899099 (View on PubMed)

Gratl A; European Vascular Research Collaborative (EVRC). Study Protocol of a Prospective Multicenter Observational Study Evaluating Acute Lower Limb Ischemia. J Surg Res. 2023 Feb;282:280-284. doi: 10.1016/j.jss.2022.09.023. Epub 2022 Nov 5.

Reference Type DERIVED
PMID: 36347128 (View on PubMed)

Other Identifiers

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1220/2021

Identifier Type: -

Identifier Source: org_study_id

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