Parathyroid Vascularization During Total Thyroidectomy Using Indocyanine Green Angiography

NCT ID: NCT05328076

Last Updated: 2024-07-05

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

TERMINATED

Total Enrollment

22 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-05-02

Study Completion Date

2023-01-19

Brief Summary

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Prospective, observational, single-center study about the use of indocyanine green angiography during total thyroidectomy.

The main objective of the study is to identify a quantitative score of parathyroid vascularization as an outcome of angiography that correlates with the absence of postoperative hypoparathyroidism.

It is planned to enroll 66 patients.

Detailed Description

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Postoperative hypoparathyroidism and subsequent hypocalcemia are the most frequent complications after thyroid surgery. The incidence ranges from 19-38%, depending on the definition of hypoparathyroidism and hypocalcemia.

Although the cause of postoperative hypoparathyroidism is multifactorial, one of the most important factors is vascularization of parathyroid glands left in situ that is insufficient or impaired by surgical manipulation. Therefore, one of the goals of thyroid surgery is not only to recognize the parathyroid glands during dissection but also to respect their vascularization in order to preserve well perfused and viable glands.

The general objective of this study is to quantitatively assess the vascularization of the parathyroids following total thyroid removal.

In particular, the investigators intend to obtain data regarding parathyroid vascularization during total thyroidectomy with indocyanine green angiography. During standard surgery, angiography will be performed using a special camera after having administered intravenously indocyanine green. This technique is used to objectively assess the degree of fluorescence of the parathyroid glands.

Conditions

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Thyroid Thyroid Cancer Hypoparathyroidism Vascularization

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Surgical group

Patients who undergo thyroid surgery and receive indocyanine green angiography

Indocyanine green

Intervention Type DRUG

Indocyanine green is used to perform intraoperative angiography.

SPY Portable Handheld Imaging (SPY-PHI)

Intervention Type DEVICE

The device is used to perform intraoperative angiography.

Interventions

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Indocyanine green

Indocyanine green is used to perform intraoperative angiography.

Intervention Type DRUG

SPY Portable Handheld Imaging (SPY-PHI)

The device is used to perform intraoperative angiography.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Able to sign informed consent
* Indication to total thyroidectomy
* No contraindication to indocyanine green administration

Exclusion Criteria

* Evidence of parathyroid disease
* Allergy to iodinated contrast
* Chronic kidney failure
* Pregnancy or lactation
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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IRCCS San Raffaele

OTHER

Sponsor Role lead

Responsible Party

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Riccardo Maggiore

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Riccardo Rosati, Prof.

Role: STUDY_DIRECTOR

San Raffaele Hospiral

Locations

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San Raffaele Hospital

Milan, , Italy

Site Status

Countries

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Italy

References

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Lang BH, Wong CK, Hung HT, Wong KP, Mak KL, Au KB. Indocyanine green fluorescence angiography for quantitative evaluation of in situ parathyroid gland perfusion and function after total thyroidectomy. Surgery. 2017 Jan;161(1):87-95. doi: 10.1016/j.surg.2016.03.037. Epub 2016 Nov 10.

Reference Type BACKGROUND
PMID: 27839936 (View on PubMed)

Vidal Fortuny J, Sadowski SM, Belfontali V, Guigard S, Poncet A, Ris F, Karenovics W, Triponez F. Randomized clinical trial of intraoperative parathyroid gland angiography with indocyanine green fluorescence predicting parathyroid function after thyroid surgery. Br J Surg. 2018 Mar;105(4):350-357. doi: 10.1002/bjs.10783. Epub 2018 Feb 6.

Reference Type BACKGROUND
PMID: 29405252 (View on PubMed)

Spartalis E, Ntokos G, Georgiou K, Zografos G, Tsourouflis G, Dimitroulis D, Nikiteas NI. Intraoperative Indocyanine Green (ICG) Angiography for the Identification of the Parathyroid Glands: Current Evidence and Future Perspectives. In Vivo. 2020 Jan-Feb;34(1):23-32. doi: 10.21873/invivo.11741.

Reference Type BACKGROUND
PMID: 31882459 (View on PubMed)

Puzziello A, Rosato L, Innaro N, Orlando G, Avenia N, Perigli G, Calo PG, De Palma M. Hypocalcemia following thyroid surgery: incidence and risk factors. A longitudinal multicenter study comprising 2,631 patients. Endocrine. 2014 Nov;47(2):537-42. doi: 10.1007/s12020-014-0209-y. Epub 2014 Feb 22.

Reference Type BACKGROUND
PMID: 24563161 (View on PubMed)

Ji YB, Song CM, Sung ES, Jeong JH, Lee CB, Tae K. Postoperative Hypoparathyroidism and the Viability of the Parathyroid Glands During Thyroidectomy. Clin Exp Otorhinolaryngol. 2017 Sep;10(3):265-271. doi: 10.21053/ceo.2016.00724. Epub 2016 Aug 13.

Reference Type BACKGROUND
PMID: 27515510 (View on PubMed)

Zaidi N, Bucak E, Yazici P, Soundararajan S, Okoh A, Yigitbas H, Dural C, Berber E. The feasibility of indocyanine green fluorescence imaging for identifying and assessing the perfusion of parathyroid glands during total thyroidectomy. J Surg Oncol. 2016 Jun;113(7):775-8. doi: 10.1002/jso.24237. Epub 2016 Apr 4.

Reference Type BACKGROUND
PMID: 27041628 (View on PubMed)

Other Identifiers

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ANGIO PARA

Identifier Type: -

Identifier Source: org_study_id

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