Preoperative Identification of the Histologically "Vulnerable" Plaque Using Non-invasive Imaging, Biomechanical Assessment and Baroreflex Evaluation in Patients With Severe Carotid Stenosis

NCT ID: NCT05566080

Last Updated: 2023-12-28

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

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-03-15

Study Completion Date

2023-09-30

Brief Summary

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Carotid artery stenosis due to atherosclerotic plaques accounts for an important cause of ischemic stroke. Current research seeks to risk stratify asymptomatic patients by characterizing rupture-prone plaques. Currently no single imaging modality can reliably identify those plaques before surgery. Recently, the 3D ultrasound (US) and the assessment of the mechanical stress on the vessel wall have been proposed as non-invasive tools that could play a role in the diagnostic work-up. Data of histological validation, however, are still needed. In this research, 3D US, non-invasive elastography, Finite Element Analysis of computed tomography angiography images and the study of the autonomic cardiovascular control will be used to identify preoperatively the vulnerable plaque in patients undergoing carotid endarterectomy. The results will be compared to that of histology of the removed plaque, aiming to provide a validation to each method for a possible application in the daily practice.

Detailed Description

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Conditions

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Carotid Artery Plaque Diagnosis

Keywords

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carotid stenosis ultrasonic imaging finite element analysis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

CROSS_SECTIONAL

Interventions

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Carotid endarterectomy

Patients who have a significant carotid stenosis and who undergo surgical carotid endarterectomy

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* age above 18 years;
* signed informed consent.

Exclusion Criteria

* medical conditions limiting expected survival to \<1 year;
* patients with significant uncontrolled or unstable medical condition (heart failure or angina pectoris class NYHA III-IV, cardiac surgery in the previous 30 days, left ventricular ejection fraction \<30%, severe chronic obstructive pulmonary disease, myocardial infarction in the previous 30 days, coronary heart disease with revascularization indication, that is, the common trunk or more than two coronary vessels);
* tracheostomy;
* paralysis of the laryngeal nerve contralateral to the carotid stenosis;
* women of childbearing potential;
* inability to give informed consent;
* patients presenting contraindications to perform a CTA examination of neck vessels with contrast medium;
* patients with medical history of stroke/TIA within the previous 6 months.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Pavia

OTHER

Sponsor Role collaborator

Ministry of Health, Italy

OTHER_GOV

Sponsor Role collaborator

IRCCS Policlinico S. Donato

OTHER

Sponsor Role lead

Responsible Party

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Daniela Mazzaccaro

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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IRCCS Policlinico San Donato

San Donato Milanese, Milan, Italy

Site Status

Countries

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Italy

References

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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Other Identifiers

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GR-2018-12366862

Identifier Type: -

Identifier Source: org_study_id