The Role of Artificial Intelligence in the Treatment of Abdominal Aortic Aneurysms

NCT ID: NCT05643664

Last Updated: 2022-12-15

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-01-01

Study Completion Date

2024-12-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

"Pilot randomized prospective clinical study of the effectiveness of the use of artificial intelligence in determining "safe" clamping zones in the surgical treatment of abdominal aortic aneurysms."

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Abdominal aortic aneurysm is a life-threatening disease, a formidable complication of which is an aneurysm rupture (Editor's Choice - European Society for Vascular Surgery). The main method of treating aneurysms is surgical reconstruction, including open or endovascular intervention ((ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms). Anatomical features of aneurysms and the presence of intraluminal thrombomass are among the criteria in deciding on the tactics of surgical treatment. These factors carry additional technical difficulties and lead to the development of intraoperative complications, including ischemic ones. Ischemia of the lower extremities is the most common complication and can be caused by thrombosis, embolism or dissection of the aortic wall (occurs in 7% of patients) (Complications Associated with Aortic Aneurysm Repair).

Thus, in order to reduce the frequency of embolic complications, it is important for the surgeon to determine a "safe" zone for applying a clamp to the aorta and main vessels. Thus, artificial intelligence (AI) can be used to interpret and analyze images of aneurysms that allow automatic quantitative measurements and determination of the exact characteristics of morphology and hydrodynamics, as well as the presence of intraluminal blood clots and calcifications. Analysis based on artificial intelligence can lead to the development of computational programs for predicting the development of aneurysms and the risk of their rupture, as well as postoperative outcomes. Artificial intelligence can also be used to determine the "safe" areas of aortic clamping. (Artificial intelligence in abdominal aortic aneurysm).

Adam and co-authors trained a neural network to detect and estimate the maximum outer diameter of aneurysms using a database of 489 CT angiographs of abdominal aortic aneurysms. AI has achieved a level of performance and accuracy suitable for clinical practice, and with the use of more CT images, further improvement in accuracy is expected (Pre-surgical and Post-surgical Aortic Aneurysm Maximum Diameter Measurement: Full Automation by Artificial Intelligence). In a study by Fujiwara et al. 145 non-contrast CT scans with suspected aneurysm were retrospectively collected. Initially, AI was trained by manually segmenting CT images. Image processing was used to determine the abdominal aortic aneurysm area and to automatically measure the size. This method has shown that AI is a useful tool for fully automatic detection and measurement of aneurysm diameter. (Fully automatic detection and measurement of abdominal aortic aneurysm using artificial intelligence). Florent Lalys and his coauthor. an automatic fast and universal algorithm for determining an intraluminal thrombus was developed. The method was tested on pre- and postoperative CT scans of the abdominal aorta and iliac artery of 145 patients and consists in determining the central line and segmentation of the aortic lumen, an optimized stage of pretreatment and the use of a 3D model (Generic thrombus segmentation from pre- and post-operative CTA).

Taking into account the references already available in some studies of the use of artificial intelligence for the treatment of cardiovascular diseases, its use is seen as a promising method for making decisions in determining "safe" clamping zones in the surgical treatment of abdominal aortic aneurysms, which will reduce the frequency of postoperative complications.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Frequency of Embolic Complications Frequency of Ischemic Complications

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

Aortic aneyrism Artificial intelligence "safe" zone of clamping embolic complications

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

1. In both groups, aneurysmectomy with prosthetics of the abdominal aorta is performed using the standard technology.
2. In the first group, the aortic and main artery clamping zone is determined by the surgeon intraoperatively.

In the second group, before surgery, multispiral computed tomography data is evaluated using artificial intelligence and the definition of "safe" areas of aortic and main artery clamping is performed. Intraoperatively, clamping is performed in the settlement zones.
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Standart technology

the zone of aortic and main artery clamping is determined by the surgeon intraoperatively.

Group Type ACTIVE_COMPARATOR

prosthetics of the abdominal aorta

Intervention Type PROCEDURE

aneurysmectomy is performed with prosthetics of the abdominal aorta using the standard technology.

Artificial intellect

The multispiral computed tomography data is evaluated using artificial intelligence and the definition of "safe" zones of aortic and main artery clamping is performed. Intraoperatively, clamping is performed in the settlement zones.

Group Type EXPERIMENTAL

prosthetics of the abdominal aorta after determining the safe zones of clamping

Intervention Type PROCEDURE

aneurysmectomy is performed with prosthetics of the abdominal aorta using the standard technology. Before surgery, multispiral computed tomography data is evaluated using artificial intelligence and safe zones of aortic and arterial clampings are determined. Intraoperatively, clamping is performed in the settlement zones.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

prosthetics of the abdominal aorta

aneurysmectomy is performed with prosthetics of the abdominal aorta using the standard technology.

Intervention Type PROCEDURE

prosthetics of the abdominal aorta after determining the safe zones of clamping

aneurysmectomy is performed with prosthetics of the abdominal aorta using the standard technology. Before surgery, multispiral computed tomography data is evaluated using artificial intelligence and safe zones of aortic and arterial clampings are determined. Intraoperatively, clamping is performed in the settlement zones.

Intervention Type PROCEDURE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Patients with aneurysmal dilation of the abdominal aorta, who are shown surgery.
* Patients who have agreed to participate in this study

Exclusion Criteria

* Chronic heart failure of functional class III -IV according to NYHA classification;
* Chronic decompensated "pulmonary" heart;
* Severe hepatic or renal insufficiency (bilirubin \>35 mmol/l, glomerular filtration rate \<60 ml/min);
* Polyvalent drug allergy;
* Malignant oncological diseases in the terminal stage with a predicted life span of up to 6 months;
* Acute cerebrovascular accident;
Minimum Eligible Age

45 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Meshalkin Research Institute of Pathology of Circulation

NETWORK

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Alexander A Gostev

Novosibirsk, Novosibirskaya Obl, Russia

Site Status

Federal State Institution Academician E.N.Meshalkin Novosibirsk State Research Institute Of Circulation Pathology Rusmedtechnology

Novosibirsk, , Russia

Site Status

Novosibirsk Research Institute of Circulation Pathology

Novosibirsk, , Russia

Site Status

E. Meshalkin National Medical Research Center

Novosibirsk, , Russia

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Russia

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Andrey A Karpenko, PhD

Role: CONTACT

Phone: +79139504100

Email: [email protected]

Alexandr A Gostev, PhD

Role: CONTACT

Phone: +79139555074

Email: [email protected]

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

NRICP-16/11/22

Identifier Type: -

Identifier Source: org_study_id