Optical Coherence Tomography Contribution Assessment in the Revascularization of Long Femoropopliteal Occlusive Lesions (TASC C and D): A Randomized Trial.


Journal

Annals of vascular surgery
ISSN: 1615-5947
Titre abrégé: Ann Vasc Surg
Pays: Netherlands
ID NLM: 8703941

Informations de publication

Date de publication:
Jan 2021
Historique:
received: 06 05 2020
revised: 26 06 2020
accepted: 29 06 2020
pubmed: 8 7 2020
medline: 20 1 2021
entrez: 8 7 2020
Statut: ppublish

Résumé

Endovascular treatment has become the first-line revascularization technique for femoropopliteal lesions. This technique lacks reliable and accurate morphological control of the arterial segment treated. Intraoperative 2-dimensional angiogram consumes iodinated contrast media and increases X-ray exposure; this subsequently provides no 3-dimensional information on the quality of the revascularization completed, what could explain some of the early and late failures of the technique. We evaluated whether intraoperative optical coherence tomography (OCT) control in addition to standard angiogram could improve the primary patency rate at 12 months in comparison to standard angiogram alone in patients with occlusive femoropopliteal lesions. The tomography by optical coherence in femoral artery trial is a multicentric, prospective, randomized, controlled, and single-blind study including patients with long de novo occlusive femoropopliteal lesions. The randomization will be achieved in 2 balanced groups of patients after crossing successfully the lesion: group 1 with intraoperative OCT control in addition to standard angiogram and group 2 with standard angiogram alone. The randomization will be stratified by center. The protocol has been submitted and approved by a French ethic's committee under reference number CPP2019-12-098. The study has been registered under the reference number NCT04434586 on the Web site of clinicaltrials.gov. The primary outcome of the study is the primary patency at 12 months. The number of patients who need to be treated is 166 (83 in each group) considering 5% of no workable data. Symptoms' improvement, target lesion revascularization, target vessel revascularization, quality-of-life questionnaires, cost utility, and cost effectiveness will be analyzed as secondary end-point variables at 12 months. The present study is to evaluate the potential benefit for patients on the result of endovascular revascularization of long occlusive femoropopliteal lesion at 12 months when using intraoperative OCT control.

Sections du résumé

BACKGROUND BACKGROUND
Endovascular treatment has become the first-line revascularization technique for femoropopliteal lesions. This technique lacks reliable and accurate morphological control of the arterial segment treated. Intraoperative 2-dimensional angiogram consumes iodinated contrast media and increases X-ray exposure; this subsequently provides no 3-dimensional information on the quality of the revascularization completed, what could explain some of the early and late failures of the technique. We evaluated whether intraoperative optical coherence tomography (OCT) control in addition to standard angiogram could improve the primary patency rate at 12 months in comparison to standard angiogram alone in patients with occlusive femoropopliteal lesions.
METHODS METHODS
The tomography by optical coherence in femoral artery trial is a multicentric, prospective, randomized, controlled, and single-blind study including patients with long de novo occlusive femoropopliteal lesions. The randomization will be achieved in 2 balanced groups of patients after crossing successfully the lesion: group 1 with intraoperative OCT control in addition to standard angiogram and group 2 with standard angiogram alone. The randomization will be stratified by center. The protocol has been submitted and approved by a French ethic's committee under reference number CPP2019-12-098. The study has been registered under the reference number NCT04434586 on the Web site of clinicaltrials.gov.
RESULTS RESULTS
The primary outcome of the study is the primary patency at 12 months. The number of patients who need to be treated is 166 (83 in each group) considering 5% of no workable data. Symptoms' improvement, target lesion revascularization, target vessel revascularization, quality-of-life questionnaires, cost utility, and cost effectiveness will be analyzed as secondary end-point variables at 12 months.
CONCLUSIONS CONCLUSIONS
The present study is to evaluate the potential benefit for patients on the result of endovascular revascularization of long occlusive femoropopliteal lesion at 12 months when using intraoperative OCT control.

Identifiants

pubmed: 32634565
pii: S0890-5096(20)30563-X
doi: 10.1016/j.avsg.2020.06.061
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT04434586']

Types de publication

Clinical Trial Protocol Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

362-369

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Maxime Dubosq (M)

Department of Vascular Surgery, Institut Cœur-Poumon, CHU Lille, Lille, France.

Yann Gouëffic (Y)

Vascular Center, Groupe Hospitalier Paris Saint Joseph, Paris, France.

Alain Duhamel (A)

Univ. Lille, CHU Lille, Metrics: Évaluation des Technologies de santé et des Pratiques Médicales, Lille, France.

Fanette Denies (F)

Univ. Lille, CHU Lille, Metrics: Évaluation des Technologies de santé et des Pratiques Médicales, Lille, France.

Benoit Dervaux (B)

Univ. Lille, CHU Lille, Metrics: Évaluation des Technologies de santé et des Pratiques Médicales, Lille, France.

Gilles Goyault (G)

Department of Vascular and Oncological Interventional Radiology, Institut Cardiovasculaire de Strasbourg (ICS), Clinique Rhena, Strasbourg, France.

Jonathan Sobocinski (J)

Department of Vascular Surgery, Institut Cœur-Poumon, CHU Lille, Lille, France. Electronic address: jonathan.sobocinski@univ-lille.fr.

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Classifications MeSH