ParisK: Validation of Imaging Techniques
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Purpose
The possibility of the identification of the risk of rupture of a carotid plaque will have tremendous impact in clinical decision making. Firstly, in symptomatic patients with a 30-69% stenosis, who are currently not operated upon according to the current guidelines, identification of the risk of rupture plaque could identify patients who have a high risk of recurrent stroke, and would benefit of carotid intervention, such as endarterectomy or stent placement. This could potentially prevent a substantial number of strokes. Secondly, in all symptomatic patients with a 70-99% stenosis carotid intervention should be considered, according to the guidelines. However, only one out of six patients with a 70-99% stenosis benefits from a carotid intervention. Identification of patients with a high risk of a recurrent stroke would reduce the number of unnecessary interventions substantially.
The main objective is to show whether imaging characteristics assessed at baseline can predict clinical events in patients with a 30-69 % symptomatic carotid stenosis.
| Condition | Intervention |
|---|---|
|
Stroke Atherosclerosis |
Other: Magnetic Resonance Imaging (MRI), Multidetector Computed Tomography (MDCT), Ultrasonography (US), Transcranial Doppler (TCD) |
| Study Type: | Observational |
| Study Design: | Time Perspective: Prospective |
| Official Title: | The Assessment of the Plaque at RISK by Non-invasive (Molecular) Imaging and Modelling (ParisK): Prospective Clinical Study for Diagnosis Efficacy for High Risk Plaque and Stroke. |
- stroke [ Time Frame: within 5 years of follow-up ] [ Designated as safety issue: No ]Ipsilateral recurrent ischemic stroke, transient ischaemic attack (TIA) or new ischemic brain lesions on follow-up brain MRI.
| Estimated Enrollment: | 300 |
| Study Start Date: | September 2010 |
| Estimated Study Completion Date: | August 2015 |
| Estimated Primary Completion Date: | December 2014 (Final data collection date for primary outcome measure) |
| Groups/Cohorts | Assigned Interventions |
|---|---|
|
symptomatic carotid stenosis 30-69%
Patients with neurological symptoms due to ischemia in the carotid artery territory and with a carotid stenosis between 30% and 69% according to the European Carotid Surgery Trial (ECST) criteria.
|
Other: Magnetic Resonance Imaging (MRI), Multidetector Computed Tomography (MDCT), Ultrasonography (US), Transcranial Doppler (TCD)
3 Tesla Magnetic Resonance Imaging (MRI), Multidetector Computed Tomography (MDCT), Ultrasonography (US), Transcranial Doppler (TCD)
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
Patients with neurological symptoms due to ischemia in the carotid artery territory and with a carotid stenosis between 30-69% according to the ECST criteria will be included.
Inclusion Criteria:
- neurological symptoms due to ischemia in the carotid artery territory as diagnosed by their neurologist based on anamneses, physical examination and brain imaging (CT or MRI)
- carotid stenosis between 30-69% according to ECST criteria
- written informed consent
Exclusion Criteria:
- patients with probable cardiac source of embolism (rhythm disorders, mitral valve stenosis, prolapse or calcification, mechanical cardiac valves, recent myocardial infarction, left ventricular thrombus, atrial myxoma, endocarditis, dilated cardiomyopathy, patent foramen ovale) or a clotting disorder
- patients with evident other cause of neurological symptoms than carotid stenosis due to atherosclerotic disease (like demyelinating diseases, epilepsy, congenital brain disorders, aneurysms, fibromuscular dysplasia etc)
- patients already scheduled for carotid endarterectomy or stenting.
- severe co-morbidity, dementia or pregnancy
- standard contra-indications for MRI
- patients who have a documented allergy to MRI or CT contrast media
- patients with renal clearance < 30 ml/minute are not eligible to undergo contrast-enhanced MRI
- patients with renal clearance < 60 ml/minute are not eligible to undergo MDCT
- patients who had a TIA or minor stroke more than 3 months before inclusion
Contacts and Locations| Contact: Martine Truijman | +31 43 3882599 | martine.truijman@mumc.nl |
| Netherlands | |
| Maastricht University Medical Center | Recruiting |
| Maastricht, Limburg, Netherlands | |
| Contact: Eline Kooi, PhD eline.kooi@mumc.nl | |
| Academic Medical Center | Recruiting |
| Amsterdam, Noord-Holland, Netherlands | |
| Contact: Paul Nederkoorn, MD, PhD p.j.nederkoorn@amc.uva.nl | |
| Erasmus Medical Center | Recruiting |
| Rotterdam, Zuid-Holland, Netherlands | |
| Contact: Aad vd Lugt, Prof. dr. a.vanderlugt@erasmusmc.nl | |
| University Medical Center Utrecht | Recruiting |
| Utrecht, Netherlands | |
| Contact: Jeroen Hendrikse, MD, PhD j.hendrikse@umcutrecht.nl | |
| Principal Investigator: | Eline Kooi, PhD | Maastricht University Medical Center |
More Information
No publications provided
| Responsible Party: | Maastricht University Medical Center |
| ClinicalTrials.gov Identifier: | NCT01208025 History of Changes |
| Other Study ID Numbers: | 09-2-082 |
| Study First Received: | September 21, 2010 |
| Last Updated: | October 22, 2012 |
| Health Authority: | Netherlands: The Central Committee on Research Involving Human Subjects (CCMO) |
Keywords provided by Maastricht University Medical Center:
|
Plaque Imaging |
Additional relevant MeSH terms:
|
Atherosclerosis Stroke Cerebral Infarction Arteriosclerosis Arterial Occlusive Diseases Vascular Diseases Cardiovascular Diseases |
Cerebrovascular Disorders Brain Diseases Central Nervous System Diseases Nervous System Diseases Brain Infarction Brain Ischemia |
ClinicalTrials.gov processed this record on May 16, 2013