Physiological Magnetic Resonance Imaging (MRI) to Improve Carotid Endarterectomy Outcomes
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Purpose
The carotid arteries are blood vessels in the neck that supply blood to the brain. Carotid stenosis disease is defined as a narrowing of these arteries due to the build up of plaque. The plaque material can also break off and move into the brain. The resulting blockage of blood supply to a portion of the brain is what causes 80% of all strokes. One treatment option is to have surgery on the carotid artery and remove the plaque. This procedure is called a carotid endarterectomy (CEA). There is evidence that proves CEA reduces the risk of stroke. The objective of this research project is to determine who is most likely to benefit from CEA surgery.
| Condition |
|---|
|
Carotid Stenosis Hypoperfusion Transient Ischemic Attack |
| Study Type: | Observational |
| Study Design: | Observational Model: Cohort Time Perspective: Prospective |
- Functional MRI (fMRI) results will be used to calculate the activation-related hemodynamic response function (HRF) in patients undergoing carotid endarterectomy, which will be significantly reduced post-operative at 3 months follow-up. [ Time Frame: Pre-operative, 3 months post-operative ] [ Designated as safety issue: No ]
- Dynamic intracranial angiography will be correlated with arterial arrival time (AAT) hemodynamic metric calculated from arterial spin labeling (ASL) perfusion MRI. [ Time Frame: Pre-operatively, 3 months post-operatively ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 50 |
| Study Start Date: | February 2011 |
| Estimated Study Completion Date: | January 2015 |
| Estimated Primary Completion Date: | March 2014 (Final data collection date for primary outcome measure) |
| Groups/Cohorts |
|---|
| Carotid endarterectomy patients |
| Lumbar stenosis laminectomy patients |
Eligibility| Ages Eligible for Study: | 30 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
Atherosclerosis is a major risk factor for ischemic cerebrovascular events such as stroke (Bots, Hoes et al. 1997). Carotid endarterectomy (CEA) and carotid stenting (CAS) are common surgical procedures aimed at reducing stroke risk. For individuals with symptomatic stenosis > 70%, CEA has a higher event-free survival compared to medical therapy (Barnett, Taylor et al. 1998) and is considered highly beneficial treatment (Rothwell, Eliasziw et al. 2003). To date, however, few studies have attempted to relate effects of the surgery to changes in brain physiology and function.
Inclusion Criteria:
- Greater than 30 years of age
- Greater than grade 9 education level
- Mini-mental state exam (MMSE) greater than 19 for carotid stenosis patients
Exclusion Criteria:
- History of acute stroke
- History of current psychiatric disorder, such as depression or movement disorder
- Diagnosed Alzheimer's Disease or dementia
Contacts and Locations| Contact: Bradley J MacIntosh, PhD | 4164806100 ext 7277 | bmac@sri.utoronto.ca |
| Canada, Ontario | |
| Sunnybrook Research Institute | Not yet recruiting |
| Toronto, Ontario, Canada, M4N3M5 | |
| Contact: Bradley J MacIntosh, PhD 4164806100 ext 7277 bmac@sri.utoronto.ca | |
More Information
Additional Information:
Publications:
| Responsible Party: | Bradley J MacIntosh, Scientist, Sunnybrook Health Sciences Centre |
| ClinicalTrials.gov Identifier: | NCT01272843 History of Changes |
| Other Study ID Numbers: | CEACOG2011 |
| Study First Received: | January 6, 2011 |
| Last Updated: | January 7, 2011 |
| Health Authority: | Canada: Canadian Institutes of Health Research |
Additional relevant MeSH terms:
|
Carotid Stenosis Ischemic Attack, Transient Carotid Artery Diseases Cerebrovascular Disorders Brain Diseases Central Nervous System Diseases |
Nervous System Diseases Arterial Occlusive Diseases Vascular Diseases Cardiovascular Diseases Brain Ischemia |
ClinicalTrials.gov processed this record on May 16, 2013