Investigation of Stent-grafts in Aortic Dissection (INSTEAD)
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Purpose
The objective of INSTEAD is to compare long-term (5 years) outcomes of endograft prosthesis versus medical management in patients with dissection of the thoracic aorta.
| Condition | Intervention | Phase |
|---|---|---|
|
Aortic Dissection |
Device: endoprosthesis |
Phase 2 Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Randomized Comparison of Strategies for Type B Aortic Dissection - the INvestigation of STEnt-grafts in Aortic Dissection (INSTEAD) Trial |
- All cause mortality [ Time Frame: 5 years post randomization ] [ Designated as safety issue: Yes ]
- Aorta-specific mortality [ Time Frame: 5 years post randomization ] [ Designated as safety issue: Yes ]
- Progression of disease [ Time Frame: 5 years ] [ Designated as safety issue: No ]
- Aortic remodeling [ Time Frame: 5 years ] [ Designated as safety issue: No ]
| Enrollment: | 140 |
| Study Start Date: | February 2002 |
| Study Completion Date: | March 2011 |
| Primary Completion Date: | October 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: stentgraft
Stentgraft
|
Device: endoprosthesis
Thoracic aortic stentgraft
Other Name: Talent endoprosthesis
|
|
No Intervention: Medical management
Antihypertensive medication
|
Device: endoprosthesis
Thoracic aortic stentgraft
Other Name: Talent endoprosthesis
|
Detailed Description:
Patients > 18 years with type B aortic dissection were randomized to either thoracic aortic endoprosthesis (stent-grafting) or antihypertensive management (medical treatment). Only stable patients without spontaneous false lumen thrombosis 14 days after index dissection were considered eligible for study inclusion. Long-term outcome measures included all-cause mortality, aorta-specific mortality and a cluster endpoint (reflecting progression of disease, conversion and additional interventions); the analysis is based on 140 randomized cases followed for at least 5 years.
Eligibility| Ages Eligible for Study: | 18 Years to 90 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- No contraindication the general anesthesia and ventilation
- Type B aortic dissection that occurred 2-52 weeks prior to randomization
- Diameter of the targeted aortic segment < 6 cm
- Subject or legal guardian understand the nature of teh study and agrees to its provisions on a written informed consent form
- Availability for appropriate follow-up visits during the F/U period of 5 years
- Capability to follow all study requirements
Exclusion Criteria:
- Pregnancy
- Thrombocytopenia
- Ongoing anticoagulation therapy
- Renal failure and/or creatinine > 2,4 mg%
- Complete thrombosis of false lumen
- Cancer likely to cause death within 1 year
- Enrollment in another clinical study
- Unwillingness to cooperate with study procedures or F/U visits
Contacts and Locations
More Information
Publications:
| Responsible Party: | Christoph A.Nienaber, MD, University of Rostock, Medical School; Dept. of Medicine/Cardiology |
| ClinicalTrials.gov Identifier: | NCT01415804 History of Changes |
| Other Study ID Numbers: | NCT00525356, INSTEAD 5 years outcomes |
| Study First Received: | August 11, 2011 |
| Last Updated: | August 11, 2011 |
| Health Authority: | Germany: Federal Institute for Drugs and Medical Devices United States: Food and Drug Administration |
Keywords provided by University of Rostock:
|
Dissection Aorta Surgery |
ClinicalTrials.gov processed this record on May 21, 2013