Brief Title
Endovascular Aneurysm Repair (EVAR) Gate Study
Official Title
Evaluation of a Randomized Comparison of Direct Versus Snare Techniques for Cannulation of Contralateral Gate During an Endovascular Aneurysm Repair (EVAR) Procedure
Brief Summary
This study will evaluate a randomized comparison of direct versus snare techniques for cannulation of contralateral gate during an endovascular aneurysm repair (EVAR) procedure. This information will be used to determine if primary snaring is superior to retrograde cannulation in decreasing procedural time and radiation exposure.
Detailed Description
Endografts currently FDA-approved for abdominal aortic aneurysm (AAA) repair are modular systems,comprised of a main body (Aortic Trunk) and two legs (Ipsilateral Leg Endoprosthesis and a contralateral leg endoprosthesis). In placement of the endograft the main body and ipsilateral limb are deployed from a retrograde common femoral artery approach. From the contralateral femoral artery, cannulation of the contralateral gate is required to deploy the contralateral iliac limb.Cannulation of the contralateral limb gate is the portion of the operation that requires the most "wire skills." Depending on the patients' body type, angulations of the aorta and the size and volume of the AAA, this portion of the procedure can be technically difficult. This portion may become lengthy and discouraging if the surgeon fails to cannulate the gate using a particular approach. Cannulation of the contralateral limb gate from a retrograde femoral artery approach is commonly achieved by first using a maneuverable guidewire and steerable catheter. Antegrade or crossover cannulation involves passing a guidewire from the ipsilateral limb to the contralateral limb gate of the endograft, which can be accomplished with a curved catheter. The wire may be retrieved on the contralateral limb using a snare device. The problem and why it is important -- difficulty in accessing the contralateral gate leads to increase procedural time and excess exposure to radiation. The standard of care is retrograde cannulation with the use of crossover snare techniques as a secondary adjunct if retrograde cannulation fails. In this study we will compare retrograde cannulation to primary snaring.
Study Type
Interventional
Primary Outcome
Primary Endpoint: Time to contralateral gate cannulation
Condition
Abdominal Aortic Aneurysm (AAA)
Intervention
Endovascular Aneurysm Repair
Study Arms / Comparison Groups
Retrograde Gate Cannulation
Description: All patients undergoing elective EVAR with a standard commercially available stent graft will be randomized after informed consent obtained; gate cannulation method will be attempted for a period of 15 minutes. If unsuccessful during this time a crossover to the alternative method (snare) will be attempted. The study will be terminated at 15 minutes in the crossover arm if still unsuccessful.
Publications
* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
Recruitment Information
Recruitment Status
Procedure
Estimated Enrollment
102
Start Date
August 2011
Completion Date
March 2014
Primary Completion Date
March 2014
Eligibility Criteria
Inclusion Criteria: - Age ≥ 18 - Patient is undergoing EVAR repair with a commercially available endograft - Willing to give consent - Procedure is Elective Exclusion Criteria: - Declines to participate - Unable to provide consent - Urgent AAA repair - Participating in another study
Gender
All
Ages
18 Years - N/A
Accepts Healthy Volunteers
No
Contacts
Jessica Titus, MD, ,
Location Countries
United States
Location Countries
United States
Administrative Informations
NCT ID
NCT02934087
Organization ID
EV001
Responsible Party
Sponsor
Study Sponsor
Minneapolis Heart Institute Foundation
Study Sponsor
Jessica Titus, MD, Principal Investigator, Minneapolis Heart Institute Foundation
Verification Date
October 2016