Screening for Thoracic Aortic Aneurysm Among a Cohort of Patients With a Degenerative Abdominal Aortic Aneurysm

Brief Title

Screening for Thoracic Aortic Aneurysm Among a Cohort of Patients With a Degenerative Abdominal Aortic Aneurysm

Official Title

Screening for Thoracic Aortic Aneurysm Among a Cohort of Patients With a Degenerative Abdominal Aortic Aneurysm : Prevalence, Description of the Different Thoracic Aortic Phenotypes by Aortic Volumetric Numerized Imaging and Their Relationship With Epidemiologic, Clinical, Biological and Genetic Factors

Brief Summary

      Many publications deal with the natural history of aortic aneurysms in literature. Except for
      connective tissue disorders as Marfan or Loeys-Dietz syndrome, aortic aneurysms are a complex
      multifactorial disease with genetic and environmental risk factors. Susceptibility loci
      identified in thoracic aortic aneurysms (TAA) and abdominal aortic aneurysms (AAA) do not
      overlap, suggesting that different genetic risk factors contribute to these two forms of
      aneuryms. With a higher prevalence correlated to ageing (5%), AAA is usually presented as the
      degenerative form of the disease. However, a recent epidemiologic study by Olsson et al. has
      revealed an increasing incidence of thoracic aortic disease among older individuals (70+/-12
      years) with 60% of aneurysmal rupture or dissection at diagnosis, and a 1.7 :1 male-to-female
      ratio compared to 6:1 in AAA. From this current knowledge arises the concept of diffuse or
      plurisegmental degenerative aneurysmal aortic disease, poorly explored so far. As regards to
      the prevention policy, there is a consensus statement in which ultrasonography screening for
      AAA is recommended for all individuals aged > 60 years (particularly in men who have ever
      smoked) and for those aged > 50 years with family history of AAA. Nevertheless, screening for
      a concomittant thoracic location of the disease (except thoracoabdominal aneurysm) is not yet
      required, whereas it could change the prognosis of the patients and influence their
      management.
    

Detailed Description

      Through the constitution of a multicentric prospective cohort of patients with infra-renal
      AAA (n=450), the investigators aimed to determine the prevalence of a concomitant TAA, and
      the epidemiologic, clinical, biological and genetic factors related to this aortic phenotype.
      Therefore, the investigators postulate for a prevalence of the AAA-TAA association inferior
      or equal to 15%. By the use of an innovating software (AMIRA) to analyse scans, the
      investigators will perform reproductive measurements of segmental diameters from a segmental
      aortic volumetric numerized imaging, and describe the different thoracic aortic phenotypes
      associated with AAA, including the form (TAA, penetrating ulcer, dolichoaorta …) and the
      location of the disease.
    

Study Type

Interventional

Primary Outcome

BLOOD SAMPLES

Secondary Outcome

 ANGIOSCAN

Condition

Abdominal Aortic Aneurysms

Intervention

blood samples

Study Arms / Comparison Groups

 abdominal aortic aneurysms

Description:  

Publications

* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.

Recruitment Status

Other

Estimated Enrollment

345

Start Date

June 2012

Completion Date

July 2018

Primary Completion Date

July 2017

Eligibility Criteria

        Inclusion Criteria:

          -  Major subject at the time of the inclusion

          -  Subject sent in hospitalization or in consultation of surgery vascular for coverage of
             the first one anévrysme of the sub-renal abdominal aorta degenerative, without anomaly
             associated by the coeliac aorta, and by the upper diameter in 40mm (according to the
             criteria of measure recommended for the analysis in echography doppler or in
             angioscanner).

          -  subject not presenting contraindication to the realization of the diagnostic
             examination by aortic angioscanner

          -  Subject having signed a consent.

        Exclusion Criteria:

        Subject under age 18

          -  pregnant Woman

          -  Subject received in the phase aigue of a break or a fissuring of an AAA under renal

          -  Subject already operated for a thoracic or abdominal aortic anévrysme

          -  Subject presenting at least one of the following pathologies:

          -  heart disorder valvulaire aortic: aortic incapacity of rank superior to 2, tight
             aortic stenosis, prosthesis valvulaire aortic

          -  context of bicuspidie station wagon diagnosed on at least 2 parents of the first
             degree

          -  of a not degenerative aortopathie anévrysmale bound(connected) in bicuspidie aortic,
             or: A dissection of type(chap) A or of type(chap) B

          -  Of a degenerative aortopathie of type anévrysme thoracoabdominal (in particular,
             affected by the coeliac aorta, defined by the segment enter the diaphragmatique
             crossing and the renal arteries)
      

Gender

All

Ages

18 Years - N/A

Accepts Healthy Volunteers

No

Contacts

BERNARD BELAIGUES, , 

Location Countries

France

Location Countries

France

NCT ID

NCT01599533

Organization ID

2011-A00042-41

Secondary IDs

2012-01

Responsible Party

Sponsor

Study Sponsor

Assistance Publique Hopitaux De Marseille

Study Sponsor

BERNARD BELAIGUES, Study Director, Assistance Publique hôpitaux de Marseille

Verification Date

October 2019