Surviving Aneurysm Surgery: A Pilot Study on Exercise Training in Abdominal Aortic Aneurysm Patients

Learn more about:
Related Clinical Trial
Detecting Abdominal Aortic Aneurysms in First Degree Relatives (Adult Offsprings) to AAA Patients (DAAAD) Contrast Enhanced Ultrasound Endoleak Identification and Classification CCR2 AAA Pilot Study NIH CCR2 AAA Study Predicting Endoleaks Following Endovascular Aortic Aneurysm Repair Using 18F-Sodium Fluoride Comparative Study of a Software With the Gold Standard Limiting AAA With Metformin (LIMIT) Trial Deep Learning Applied to Plain Abdominal Radiographic Surveillance After Endovascular Aneurysm Repair (EVAR) of Abdominal Aortic Aneurysm (AAA) Carbon Dioxide Guided Angiography in Endovascular Abdominal Aortic Aneurysm Repair MuLtibranchEd Graft for OPen RepAir of ThoRacoabdominal Aneurysms Aneurysm Diameter and Surgical Outcome Evaluation of the Long Term Efficacy of Endovascular Treatment of Type 2 Endoleaks Point-of-care Ultrasound in Finland BNP and Vascular Surgery Understanding the Role of Autoimmune Disorders on the Initial Presentation of Cardiovascular Disease Heart Rate and Initial Presentation of Cardiovascular Diseases (Caliber) Social Deprivation and Initial Presentation of 12 Cardiovascular Diseases: a CALIBER Study The Effects of Anesthesia on Patients Undergoing Surgery for Repair of a Thoracoabdominal Aneurysm. The Role of Alcohol Consumption in the Aetiology of Different Cardiovascular Disease Phenotypes: a CALIBER Study Body Mass Index and Initial Presentations of Cardiovascular Diseases Totally Percutaneous Approach to Endovascular Treatment of Aortic Aneurysms (PEVAR-PRO) Haemostasis Management of Abdominal Aortic Procedures Overlay of 3D Scans on Live Fluoroscopy for Endovascular Procedures in the Hybrid OR Evaluation of the Safety and Efficacy of the Multilayer Stent Serum Uric Acid Levels and Onset of Cardiovascular Diseases: a CALIBER Study Ethnicity and Onset of Cardiovascular Disease: A CALIBER Study Fenestrated AAA Endovascular Graft Post-Approval Study Preconditioning Shields Against Vascular Events in Surgery Zenith Low Profile AAA Endovascular Graft (ZLP) Clinical Study Terumo Aortic Global Endovascular Registry A Study of Remote Ischaemic Preconditioning in Patients With Atherosclerosis Undergoing Vascular Surgery Preconditioning Shields Against Vascular Events in Surgery Risk Factors in the Initial Presentation of Specific Cardiovascular Disease Syndromes White Blood Cell Counts and Onset of Cardiovascular Diseases: a CALIBER Study Contrast-enhanced Ultrasound in Follow-up After Endovascular Aneurysm Repair Use of Fish Oil to Reduce Inflammation During Endovascular Abdominal Aortic Repair Contrast Enhanced Ultrasound, Endoleak Detection Following EVAR v1.3 Glycemic Control to Prevent Cardiac Morbidity in Vascular Surgery Performance and Safety of a Second Generation Antimicrobial Graft in Abdominal Position AneuFix – Prophylactic Sac Filling ANEUFIX for Endoleak Type II Repair Endurant Evo US Clinical Trial The Use of Carbon Dioxide as a Contrast Media for Performing Endovascular Procedures A Study of the Safety of Targeted AAA Screening Zenith® Low Profile AAA Endovascular Graft Zenith® Low Profile AAA Endovascular Graft Zenith(R) Low Profile AAA Endovascular Graft Clinical Study Hemodynamic Changes After Aortic Aneurysm Treatment With Stent-Graft Zenith® AAA Endovascular Graft Clinical Study Talent Converter Post-Approval Study Arterial Stiffness, Blood Pressure and Cardiac Output Study LIFE Study: Least Invasive Fast-Track EVAR DynaCT in Preoperative Imaging Before Insertion of Stentgraft TriVascular European Union (EU) Abdominal Stent Graft Trial Percutaneous Endovascular Aneurysm Repair (PEVAR) Trial Biomarkers of Aneurysm Wall Strength Post Implant Syndrome After EVAR and EVAS (INSPIRE Study) Control Post Endovascular Treatment of Aortic Aneurisms Through Magnetic Resonance and Ultrasound (SAFEVAR) Estimation of Biomechanical Aortic Wall Properties in Healthy and Aneurysmal Aortas Using Novel Imaging Techniques ANEUFIX for Endoleaks Type II TriVascular Canadian LIFE Study: Least Invasive Fast-Track EVAR (Endovascular Aneurysm Repair) Screening Cardiovascular Patients for Aortic aNeurysms (SCAN) Emergency Department Ultrasound in Renal Colic Endurant Evo International Clinical Trial Physician Modified Endovascular Grafts Talent Aortic Cuff Stent Graft System Compassionate Use Registry Fusion of CT Angiography With 3D Contrast Ultrasound as a Method for Follow up for Endovascular Aneurysm Repair Evaluation of a New Imagingtechnologie for Thrombosis The Effect of Surgery on Central Aortic Pressure & haEmodynamics Study Image Fusion of Preprocedural CTA With Real Time Fluoroscopy to Enhance EVAR Repair Post-operative CT Follow up After Nellix Endoprosthesis Implantation Endovascular Exclusion of TAAA/AAA Utilizing Fenestrated/Branched Stent Grafts Zenith® p-Branch™: Single-Center Study Observatory of Screening Aneurysms of the Abdominal Aorta During Echocardiography. National Epidemiological Survey Female Aneurysm Screening STudy The Pivotal Study of the Aptus Endovascular AAA Repair System Endovascular Treatment of Aorto-iliac Disease Using in Situ Fenestration Interest of a Post-operative Ultrasound With Systematic Use of Ultrasonic Contrast in the Follow-up of Aortic Endoprosthesis: Prospective Study at the University Hospital of Nice Zenith® Fenestrated Abdominal Aortic Aneurysm (AAA) Endovascular Graft Continued Access Study Endovascular Aneurysm Repair (EVAR) Gate Study Powerlink Bifurcated Stent Graft Long-Term Follow-up Study Screening Cardiovascular Patients for Aortic Aneurysms Zenith(R) Fenestrated Abdominal Aortic Aneurysm (AAA) Endovascular Graft Clinical Study Global Fenestrated Anaconda Clinical sTudy TriVascular Post-Market Registry Vasovist Endoleak Study AAA Registry: Clinical Outcomes of Highly Angulated anatomY Treated With the Aorfix™ Stent Graft Italian Multicenter Database for Open Conversions After EVAR Evaluation of the Endovascular Repair for Aortic Aneurysm (EVAR) Program at LHSC Preoperative Methylprednisolone in Endovascular Aortic Repair Prospective Aortic Biobank of POP-STAR E-tegra Stent Graft System in the Treatment of Infra-renal Abdominal Aortic Aneurysms EValuation of Systemic Atherothrombosis in Patients With ARTerial Disease of the Lower Limbs A Clinical Study to Evaluate the Safety and Performance of the Modular AAA Stent-Graft System Prospective Aneurysm Trial: High Angle Aorfix™ Bifurcated Stent Graft The Vascutek Custom Fenestrated Anaconda Post-Market Surveillance Study Advanced MRI in AAA Korean Registry of Percutaneous EVAR With INCRAFT Stent Graft for the Treatment of Abdominalaortic Aneurysm (K-INCRAFT) Safety and Efficacy of the SETA LATECBA Stent Graft for EVAR in Subjects With AAA UVA Brain and Aortic Aneurysm Study Acute Technical Outcomes of the Talent Abdominal Aortic Aneurysm (AAA) Stent-Graft Versus Cook Zenith Stent-Graft South American Abdominal Stent Graft Trial Zenith® Spiral-Z® AAA Iliac Leg Graft Post-market Registry AneuRx Post Market Study in the Treatment of AAA Predicting Aneurysm Growth and Rupture With Longitudinal Biomarkers The Boston Scientific ENOVUS Trial The (PIVOTAL) Study Suprarenal Proximal Cuff Study for Treatment of Abdominal Aortic Aneurysm Relation betwEen Abdominal Aorta and Carotid Artery Responses to SymPathetic stimulatiON uSing duplEx Ultrasound ARBITER-II: Aorfix™ Bifurcated Safety and Performance Trial: Phase II, Angulated Vessels Evaluation of Predictors of Aortic Aneurysm Growth and Rupture Compassionate Use of the Incraft® AAA Stent Graft System Aortic Distensibility Randomized Preventive Vascular Screening Trial of 65-74 Year Old Men in the Central Region of Denmark CRD007 for the Treatment of Abdominal Aorta Aneurysm (The AORTA Trial) ACT Guided Heparinization During Open Abdominal Aortic Aneurysm Repair. Cross-sectional Study of Prevalence Rate of Abdominal Aortic Aneurysm in OSAHS Patients From BTCH Mechanism and Prevention of Remote Organ Injury Following Ruptured Aortic Aneurysm Study of Abdominal Aortic Stent Grafts in the Treatment of Infrarenal Abdominal Aortic Aneurysms Study on Anti-inflammatory Effect of Anti-hypertensive Treatment in Patients With Small AAA’s and Mild Hypertension DynaCT Imaging in EVAR: Comparing Clinical Benefit of DynaCT to Multidetector CT as the Current Gold Standard. Zenith® LP Abdominal Aortic Aneurysm (AAA) Post-Market Registry Endovascular Exclusion of Thoracoabdominal and/or Paravisceral Abdominal Aortic Aneurysm Safety and Efficacy of Allogeneic MSCs in Promoting T-regulatory Cells in Patients With Small Abdominal Aortic Aneurysms Post-Market Study to Assess Outcomes of Patients Treated With AFX System Compared to Other EVAR Devices Dutch Randomised Endovascular Aneurysm Management (DREAM-) Trial Metformin Therapy in Non-diabetic AAA Patients Tonometry(1) and Duplex Ultrasound(2) to Predict CV Events in to be Treated Patients With an AAA Tonometry and Duplex Ultrasound to Predict AAA Progression and CV Events in Aneurysm Patients (1-2-3 Trial) Endoprosthesis Treatment Effects on Human Abdominal Aorta Aneurysms (AAA) Metabolic Activity Surviving Aneurysm Surgery: A Pilot Study on Exercise Training in Abdominal Aortic Aneurysm Patients Treovance Stent-Graft With Navitel Delivery System for Patients With Infrarenal Abdominal Aortic Aneurysms Cyclosporine A in Patients With Small Diameter Abdominal Aortic Aneurysms Intraoperative Assessment of Pulsatile Aneurysm Wall Motion During Endovascular Aneurysm Repair Curcumin to Prevent Complications After Elective Abdominal Aortic Aneurysm (AAA) Repair Post Implantation Syndrome and Administration on NSAIDs in Patients Undergoing EVAR for AAA LUCY Study: TriVascular Evaluation of Females Who Are Underrepresented Candidates for Abdominal Aortic Aneurysm Repair Elective Abdominal Aortic Aneurism – Open Versus Endovascular Repair TriVascular Evaluation of Females Who Are Underrepresented Candidates for Abdominal Aortic Aneurysm Repair in Europe Statin Use in Abdominal Aortic Aneurysm Repair GORE® EXCLUDER® Endoprosthesis French Mandatory Registry Endovascular Exclusion of Abdominal Aortic Aneurysms in High Risk Patients Aneurysma Hernia Study – Incidence of Incisional Hernias After Abdominal Aortic Aneurysm Repair Predictors of AAA Expansion and/or Rupture Non-invasive Monitoring of Endovascular Repair of Abdominal Aortic Aneurysm (VBA) Comparison of Beta-blocker Versus Angiotensin Receptor Blocker for Suppression of Aneurysm Expansion in Patients With Small Abdominal Aortic Aneurysm and Hypertension (BASE Trial) Preferences for Open Vs. Endovascular Repair for Abdominal Aortic Aneurysm Pharmacokinetics of CRD007 in Patients With Abdominal Aorta Aneurisms. Study of the Endovascular QUANTUM LP™ Stent Graft System in Abdominal Aortic Aneurysms (AAA) Immediate Management of the Patient With Rupture : Open Versus Endovascular Repair Study of the Glycocalyx in Abdominal Aortic Aneurysm Effect of Pre-operative Exercise in Abdominal Aortic Aneurysms (AAA) Patients. Validation of Fenestrations Positioning by Numerical Simulation Prevalence and Screening of Abdominal Aortic Aneurysms Among Men With Coronary Artery Disease START – Early Thrombocyte Administration to Patients With Ruptured Abdominal Aortic Aneurism Intraoperative Perfusion Patterns of the Sigmoid Colon During Elective Open Abdominal Aortic Aneurysm Repair The Inter and Intra Reliability of Cardiopulmonary Exercise Testing in Abdominal Aortic Aneurysm Patients Prevalence of Carotid Artery Stenosis and Abdominal Aortic Aneurysms in Brussels: a Population-based Screening Study. Screening of Abdominal Aortic Aneurysms Among Male Patients With TIA Symptoms The Nellix® EndoVascular Aneurysm Sealing System for the Treatment of Infrarenal Abdominal Aortic Aneurysms Screening of Abdominal Aortic Aneurysms Among Men With Coronary Artery Disease Cordis Bilateral AAA Device Compared to Open Surgical Repair of Abdominal Aortic Aneurysms (ARIBA) A Large Surgical Registry for Abdominal Aortic Aneurysms (AAA) Circulating microRNAs and Degenerative Abdominal Aorta Aneurysm Follow-up After Endovascular Repair of Abdominal Aortic Aneurysm Abdominal Aortic Aneurysms and Pseudoexfoliation Syndrome The Efficacy of Ticagrelor on Abdominal Aortic Aneurysm (AAA) Expansion Physician-Sponsored IDE for Talent Endoluminal Spring Graft System in Patients With Abdominal Aortic Aneurysms (AAA) Impact of Limb Remote Ischemic Preconditioning on Mortality and Quality of Life During Abdominal Aortic Aneurysm Repair Magnetic Resonance Elastography in Patients With Abdominal Aortic Aneurysms 34mm Cuff Study for Endovascular Repair of Abdominal Aortic Aneurysms Metformin for Abdominal Aortic Aneurysm Growth Inhibition Clinical Study of Abdominal Aortic Aneurysm Exclusion (TALENT Abdominal) A Phase I Evaluation of the Safety of the TriVascular Stent-Graft System in the Treatment of Abdominal Aortic Aneurysms Screening for Abdominal Aortic Aneurysm and Abdominal Aortic Atherosclerosis by Hand-Held Ultrasonography Clinical Study of the Treovance Stent-Graft for Patients With Abdominal Aortic Aneurysms Development of Novel Imaging Markers Predicting the Progression of Abdominal Aortic Aneurysm Using 3D Computed Tomography Structured Exercise Programme and Abdominal Aortic Aneurysm Surgery Study of the Effectiveness of Telmisartan in Slowing the Progression of Abdominal Aortic Aneurysms Evaluation of Effect of Angiotensin-converting Enzyme (ACE) Inhibitors on Small Aneurysm Growth Rate A Prospective Analysis on the Expansion Rates of Abdominal Aortic Aneurysms Reduction of Myocardial Infarction by Preconditioning in Patients With Ruptured Abdominal Aortic Aneurysm Magnetic Resonance Imaging To Predict Outcomes In Aortic Aneurysms Abdominal Aortic Aneurysm Sac Healing and Prevention of Endoleaks A MULTICENTER, OPEN LABEL, PROSPECTIVE, NON-RANDOMIZED STUDY OF INCRAFT™ IN SUBJECTS WITH ABDOMINAL AORTIC ANEURYSMS (INNOVATION) Abdominal Aortic Aneurysm Surgery and Thrombosis Ultra-sound for AAA Screening in Smoking Israeli Arab Men Prophylactic Mesh Implantation After Abdominal Aortic Aneurysm Repair Compassionate Use Treatment for a Single Patient With a Custom Made Branched/Fenestrated Endovascular Device for the Treatment of Complex Abdominal Aortic Aneurysm Comparison of Methods to Improve Abdominal Aortic Aneurysm (AAA) Screening Rates in the Primary Care Setting. Safety Study for the Treatment of Abdominal Aortic Aneurysms Prevention of Incisional Hernia After Elective Open Abdominal Aortic Aneurysm (AAA) Repair Sodium Fluoride Imaging of Abdominal Aortic Aneurysms Biomarker Profiling in Abdominal Aortic Aneurysm Patients Vascutek Anaconda™ Abdominal Aortic Aneurysm (AAA) Post-Market Surveillance Registry Limb Remote Ischemic Preconditioning Reduces Heart and Lung Injury After Abdominal Aortic Aneurysm Repair China Post-market Study of the INCRAFT® AAA Stent Graft System in Subjects With Abdominal Aortic Aneurysms (INITIATION) Screening for Thoracic Aortic Aneurysm Among a Cohort of Patients With a Degenerative Abdominal Aortic Aneurysm A Multicenter, Open Label, Prospective, Non-randomized Study of the InCraft® Stent Graft System in Subjects With Abdominal Aortic Aneurysms (INSPIRATION) Prevention of Endoleaks Using Autologous Platelet Gel on Unruptured Abdominal Aortic Aneurysms Screening for Abdominal Aortic Aneurysm in 65 Year Old Males in Oslo European (EU) Post Approval Study of the INCRAFT® AAA Stent Graft System in Subjects With Abdominal Aortic Aneurysms Prevention of Type II Endoleaks During Endovascular Treatment of Abdominal Aortic Aneurysm: Endovascular Treatment Versus Combination With Coil Embolisation of the Aneurysmal Sac HORIZON CE Pivotal Study to Treat Abdominal Aortic Aneurysm Screening Programme for Abdominal Aortic Aneurysm by Hand-Held-Ultrasonography in Primary Health Care ACZ885 for the Treatment of Abdominal Aortic Aneurysm Measurement of Maximum Diameter of Native Abdominal Aortic Aneurysm by Angio-CT Intact Abdominal Aortic Aneurysm Repair in Portugal The Altura Abdominal Aortic Aneurysm (AAA) Endograft Safety and Feasibility Study

Brief Title

Surviving Aneurysm Surgery: A Pilot Study on Exercise Training in Abdominal Aortic Aneurysm Patients

Official Title

Surviving Aneurysm Surgery: A Pilot Randomised Controlled Trial on Exercise Training in Abdominal Aortic Aneurysm Patients

Brief Summary

      An abdominal aortic aneurysm (AAA) is an enlargement or ballooning of the main artery
      supplying high pressure blood from the heart to the body. AAAs may continue to stretch until
      they burst (rupture) causing 7000 deaths per year in the United Kingdom (UK); 2.1% of all
      deaths in men over 65. Planned repair before rupture is critical and the National AAA
      Screening Programme (NAAASP) is being introduced to identify AAAs in men before rupture.
      Screening will identify over 9000 men per year with a previously undiagnosed AAA. More than
      90% of screen detected AAAs are small, do no require repair, enter ultrasound follow-up
      (surveillance) and may benefit from exercise to improve fitness before repair.

      Over 4000 elective AAA repairs per year are performed in the UK and it has been suggested
      that exercise training and weight loss may reduce mortality and complications of AAA repair.
      This pilot study will examine the feasibility of supervised exercise training for patients
      with AAAs and determine the optimal duration of training to achieve worthwhile improvements
      in fitness.
    

Detailed Description

      Abdominal aortic aneurysm (AAA) affects 4% of men aged 65-79, a prevalence rising as our
      population ages. As most patients suffering rupture die immediately, elective AAA repair is
      critical and the National AAA Screening Programme (NAAASP) is being implemented across the UK
      to identify AAAs for elective repair. Manchester is the first major urban population to be
      screened. The UK had the highest mortality rates following elective open AAA repair in Europe
      (7% v 3.5%); the AAA Quality Improvement Programme's (AAAQIP) target is to reduce this to
      under 3.5% by 2013.

      The benefits of exercise across a broad spectrum of medical conditions are now increasingly
      recognised; especially in the elderly. Exercise training may reduce mortality and
      complications in major surgery. Cardiopulmonary exercise testing (CPET) measures
      cardiopulmonary reserve and predicts outcome in major surgery. The Manchester CPET study
      group demonstrated that anaerobic threshold (AT) and peak oxygen consumption (VO2 peak)
      predict 30 and 90-day mortality in elective AAA repair.

      The investigators propose a pilot randomised controlled trial (RCT) to determine whether a
      structured exercise programme improves fitness measured by CPET, and the optimal duration of
      training for AAA surgery. As over 90% of AAAs detected by screening are < 5.5cm and enter
      surveillance, these patients offer a unique opportunity to explore the ideal duration of
      exercise training as surgery is not indicated for months or years.

      100 participants on AAA surveillance will be recruited and randomised to either exercise
      training or standard preoperative care (50 in each arm) to answer the following research
      questions:

        1. Can a supervised exercise programme improve performance in CPET measures that predict
           outcome in AAA surgery?

        2. What is the optimal period of training needed to achieve a significant improvement in
           CPET scores?

        3. How long is any exercise-induced improvement in fitness sustained?

        4. The economic and health costs of a supervised exercise training programme

      Exercise subjects will attend a 60 minute supervised exercise programme of moderate intensity
      (70% of heart rate reserve) x3/week at a local gym. All participants will undergo CPET
      assessment of cardiopulmonary fitness and complete a health-related quality of life (Medical
      Outcomes Study 36-Item Short-Form Health Survey) at baseline and 18 weeks. The exercise
      subjects will undergo further CPET studies at 6, 12 and 36 weeks to investigate the duration
      of training needed to optimise fitness and the length of time improvements in fitness
      persist. Other important health related outcomes include blood pressure and lipid profile and
      frequency of health service visits (e.g. General Practitioner appointments) will be recorded
      for all participants at baseline and 18 weeks to provide data on the effects of exercise on
      health care costs. Longitudinal regression models, with Normal and Poisson distributions as
      appropriate, will be used to assess differences between the groups with respect to CPET
      changes, other health-related outcomes and frequency of health service visits over the whole
      study period. This pilot study will also explore strategies to encourage participation and
      compliance with exercise which may also improve general health outcomes and save National
      Health Service (NHS) costs by reducing demand.

      The overall aim is to collect the data needed to design a definitive multicentre trial on
      whether physical exercise reduces morbidity and/or mortality in AAA repair.

      Those aged >65 are the fastest growing segment of our population. This pilot study will
      contribute to public health policy drive on the impact of physical activity on functional
      capacity, quality of life and independence.
    


Study Type

Interventional


Primary Outcome

Cardiopulmonary Exercise Test Score

Secondary Outcome

 Cardiopulmonary Exercise Test Score

Condition

Abdominal Aortic Aneurysm

Intervention

Exercise Training

Study Arms / Comparison Groups

 Control
Description:  Standard pre-operative care, no active intervention

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

Behavioral

Estimated Enrollment

100

Start Date

June 2013

Completion Date

May 2014

Primary Completion Date

December 2013

Eligibility Criteria

        Inclusion Criteria:

          -  Men or women with an AAA ≥3.5cm to <5.5cm in men and ≥3.5cm to <5.0cm in women

          -  Age 50-85 years and willing to consider exercise training

          -  Fit for either open or Endovascular Aneurysm Repair AAA repair

        Exclusion Criteria:

          -  Unable to participate in an exercise test or inability to exercise consistently
             because of musculoskeletal or other health problems

          -  History of severe liver disease (INR>2, serum albumin <3.0g/dL, jaundice)

          -  Unstable angina: Patients with angina of less than 2 months' duration, severe or
             occurring three or more times per day, or angina that is becoming either more frequent
             of precipitated by less exertion or angina at rest

          -  Uncontrolled atrial fibrillation (AF) or other arrhythmia: Untreated episodes of
             paroxysmal AF in the last 3 months

          -  Moderate or severe aortic valve stenosis (peak systolic pressure gradient > 40mmHg and
             with an aortic valve area of <1cm^2.

          -  Class III/IV heart failure and / or an ejection fraction <25%

          -  Active pericarditis or myocarditis

          -  CPET induced ischaemia

          -  Diagnosis or treatment for a malignancy (excluding skin) over the previous 12 months
      

Gender

All

Ages

50 Years - 85 Years

Accepts Healthy Volunteers

Accepts Healthy Volunteers

Contacts

Charles M McCollum, MD, , 

Location Countries

United Kingdom

Location Countries

United Kingdom

Administrative Informations


NCT ID

NCT01805973

Organization ID

2013VSAS001


Responsible Party

Sponsor

Study Sponsor

Manchester University NHS Foundation Trust

Collaborators

 University of Manchester

Study Sponsor

Charles M McCollum, MD, Principal Investigator, Manchester University NHS Foundation Trust


Verification Date

May 2020