Brief Title
The Use of Carbon Dioxide as a Contrast Media for Performing Endovascular Procedures
Official Title
The Use of Carbon Dioxide as a Contrast Media for Performing Endovascular Procedures
Brief Summary
Prospective randomized comparison between endovascular procedures performed with iodinated contrast or carbon dioxide as intraarterial contrast.
Detailed Description
120 patients will undergo endovascular procedures: 40 for the treatment of lower limb ischemia caused by aortoiliac stenosis classified according to the consensus for the management of peripheral arterial disease (TASC) A or B with an indication for angioplasty as the inclusion criteria; 40 for the treatment of lower limb ischemia due to stenosis femoropopliteal TASC A or B with an indication of angioplasty as the inclusion criteria and 40 for the treatment of abdominal aortic aneurysm (AAA) with indication for endovascular repair. Of these procedures, half chosen randomly by computerized simple random, will be submitted to the endovascular procedure in question using only iodinated contrast and the other half will be submitted to the endovascular procedure using carbon dioxide (CO2). There will be no CO2 injection in the aortic arch or cerebral territory. The patient previously evaluated at the Hospital Municipal Dr. Moses Deutsch will be referred to the operating room of the Albert Einstein Hospital where it will be performed under general anesthesia with intubation or blockage associated with sedation, and the same in the supine position (DDH).The femoral artery will be punctured with Seldinger technique unilaterally or bilaterally, according to the indication for the procedure. By using the guide wire will be one or two sheaths inserted in a retrograde manner. Through the introducer, is manually injected retrogradely 50 ml of CO 2, in obtaining images of the apparatus module CO2 Philips mode subtraction angiography. In angioplasty for obstructive disease, with the module roadmap will be held the passage of the guidewire through the stenotic region or occlusion, and dilatation balloon angioplasty specific. After angioplasty, there will be a new injection of contrast for the evaluation of partial results. As appropriate, will be held stent placement, in which case there will be a last angiography with 50 ml of CO2. In endovascular repair of abdominal aortic aneurysms, there will be a first injection of CO2 for the study of the neck of the aneurysm and stent implantation. After the release of the entire stent, a new angiography is performed by injection of CO2 for the control of surgical outcome. In all procedures will be performed to measure pressure through the femoral sheath prior to angioplasty, after angioplasty and stent after the placement. During the use of CO2 as contrast medium, with questions at the trial of such factors as the extent of injury, indication of repair, endoleak, leak, rupture or thrombosis by arteriography will be performed by manual injection of iodinated contrast.Of course this amount of contrast is measured.
Study Type
Interventional
Primary Outcome
Contrastation analysis of the arterial lumen on endovascular procedures using CO2 as contrast media.
Secondary Outcome
clinical outcome: changes in the post-surgery ABI
Condition
Critical Lower Limb Ischemia
Intervention
CO2
Study Arms / Comparison Groups
lower limb angioplasty with CO2
Description: lower limb angioplasty made with carbon dioxide as contrast media
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
Drug
Estimated Enrollment
120
Start Date
April 2012
Completion Date
May 2018
Primary Completion Date
July 2014
Eligibility Criteria
Inclusion Criteria: - critical lower limb ischemia resulting from arterial disease morphology TASC A or B or abdominal aortic aneurysms with correction indication - Agreement and signing the informed consent. Exclusion Criteria: - exhibited severe chronic obstructive pulmonary disease (COPD) - kidney failure - heart failure - pregnancy - TASC C or D lesions
Gender
All
Ages
N/A - N/A
Accepts Healthy Volunteers
No
Contacts
Nelson Wolosker, ,
Location Countries
Brazil
Location Countries
Brazil
Administrative Informations
NCT ID
NCT01861327
Organization ID
CO2
Responsible Party
Sponsor-Investigator
Study Sponsor
Nelson Wolosker
Collaborators
Ministério da Saúde
Study Sponsor
Nelson Wolosker, Principal Investigator, Hospital Israelita Albert Einstein
Verification Date
February 2017