Safety and validity of extracorporeal fenestration and in situ fenestration in patients with aortic disease involving the left subclavian artery: a prospective, single-center, randomized controlled study.

IF 2 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Trials Pub Date : 2025-01-30 DOI:10.1186/s13063-025-08746-5
Xiaojian Jia, Jingjin Wu, Caiyou Ding, Yanbo Lou
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引用次数: 0

Abstract

Background: Thoracic aortic pathologies involving the aortic arch are a great challenge for vascular surgeons. Maintaining the patency of supra-aortic branches while excluding the aortic lesion remains difficult. Thoracic EndoVascular Aortic Repair (TEVAR) with fenestrations provides a feasible and effective approach for this type of disease. The main purpose of this trial is to assess the safety and validity of extracorporeal fenestration and in situ fenestration in patients with aortic disease involving the left subclavian artery.

Methods: This is a prospective, single-center, randomized controlled study. A total of 170 eligible patients will be recruited from The Fourth Affiliated Hospital, Zhejiang University School of Medicine in China and randomized on a 1:1 basis either to the group A (extracorporeal fenestration) or the group B (in situ fenestration). The primary outcome will be the all-cause mortality (30 days). The secondary outcomes will include incidence of secondary intervention (30 days, 6 months, 1 year), incidence of endoleak (30 days, 6 months, 1 year), incidence of major adverse events (MAE) (i.e., immediate procedural success and complications) (30 days, 6 months, 1 year), immediate technical success rate, and all-cause mortality (6 months, 1 year).

Discussion: Suppose extracorporeal fenestration non-inferior to in situ fenestration in patients with aortic disease involving the left subclavian artery. This trial aims to demonstrate the safety and validity of extracorporeal fenestration and in situ fenestration in patients with aortic disease involving the left subclavian artery, which is expected to provide a reference for Thoracic EndoVascular Aortic Repair (TEVAR) with fenestrations.

Trial registration: ClinicalTrials.gov NCT06256757. Registered on February 5, 2024. https://clinicaltrials.gov/study/NCT06256757 .

涉及左锁骨下动脉的主动脉疾病患者体外开窗和原位开窗的安全性和有效性:一项前瞻性、单中心、随机对照研究
背景:涉及主动脉弓的胸主动脉病变对血管外科医生来说是一个巨大的挑战。在排除主动脉病变的同时保持主动脉上分支的通畅仍然是困难的。胸椎血管内主动脉瓣开窗修复术(TEVAR)为治疗该类疾病提供了一种可行而有效的方法。本试验的主要目的是评估体外开窗和原位开窗治疗累及左锁骨下动脉的主动脉疾病患者的安全性和有效性。方法:这是一项前瞻性、单中心、随机对照研究。从中国浙江大学医学院附属第四医院招募170名符合条件的患者,按1:1的比例随机分为A组(体外开窗)和B组(原位开窗)。主要结局为全因死亡率(30天)。次要结局包括二次干预发生率(30天、6个月、1年)、endo渗漏发生率(30天、6个月、1年)、主要不良事件(MAE)发生率(即即时手术成功和并发症)(30天、6个月、1年)、即时技术成功率和全因死亡率(6个月、1年)。讨论:对于累及左锁骨下动脉的主动脉疾病患者,假设体外开窗术优于原位开窗术。本试验旨在证明体外开窗和原位开窗治疗累及左锁骨下动脉的主动脉疾病的安全性和有效性,为胸椎血管内主动脉瓣开窗修复(TEVAR)提供参考。试验注册:ClinicalTrials.gov NCT06256757。2024年2月5日注册。https://clinicaltrials.gov/study/NCT06256757。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Trials
Trials 医学-医学:研究与实验
CiteScore
3.80
自引率
4.00%
发文量
966
审稿时长
6 months
期刊介绍: Trials is an open access, peer-reviewed, online journal that will encompass all aspects of the performance and findings of randomized controlled trials. Trials will experiment with, and then refine, innovative approaches to improving communication about trials. We are keen to move beyond publishing traditional trial results articles (although these will be included). We believe this represents an exciting opportunity to advance the science and reporting of trials. Prior to 2006, Trials was published as Current Controlled Trials in Cardiovascular Medicine (CCTCVM). All published CCTCVM articles are available via the Trials website and citations to CCTCVM article URLs will continue to be supported.
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