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Trial registered on ANZCTR
Registration number
ACTRN12617001210369
Ethics application status
Approved
Date submitted
15/08/2017
Date registered
18/08/2017
Date last updated
5/04/2023
Date data sharing statement initially provided
5/04/2023
Date results information initially provided
5/04/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
Does cerebral perfusion impact on cognitive function following intervention for carotid artery stenosis?
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Scientific title
Does cerebral perfusion impact on cognitive function following intervention for carotid artery stenosis?
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Secondary ID [1]
292665
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
carotid artery stenosis
304406
0
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cognition
304407
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Condition category
Condition code
Cardiovascular
303736
303736
0
0
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Diseases of the vasculature and circulation including the lymphatic system
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Mental Health
303737
303737
0
0
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Studies of normal psychology, cognitive function and behaviour
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Cerebral perfusion (as measured by cerebral blood flow on transcranial doppler, cerebral oximetry on near-infrared spectroscopy, and magnetic resonance imaging with arterial spin labelling protocols and diffusion weighted imaging), and cognitive function (as measured by CogState, DKEFS Verbal Fluency test, and Stroop test) will be measured pre-intervention/1 week post-intervention/4 weeks post-intervention/3 months post-intervention in patients who undergo either carotid endarterectomy for high-grade carotid artery stenoses for stroke risk reduction (under current algorithms and evidence for carotid intervention). Cerebrovascular reserve as per Ringelstein calculations will also be measured pre-intervention/4 weeks post-intervention/3 months post-intervention using hypocapnic (baseline minus 6mmHg EtCO2), room air, 3% CO2 inhalation, and 6% CO2 inhalation.
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Intervention code [1]
298901
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Not applicable
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Comparator / control treatment
Healthy age and education matched subjects with or without out high-grade carotid stenoses will undergo the above listed measurements at 4 time points equivalent to those undergoing carotid intervention - baseline measurement (equivalent to pre-intervention), 1-2 weeks post-baseline (equivalent to 1 week post-intervention), 4-6 weeks post-baseline (equivalent to 4 weeks post-intervention), and 3-4 months post-baseline (equivalent to 3 months post-intervention).
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Control group
Active
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Outcomes
Primary outcome [1]
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Cognitive function as measured by CogState battery, DKEFS Verbal Fluency test, Stroop test; measured as a composite.
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Assessment method [1]
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Timepoint [1]
303104
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Pre-intervention (approx 1 week pre), 1 week post-intervention, 4 weeks post-intervention, 3 months post-intervention
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Primary outcome [2]
303108
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Cerebral perfusion as measured by MRI arterial spin labelled protocol
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Assessment method [2]
303108
0
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Timepoint [2]
303108
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Pre-intervention (approx 1 week pre), 1 week post-intervention
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Primary outcome [3]
303110
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Cerebrovascular reactivity as measured by transcranial doppler of middle cerebral artery flows, with four stimuli (hypocapnic ie baseline minus 6mmHg EtCO2, baseline at room air, 3% CO2, 6% CO2), calculated as per Ringelstein's equation.
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Assessment method [3]
303110
0
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Timepoint [3]
303110
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Pre-intervention (approx 1 week pre), 1 week post-intervention, 4 weeks post-intervention, 3 months post-intervention
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Secondary outcome [1]
337892
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Quality of life as measured by WHO-QOL questionnaire
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Assessment method [1]
337892
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Timepoint [1]
337892
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Pre-intervention, 1 week post-intervention, 4 weeks post-intervention, 3 months post-intervention.
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Secondary outcome [2]
337898
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Mood as measured by POMS-A questionnaire, administered immediately prior to cognitive testing
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Assessment method [2]
337898
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Timepoint [2]
337898
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Pre-intervention, 1 week post-intervention, 4 weeks post-intervention, 3 months post-intervention.
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Eligibility
Key inclusion criteria
Patients 45-89 years of age planned for carotid endarterectomy or carotid artery stenting of high-grade carotid stenoses for stroke risk reduction.
Healthy control group: 45-89 years of age, age and education matched volunteers/spouses.
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Minimum age
45
Years
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Maximum age
89
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Non-English speaking
Functional impairment impeding physical ability to participate in cognitive testing
Diagnosed dementia
Haemorrhagic stroke
Stroke post-operatively
On neuro-modulating drugs
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
Generalised linear mixed model
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
18/08/2017
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Actual
18/08/2017
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Date of last participant enrolment
Anticipated
31/10/2019
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Actual
31/10/2019
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Date of last data collection
Anticipated
31/01/2020
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Actual
10/01/2020
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Sample size
Target
66
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Accrual to date
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Final
68
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
8808
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Sir Charles Gairdner Hospital - Nedlands
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Recruitment hospital [2]
8809
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St John of God Hospital, Subiaco - Subiaco
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Recruitment hospital [3]
8810
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Mount Hospital - Perth
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Recruitment postcode(s) [1]
16931
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6009 - Nedlands
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Recruitment postcode(s) [2]
16932
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6008 - Subiaco
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Recruitment postcode(s) [3]
16933
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6000 - Perth
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Funding & Sponsors
Funding source category [1]
297300
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Other Collaborative groups
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Name [1]
297300
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Heart Research Institute
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Address [1]
297300
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Harry Perkins Institute of Medical Research
Level 2, QQ block, Queen Elizabeth II Medical Campus
6 Verdun Street
Nedlands
WA 6009
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Country [1]
297300
0
Australia
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Funding source category [2]
297307
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Hospital
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Name [2]
297307
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Sir Charles Gairdner Hospital
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Address [2]
297307
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Hospital Avenue
Nedlands
WA 6009
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Country [2]
297307
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Australia
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Funding source category [3]
297308
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University
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Name [3]
297308
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School of Science (Exercise and Sports Science), University of Western Australia
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Address [3]
297308
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35 Stirling Highway
Crawley
WA 6009
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Country [3]
297308
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Australia
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Funding source category [4]
300191
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Commercial sector/Industry
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Name [4]
300191
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WL Gore & Associates
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Address [4]
300191
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Suite 1 13a Narabang Way
Belrose, NSW 2085
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Country [4]
300191
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Australia
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Funding source category [5]
300192
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Commercial sector/Industry
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Name [5]
300192
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Boston Scientific
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Address [5]
300192
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Building 1, L6 Connect Corporate Centre,
191 O’Riordan Street, Mascot, NSW 2020
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Country [5]
300192
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Australia
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Funding source category [6]
300193
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Commercial sector/Industry
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Name [6]
300193
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Abbott Medical
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Address [6]
300193
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Abbott Vascular
299 Lane Cove Road
Macquarie Park, NSW 2113
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Country [6]
300193
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Australia
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Funding source category [7]
300194
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University
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Name [7]
300194
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Curtin University
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Address [7]
300194
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Kent Street, Bentley, Perth, Western Australia 6102
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Country [7]
300194
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Australia
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Primary sponsor type
Individual
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Name
Dr Shirley Jansen
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Address
Dept of Vascular and Endovascular Surgery
Sir Charles Gairdner Hospital
Hospital Avenue
Nedlands, Perth
WA 6009
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Country
Australia
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Secondary sponsor category [1]
296272
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Individual
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Name [1]
296272
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Dr Chi Ho Ricky Kwok
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Address [1]
296272
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Dept of Vascular and Endovascular Surgery
Sir Charles Gairdner Hospital
Hospital Avenue
Nedlands, Perth
WA 6009
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Country [1]
296272
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Australia
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Secondary sponsor category [2]
296273
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Individual
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Name [2]
296273
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Winthrop Professor Daniel Green
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Address [2]
296273
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School of Science (Exercise and Sports Science)
University of Western Australia (M408)
35 Stirling Highway
Crawley, Perth
Western Australia 6009
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Country [2]
296273
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
298408
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Human Research Ethics Committee, Sir Charles Gairdner Hospital
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Ethics committee address [1]
298408
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Sir Charles Gairdner Hospital
Level 2, A Block, Hospital Avenue, NEDLANDS WA 6009
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Ethics committee country [1]
298408
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Australia
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Date submitted for ethics approval [1]
298408
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30/11/2014
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Approval date [1]
298408
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11/02/2015
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Ethics approval number [1]
298408
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RGS0000001708
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Summary
Brief summary
The link between carotid artery disease and stroke is well defined in severe carotid artery stenosis. The link between carotid artery disease, cerebral perfusion, and cognitive function, is less well characterised, particularly in the absence of clinical stroke. Characterising the relationship between carotid stenosis, cerebral perfusion, and cognitive function is relevant to 1). understanding the role of carotid intervention in improving cerebral perfusion and cognitive function and, thereby, dementia prevention; 2). reconsidering the threshold for intervention in those patients who are judged ‘asymptomatic’ by current criteria (whereby indications for intervention are based on stroke risk reduction); and 3). examining whether the two distinct forms of intervention for carotid stenosis (carotid endarterectomy and carotid artery stenting) have different impacts on cognitive function. Alongside our study of the impact of intervention for carotid stenosis and cognition, we will also examine relationships between changes in cognition and quality of life. If improvement in cerebral perfusion and cognitive function in patients treated for asymptomatic carotid artery stenosis can be demonstrated, this would impact significantly on decision making and treatment for these patients with respect to the prevention of cognitive decline.
The overarching aim of this research is to determine whether changes in cognitive function occur in older adults following intervention for carotid artery stenosis.
The primary objectives are to investigate whether:
1) carotid endarterectomy (CEA) improves cognitive function in patients with symptomatic and asymptomatic carotid artery stenosis,
2) changes in cognitive function following CEA are related to changes in cerebral blood flow and cerebrovascular reserve (CVR) in patients with symptomatic and asymptomatic carotid artery stenosis,
4) changes in cognitive function following CEA are related to findings on MRI, and specifically, on arterial spin-labelled cerebral perfusion imaging,
5) changes in cognitive function following CEA are independent of changes in mood scores,
6) changes in cognitive function following CEA are related to changes in quality of life.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
76994
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Dr Chi Ho Ricky Kwok
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Address
76994
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Dept of Vascular and Endovascular Surgery
Sir Charles Gairdner Hospital
Hospital Ave
Nedlands
WA 6009
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Country
76994
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Australia
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Phone
76994
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+61 8 6457 3333
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Fax
76994
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+61 8 6457 2298
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Email
76994
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[email protected]
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Contact person for public queries
Name
76995
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Dr Ricky Kwok
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Address
76995
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Dept of Vascular and Endovascular Surgery
Sir Charles Gairdner Hospital
Hospital Ave
Nedlands
WA 6009
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Country
76995
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Australia
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Phone
76995
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+61 8 6457 3333
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Fax
76995
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+61 8 6457 2298
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Email
76995
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[email protected]
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Contact person for scientific queries
Name
76996
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Dr Ricky Kwok
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Address
76996
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Dept of Vascular and Endovascular Surgery
Sir Charles Gairdner Hospital
Hospital Ave
Nedlands
WA 6009
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Country
76996
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Australia
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Phone
76996
0
+61 8 6457 3333
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Fax
76996
0
+61 8 6457 2298
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Email
76996
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
deidentified cognitive and perfusion data
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When will data be available (start and end dates)?
From publication until Jan 2027.
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Available to whom?
Upon request with a sound proposal, as determined by primary sponsor
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Available for what types of analyses?
To achieve aims of approved proposal
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How or where can data be obtained?
Request initially via email
[email protected]
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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