Please note that the copy function is not enabled for this field.
If you wish to
modify
existing outcomes, please copy and paste the current outcome text into the Update field.
LOGIN
CREATE ACCOUNT
LOGIN
CREATE ACCOUNT
MY TRIALS
REGISTER TRIAL
FAQs
HINTS AND TIPS
DEFINITIONS
Trial Review
The ANZCTR website will be unavailable from 1pm until 3pm (AEDT) on Wednesday the 30th of October for website maintenance. Please be sure to log out of the system in order to avoid any loss of data.
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
information for consumers
Download to PDF
Trial registered on ANZCTR
Registration number
ACTRN12618000295246p
Ethics application status
Not yet submitted
Date submitted
15/01/2018
Date registered
27/02/2018
Date last updated
27/02/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Sac Pressure in Endovascular Aneurysm Repair (SPEAR) trial
Query!
Scientific title
A Prospective Validation study of the Utility of Intra-Aortic Aneurysm Sac Pressure Measurements as a Predictor of Endoleak and further intervention in Patients undergoing Endovascular Aortic Aneurysm Repair (EVAR)
Query!
Secondary ID [1]
293776
0
None
Query!
Universal Trial Number (UTN)
U1111-1207-7203
Query!
Trial acronym
SPEAR
Query!
Linked study record
Query!
Health condition
Health condition(s) or problem(s) studied:
Aortic Aneurysms
306171
0
Query!
Endoleak
306172
0
Query!
Condition category
Condition code
Surgery
305283
305283
0
0
Query!
Surgical techniques
Query!
Cardiovascular
305340
305340
0
0
Query!
Diseases of the vasculature and circulation including the lymphatic system
Query!
Intervention/exposure
Study type
Interventional
Query!
Description of intervention(s) / exposure
Intra-sac pressure monitoring will be performed during endovascular aortic aneurysm repair (EVAR). The procedure will be performed by an experience Vascular surgeon. The pressure will be measured using a pressure transducing catheter that will be introduced at the start of the case through a separate femoral micro-puncture. The pressure will be measure at pre-defined intervals; before deployment of the stent graft, after deployment of the stent graft, after balloon moulding of the stent graft and after administration of protamine if it is given at the end of the case. The results will be correlated with any ability to predict continued endoleak or endotension at the completion of the procedure and upon follow up for 24 months.
Query!
Intervention code [1]
300030
0
Treatment: Devices
Query!
Comparator / control treatment
No control group
Query!
Control group
Uncontrolled
Query!
Outcomes
Primary outcome [1]
304441
0
The presence or absence of endoleak at completion of procedure measured on angiography or on ultrasound.
Query!
Assessment method [1]
304441
0
Query!
Timepoint [1]
304441
0
Assessment for endoleak or endotension will be performed before discharge, prior to 6 weeks to 3 months follow-up, prior to 6 month follow-up, prior to 12 months follow-up and prior to 24 months follow-up. The primary time-point is 12 months. All assessments for endoleak and endotension will be performed a maximum of 2 weeks before the scheduled follow-up appointment.
Query!
Secondary outcome [1]
341942
0
Aneurysm sac diameter measured on pre-operative ultrasound and CT and on ultrasound.
Query!
Assessment method [1]
341942
0
Query!
Timepoint [1]
341942
0
The secondary time-point is 12 and 24 months.
Query!
Secondary outcome [2]
341943
0
The need for re-intervention of any type due to type I or type III endoleaks or continued aneurysm sac growth. The need for re-intervention will be made during the course of clinical follow-up and is at the discretion of the treating surgeon. The diagnosis of endoleaks or continued aneurysm growth after the procedure will be made by the Vascular surgeons on the basis of ultrasound by experienced vascular sonographers and by fine slice contrast CT scans.
Query!
Assessment method [2]
341943
0
Query!
Timepoint [2]
341943
0
The secondary time-point is 12 and 24 months.
Query!
Secondary outcome [3]
341944
0
Post-operative surgical complications graded by the Clavien-Dindo Classification of Surgical Complications up to day 30 post-op. The data for this will be collected through medical records or noted by the treating vascular surgeon.
Query!
Assessment method [3]
341944
0
Query!
Timepoint [3]
341944
0
Complications within the first 30 days as assessed by medical records or noted by the treating vascular surgeon.
Query!
Eligibility
Key inclusion criteria
All patients over the age of 18 years of age who are undergoing elective or semi-urgent booked endovascular aortic aneurysm repair at the John Hunter Hospital.
Query!
Minimum age
18
Years
Query!
Query!
Maximum age
No limit
Query!
Query!
Sex
Both males and females
Query!
Can healthy volunteers participate?
No
Query!
Key exclusion criteria
Patients from the above group will be excluded if they:
• are under 18 years of age, or
• refuse or are unable to give written informed consent to participate in the study, or
• are unable to understand verbal and written consent documentation due to English not being the primary language, or
• have severe renal impairment, or
• severe allergy to iodine contrast which contraindicated endovascular repair, or
• require a thoraco-abdominal aneurysm repair, or
• pregnant or lactating females
Query!
Study design
Purpose of the study
Diagnosis
Query!
Allocation to intervention
Non-randomised trial
Query!
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
There is no allocation concealment as the intervention is performed on all participants by the treating team.
Query!
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Non-randomised trial
Query!
Masking / blinding
Open (masking not used)
Query!
Who is / are masked / blinded?
Query!
Query!
Query!
Query!
Intervention assignment
Single group
Query!
Other design features
Query!
Phase
Not Applicable
Query!
Type of endpoint/s
Safety/efficacy
Query!
Statistical methods / analysis
The primary outcome, the presence or absence of endoleaks at 12 months follow-up is a binary measurement based on ultrasound and CT imaging findings. The predictive performance of the intra-sac pressure measurements (and changes in these between pre- and post-surgery) will be assessed through a logistic regression model. Predictive performance will be measured using the AUC (and will be adjusted for internal optimism bias using bootstrap re-sampling). Model calibration will be assessed using Hosmer-Lemeshow’s test as well as graphical methods. A model including patient level characteristics will also be assessed and compared to the model including patient characteristics and intra-sec pressure. Mixed effects linear regression models will be used to assess the relationship between sac pressure and sac diameter measured at each follow-up time point.
Query!
Recruitment
Recruitment status
Not yet recruiting
Query!
Date of first participant enrolment
Anticipated
1/04/2018
Query!
Actual
Query!
Date of last participant enrolment
Anticipated
1/12/2019
Query!
Actual
Query!
Date of last data collection
Anticipated
1/12/2021
Query!
Actual
Query!
Sample size
Target
100
Query!
Accrual to date
Query!
Final
Query!
Recruitment in Australia
Recruitment state(s)
NSW
Query!
Recruitment hospital [1]
9753
0
John Hunter Hospital - New Lambton
Query!
Recruitment postcode(s) [1]
18531
0
2305 - New Lambton
Query!
Funding & Sponsors
Funding source category [1]
298392
0
Hospital
Query!
Name [1]
298392
0
John Hunter Hospital
Query!
Address [1]
298392
0
Lookout Road, New Lambton Heights, NSW, 2305
Query!
Country [1]
298392
0
Australia
Query!
Funding source category [2]
298394
0
Commercial sector/Industry
Query!
Name [2]
298394
0
Abbott Australasia Pty. Ltd.
Query!
Address [2]
298394
0
299 Lane Cove Road
Macquarie Park, NSW 2113
Query!
Country [2]
298394
0
Australia
Query!
Primary sponsor type
Individual
Query!
Name
Dr Arvind Deshpande
Query!
Address
John Hunter Hospital, Lookout Road, New Lambton Heights, NSW, 2305
Query!
Country
Australia
Query!
Secondary sponsor category [1]
297520
0
Hospital
Query!
Name [1]
297520
0
John Hunter Hospital
Query!
Address [1]
297520
0
Lookout Road, New Lambton Heights, NSW, 2305
Query!
Country [1]
297520
0
Australia
Query!
Ethics approval
Ethics application status
Not yet submitted
Query!
Ethics committee name [1]
299385
0
Hunter New England HREC
Query!
Ethics committee address [1]
299385
0
Hunter New England Health Locked Bag 1, New Lambton NSW 2305
Query!
Ethics committee country [1]
299385
0
Australia
Query!
Date submitted for ethics approval [1]
299385
0
21/01/2018
Query!
Approval date [1]
299385
0
Query!
Ethics approval number [1]
299385
0
Query!
Summary
Brief summary
Endovascular aortic aneurysm repair (EVAR) is being performed at an increasing rate in both the elective and emergency settings. The lower immediate morbidity and mortality rates of EVAR have been influential in the rapid adoption of this technique. However, the need for ongoing monitoring and higher rates of subsequent re-intervention that are required remain a concern for Vascular surgeons. The ability to be able to identify and predict the patient group most likely to require such re-interventions would be highly beneficial to rationalising treatment for patients. Intra-operative pressure measurements of the aneurysm sac is one method that may be able to guide therapy and this study is an extension of the currently mixed evidence surrounding this area. The primary aim will be to assess if intra-sac pressure measurements (and changes in these measurements) can predict the development of intra-operative or persistent endoleaks or continued aneurysm sac enlargement. The intra-sac pressure measurements will be measured in terms of reduction in systolic and diastolic pressures as well as pulse pressure and as a ratio to the systemic circulation pressure. The progress of the aneurysm sac post-operatively will be monitored through the usual follow-up procedure of ultrasounds at regular intervals. If any persistent endoleaks are detected or there is continued sac enlargement then Computed Tomography (CT) with contrast injection or conventional angiography will be performed to further delineate the pathology.
Query!
Trial website
N/A
Query!
Trial related presentations / publications
N/A
Query!
Public notes
N/A
Query!
Contacts
Principal investigator
Name
80242
0
Dr Arvind Deshpande
Query!
Address
80242
0
John Hunter Hospital, Lookout Road, New Lambton Heights, NSW, 2305
Query!
Country
80242
0
Australia
Query!
Phone
80242
0
+61 2 4921 3000
Query!
Fax
80242
0
Query!
Email
80242
0
[email protected]
Query!
Contact person for public queries
Name
80243
0
Joel Petit
Query!
Address
80243
0
John Hunter Hospital, Lookout Road, New Lambton Heights, NSW, 2305
Query!
Country
80243
0
Australia
Query!
Phone
80243
0
+61 2 4921 3000
Query!
Fax
80243
0
Query!
Email
80243
0
[email protected]
Query!
Contact person for scientific queries
Name
80244
0
Joel Petit
Query!
Address
80244
0
John Hunter Hospital, Lookout Road, New Lambton Heights, NSW, 2305
Query!
Country
80244
0
Australia
Query!
Phone
80244
0
+61 2 4921 3000
Query!
Fax
80244
0
Query!
Email
80244
0
[email protected]
Query!
No information has been provided regarding IPD availability
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.
Download to PDF