check_circleStudy Completed

Carotid stenosis

Gadobutrol enhanced MRA of the supra-aortic vessels

Trial purpose

Subjects referred for a routine CTA (computed tomography angiography) or MRA (magnetic resonance angiography) will be invited to participate in the study and subjects will be involved in the study for between 2 and 12 days. Two to three visits to the study doctor will be required.
This study will compare the diagnostic results of Gadobutrol enhanced MRA images with MRA images taken without contrast agent using images from a CTA as the standard of reference, which may have been performed up to 60 days prior to enrolment. If a CTA has not been performed in this prior time period, a CTA is required for the study.
MRA and CTA images will be collected for an independent review (blinded read).

Key Participants Requirements

Sex

Both

Age

18 - N/A
  • - Male or female subjects, aged 18 years and older
    - Any of the following:
     -- Known or suspected supra-aortic arterial disease based on:
     --- Prior stroke
     --- Transient ischemic attack (TIA)
     --- Amaurosis Fugax (transient monocular blindness)
     -- Referred for evaluation of any supra-aortic vessel (for clinically significant stenosis)
     -- Follow-up for a stent in a supra-aortic vessel
     -- Prior imaging study (CTA or ultrasound) showing ≥ 50% stenosis of a supra-aortic vessel segment (within 60 days before consent). The proportion of subjects with positive disease (determined by the investigator, based on CTA or ultrasound) will be monitored during the study, and enrolment may be further restricted to require ≥ 70% stenosis to ensure that overall there are an adequate number of subjects with clinically significant disease for the evaluation of study endpoints.
    - Willingness to undergo the routine Contrast Enhanced Magnetic Resonance Angiography [CE MRA] examination with gadobutrol
    - Willingness and ability to follow directions and complete all study procedures specified in the protocol
    - Females of childbearing potential only: Negative pregnancy test on the day of the MRA before the administration of study drug
  • - Pregnant or nursing (including pumping for storage and feeding)
    - Received any other investigational product or participation in any other clinical trial within 30 days before enrollment into this study
    - Previous enrollment into this study or into any other Bayer sponsored study using gadobutrol
    - Contraindication to the MRA examinations (e.g. inability to hold breath; severe arrhythmias; very low cardiac output, severe claustrophobia, defibrillators or other metallic devices not approved for MRI)
    - Contraindication to the use of Gd-containing contrast agents (including subjects with suspicion for or known to have Nephrogenic Systemic Fibrosis [NSF])
    - History of severe allergic or anaphylactoid reaction to any allergen including drugs and contrast agents
    - Received any contrast agent within 72 hours before the study MRA, or scheduled receipt of any contrast agent within 24 hours after the study MRA (Note: This applies also to a CTA potentially scheduled during the course of the study.)
    - Estimated glomerular filtration rate (eGFR) value < 30 ml/min/1.73 m2 derived from a serum creatinine result within 2 weeks before the gadobutrol injection. Any subject on hemodialysis or peritoneal dialysis is excluded from participation. Use the value obtained prior to and closest to the time of the MRA, if there are multiple creatinine values. (Do not use the core lab value if not available prior to the MRA.)
    - Acute renal insufficiency of any intensity, either due to hepato-renal syndrome or occurring in the peri-operative liver transplantation period
    - Severe cardiovascular disease (e.g. acute myocardial infarction [< 14 days], unstable angina, congestive heart failure New York Heart Association class IV) or known long QT syndrome
    - Suspected clinical instability or unpredictability of the clinical course during the study period (e.g. due to previous surgery)
    - Scheduled or potentially expected for the period between the CTA and gadobutrol MRA:
     -- Any procedure that may alter the MRA or CTA interpretation, or
     -- Any interventional or surgical procedure involving the supra-aortic vessels

Trial summary

Enrollment Goal
479
Trial Dates
May 2011 - May 2014
Phase
Phase 3
Could I Receive a placebo
No
Products
Gadavist/Gadovist (Gadobutrol, BAY86-4875)
Accepts Healthy Volunteer
No

Where to participate

StatusInstitutionLocation
Withdrawn
Bern, 3010, Switzerland
Completed
St. Gallen, 9007, Switzerland
Withdrawn
Luzern, 6000, Switzerland
Completed
Karlsruhe, 76133, Germany
Completed
Augsburg, 865156, Germany
Withdrawn
Frankfurt, 60596, Germany
Completed
Jena, 07740, Germany
Withdrawn
Kiel, 24105, Germany
Completed
Erlangen, 91054, Germany
Withdrawn
Newport Beach, 92658-6100, United States
Completed
Louisville, 40202, United States
Completed
Savannah, 31406, United States
Completed
Jackson, 39216, United States
Completed
Bronx, 10467, United States
Completed
Seattle, 98195, United States
Completed
Madison, 53792, United States
Completed
Philadelphia, 19104, United States
Completed
BRON Cedex, 69677, France
Completed
Marseille, 13385, France
Completed
PARIS, 75877, France
Completed
Warszawa, 02-097, Poland
Completed
Wroclaw, 50-556, Poland
Completed
Bydgoszcz, 85-094, Poland
Completed
Lodz, 90-153, Poland
Withdrawn
Zamosc, 22-400, Poland
Completed
Massa-Carrara, 54100, Italy
Completed
Ferrara, 44023, Italy
Completed
Catania, 95123, Italy
Completed
Roma, 00168, Italy
Completed
Venezia, 30174, Italy
Completed
Uppsala, 751 85, Sweden
Completed
Linköping, 581 85, Sweden
Withdrawn
Praha 5, 150 30, Czech Republic
Completed
Brno, 62500, Czech Republic
Withdrawn
Praha 2, 128 21, Czech Republic
Completed
Clayton, 3168, Australia
Completed
Parkville, 3052, Australia
Completed
New Lambton Heights, 2305, Australia
Withdrawn
Bedford Park, 5042, Australia
Completed
Wien, 1090, Austria
Completed
Innsbruck, 6020, Austria
Withdrawn
Wiener Neustadt, 2700, Austria
Completed
Istanbul, 34093, Turkey
Completed
Erzurum, 25240, Turkey
Completed
Antalya, 07059, Turkey
Completed
Seoul, 06351, Korea, Republic Of
Completed
Seoul, 05505, Korea, Republic Of
Completed
Donggu,, 61469, Korea, Republic Of
Completed
Seoul, 03722, Korea, Republic Of
Completed
Aosta, 11100, Italy
Withdrawn
New York, 10032, United States
Completed
Boston, 02114, United States
Completed
Rochester, 14642, United States
Completed
Memphis, 38104, United States
Completed
Providence, 02903, United States
Completed
Tucson, 85724, United States
Completed
Ann Arbor, 48109-0330, United States
Completed
Shanghai, 200032, China
Completed
Shanghai, 200433, China
Withdrawn
Boston, 02115, United States
Withdrawn
Milwaukee, 53215, United States
Withdrawn
Cleveland, 44195, United States
Withdrawn
Aarau, 5001, Switzerland
Withdrawn
Dresden, 01307, Germany
Completed
BREST CEDEX, 29609, France
Withdrawn
Plzen, 304 60, Czech Republic
Completed
Baltimore, 21201, United States
Completed
Jacksonville, 32209, United States
Completed
Münster, 48145, Germany
Withdrawn
Rosario, S2000DTC, Argentina
Completed
Adrogué, B1846DWA, Argentina
Completed
Buenos Aires, C1115AAB, Argentina
Completed
Buenos Aires, C1425BEE, Argentina
Withdrawn
Sao Paulo, 05403-900, Brazil
Withdrawn
São Paulo, 05651-900, Brazil
Withdrawn
Hershey, 17033, United States
Completed
PARIS CEDEX 15, 75908, France
Withdrawn
Sao Paulo, 01323-001, Brazil

Primary Outcome

  • Proportion of assessable segments
    date_rangeTime Frame:
    Up to 2 weeks
    enhanced_encryption
    Safety Issue:
    No
  • Sensitivity for detection of clinically significant disease (70 to 99% stenosis) on a segmental basis
    date_rangeTime Frame:
    Up to 2 weeks
    enhanced_encryption
    Safety Issue:
    No
  • Specificity for exclusion of clinically significant disease (70 to 99% stenosis) on a segmental basis
    date_rangeTime Frame:
    Up to 2 weeks
    enhanced_encryption
    Safety Issue:
    No
  • Gadovist minimum performance criteria: Sensitivity > 50%
    date_rangeTime Frame:
    Up to 2 weeks
    enhanced_encryption
    Safety Issue:
    No
  • Gadobutrol minimum performance criteria: Specificity > 50%
    date_rangeTime Frame:
    Up to 2 weeks
    enhanced_encryption
    Safety Issue:
    No

Secondary Outcome

  • Minimum diameter of the segment
    date_rangeTime Frame:
    Up to 2 weeks
    enhanced_encryption
    Safety Issue:
    No
  • Location and length of stenotic segments with ≥ 70% stenosis
    date_rangeTime Frame:
    Up to 2 weeks
    enhanced_encryption
    Safety Issue:
    No
  • Secondary radiologic indicators for diagnosis of clinically significant disease
    date_rangeTime Frame:
    Up to 2 weeks
    enhanced_encryption
    Safety Issue:
    No
  • Artifacts by type (segmental)
    date_rangeTime Frame:
    Up to 2 weeks
    enhanced_encryption
    Safety Issue:
    No
  • Diagnostic confidence (segmental)
    date_rangeTime Frame:
    Up to 2 weeks
    enhanced_encryption
    Safety Issue:
    No
  • Additional imaging studies recommended (example: CTA, CE MRA, Ultrasound, Nuclear Medicine)
    What additional imaging studies would be necessary is a measure of 1) what test provides a definitive diagnosis for treatment decisions and 2) is a direct measure of additional cost a health system would incur for additional imaging studies to reach a definitive diagnosis. This is critical to determining the total cost of imaging for a patient diagnosis in any health system reimbursement structure. Therefore the social/societal cost for not providing a definitive diagnosis with a single imaging study can be determined for health policy and reimbursement decisions.
    date_rangeTime Frame:
    Up to 2 weeks
    enhanced_encryption
    Safety Issue:
    No

Trial design

Multicenter, open-label study to evaluate the safety and efficacy (by blinded reading) of contrast–enhanced magnetic resonance angiography (MRA) after a single intravenous injection of 0.1 mmol/kg gadobutrol in subjects with known or suspected vascular disease of the supra-aortic vessels
Trial Type
Interventional
Intervention Type
Drug
Trial Purpose
Diagnostic
Allocation
N/A
Blinding
Open Label
Assignment
Single Group Assignment
Trial Arms
1