Long-term Neurocognitive Sequelae of Subclinical Microembolization During Carotid Interventions

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 evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01718600
Recruitment Status : Unknown
Verified April 2015 by Wei Zhou, Stanford University.
Recruitment status was:  Recruiting
First Posted : October 31, 2012
Last Update Posted : April 6, 2015
University of Wisconsin, Madison
Washington University School of Medicine
Information provided by (Responsible Party):
Wei Zhou, Stanford University

Brief Summary:
Microembolization is commonly associated with carotid artery stenting (CAS), but our understanding of subclinical microembolization is superficial. Through collaborative effects of multidisciplinary team-experts, novel approaches, and longitudinal evaluations, we hope to better understand the clinical significance and long-term cognitive effects of microemboli. This proposal may change our current clinical practice by providing a better outcome measure for carotid interventions and improving outcomes of CAS procedures through risk factor stratification. Our central hypothesis is that development of subclinical microemboli is associated with decline in cognitive function following CAS and that the risk of development of microemboli themselves is associated with patient- and procedure-related factors. We hope that this prospective study will help to clarify these important issues in the era of rapidly evolving percutaneous interventions.

Condition or disease Intervention/treatment
Carotid Artery Stenosis Behavioral: Neuropsychological testing

Study Type : Observational
Estimated Enrollment : 200 participants
Observational Model: Cohort
Time Perspective: Prospective
Study Start Date : June 2011
Estimated Primary Completion Date : June 2016
Estimated Study Completion Date : June 2016

Group/Cohort Intervention/treatment
Neuroimaging Correlates
Carotid revascularization can significantly reduce the risk of stroke in patients with severe carotid stenosis; however, it has been associated with cognitive decline in 25% of the older adults who undergo the procedure. Neuroimaging techniques that characterize white matter integrity and regional hypoperfusion have the potential to provide sensitive brain structure indicators that may be associated with memory decline following revascularization procedures. In this proposal, we hope to determine the risk factors and cognitive effect of microembolization following carotid revascularization procedures.
Behavioral: Neuropsychological testing

Primary Outcome Measures :
  1. Incidence of microemboli in correlation with changes in neurocognitive assessment performance [ Time Frame: 1 year following CAS procedure ]

Secondary Outcome Measures :
  1. Risk factor stratification for incidence of microemboli [ Time Frame: 1 year following CAS procedure ]

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Ages Eligible for Study:   40 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
Patients undergoing carotid intervention

Inclusion Criteria:

  • Patient is male or female >40 yrs of age.
  • Patient has occlusive extracranial carotid stenosis (≥70%)
  • Patient is scheduled to undergo an endovascular intervention of a lesion in the extracranial carotid artery
  • Patient agrees to voluntarily participate and signs an informed consent.
  • Patient agrees to be available for follow-up and is able to participate in all study testing procedures.
  • Patient has sufficient visual and auditory acuity for cognitive testing.

Exclusion Criteria:

  • Patient is unable to safely and comfortably undergo magnetic resonance imaging procedures (e.g., claustrophobia, implanted medical devices that are MRI incompatible such as pacemaker, defibrillator, neural stimulator etc)
  • Patient has an untreated or unsuccessfully controlled psychiatric disease (schizophrenia, bipolar disorder).
  • Patient has prominent suicidal or homicidal ideation.
  • Patient has acute illness or unstable chronic illness (e.g. uncontrolled hypertension, hepatic encephalopathy, portal hypertension, ascites, and esophageal varices, pancreatitis).
  • Patient with a history of neurological (e.g., multiple sclerosis, seizure disorder, Parkinson's disease) or systemic illness affecting central nervous system function.
  • Patient has prior closed head injury with ≥24 hours of amnesia.
  • Patient is unable to understand or sign the informed consent.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01718600

Contact: Wei Zhou, MD 650-493-5000 ext 67339

United States, California
Palo Alto Veterans Affairs Recruiting
Palo Alto, California, United States, 94304
Contact: Elizabeth Hitchner, MA    650-493-5000 ext 68632   
Principal Investigator: Wei Zhou, MD         
United States, Missouri
Washington University School of Medicine Recruiting
St Louis, Missouri, United States, 63110
Contact: Kristin Geile, RN, MSN, CCRC    314-286-1506   
United States, Wisconsin
University of Wisconsin, Madison Recruiting
Madison, Wisconsin, United States
Contact: Vivek Prabhakaran, MD, PhD   
Principal Investigator: Vivek Prabhakaran, MD, PhD         
Sponsors and Collaborators
Stanford University
University of Wisconsin, Madison
Washington University School of Medicine

Responsible Party: Wei Zhou, Professor of Surgery, Stanford University Identifier: NCT01718600     History of Changes
Other Study ID Numbers: R01NS070308 ( U.S. NIH Grant/Contract )
First Posted: October 31, 2012    Key Record Dates
Last Update Posted: April 6, 2015
Last Verified: April 2015

Keywords provided by Wei Zhou, Stanford University:
carotid artery stenting
neuropsychological testing

Additional relevant MeSH terms:
Carotid Stenosis
Carotid Artery Diseases
Cerebrovascular Disorders
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Arterial Occlusive Diseases
Vascular Diseases
Cardiovascular Diseases