NCT04758728

Brief Summary

Aim of the present study is to investigate the efficiency of adrenaline (epinephrine) used locally in reducing and avoiding post-operative formation of subcutaneous ecchymoses and hematomas, in comparison with traditional practice of hemostasis, and to assess improvement in the quality of life of subjects undergoing classic great saphenous vein stripping, who received or did not receive adrenaline as a local hemostatic.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
40

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Sep 2015

Shorter than P25 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

September 10, 2015

Completed
8 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 14, 2016

Completed
27 days until next milestone

Study Completion

Last participant's last visit for all outcomes

June 10, 2016

Completed
4.7 years until next milestone

First Submitted

Initial submission to the registry

February 9, 2021

Completed
8 days until next milestone

First Posted

Study publicly available on registry

February 17, 2021

Completed
Last Updated

February 18, 2021

Status Verified

February 1, 2021

Enrollment Period

8 months

First QC Date

February 9, 2021

Last Update Submit

February 17, 2021

Conditions

Keywords

great saphenous veinsaphenectomysaphenous vein strippingecchymosishaematomaadrenalineepinephrinhemostasischronic venous insufficiencyvenous refluxvenous disease

Outcome Measures

Primary Outcomes (16)

  • Subcutaneous ecchymoses number 1d-postop

    The absolute number of subcutaneous ecchymoses on the operated limb on 1st post-operative day

    24 hours post-operatively

  • Subcutaneous ecchymoses number 8d-post-op

    The absolute number of subcutaneous ecchymoses on the operated limb on 8th post-operative day

    192 hours post-operatively

  • Subcutaneous ecchymoses number 14d-post-op

    The absolute number of subcutaneous ecchymoses on the operated limb on 14th post-operative day

    336 hours post-operatively

  • Subcutaneous hematomas number 1d-postop

    The absolute number of subcutaneous hematomas in the operated limb on 1st post-operative day

    24 hours post-operatively

  • Subcutaneous hematomas number 8d-postop

    The absolute number of subcutaneous hematomas in the operated limb on 8th post-operative day

    192 hours post-operatively

  • Subcutaneous hematomas number 14d-postop

    The absolute number of subcutaneous hematomas in the operated limb on 14th post-operative day

    336 hours post-operatively

  • Subcutaneous ecchymoses total area 1d-postop

    The total area in mm2 of subcutaneous ecchymoses in the operated limb on 1st post-operative day

    24 hours post-operatively

  • Subcutaneous ecchymoses total area 8d-postop

    The total area in mm2 of subcutaneous ecchymoses in the operated limb on 8th post-operative day

    192 hours post-operatively

  • Subcutaneous ecchymoses total area 14d-postop

    The total area in mm2 of subcutaneous ecchymoses in the operated limb on 14th post-operative day

    336 hours post-operatively

  • Subcutaneous hematomas total area 1d-postop

    The total area in mm2 of subcutaneous hematomas in the operated limb on 1st post-operative day

    24 hours post-operatively

  • Subcutaneous hematomas total area 8d-postop

    The total area in mm2 of subcutaneous hematomas in the operated limb on 8th post-operative day

    192 hours post-operatively

  • Subcutaneous hematomas total area 14d-postop

    The total area in mm2 of subcutaneous hematomas in the operated limb on 14th post-operative day

    336 hours post-operatively

  • QoL-SF36 preop

    Quality of life assessment based on the 36-Item Short Form Survey (SF-36) questionnaire preoperatively. It is an often-used, well-researched, self-reported measure of health. It stems from a study called the Medical Outcomes Study. It taps eight health concepts: physical functioning, bodily pain, role limitations due to physical health problems, role limitations due to personal or emotional problems, emotional well-being, social functioning, energy/fatigue, and general health perceptions. It also includes a single item that provides an indication of perceived change in health. The eight scaled scores, which are the weighted sums of the questions in their section are directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability.

    24 hours pre-operatively

  • QoL-SF36 1month-postop

    Quality of life assessment based on the 36-Item Short Form Survey (SF-36) questionnaire 30 days post-operatively. It is an often-used, well-researched, self-reported measure of health. It stems from a study called the Medical Outcomes Study. It taps eight health concepts: physical functioning, bodily pain, role limitations due to physical health problems, role limitations due to personal or emotional problems, emotional well-being, social functioning, energy/fatigue, and general health perceptions. It also includes a single item that provides an indication of perceived change in health. The eight scaled scores, which are the weighted sums of the questions in their section are directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability.

    30 days post-operatively

  • QoL-CIVIQ2 preop

    Quality of life assessment based on the ChronIc Venous Insufficiency quality of life Questionnaire version 2 (CIVIQ-2) questionnaire preoperatively. The CIVIQ was developed and validated (relevance, acceptability, reliability, construct validity, and sensitivity) by French researchers in 1996. The CIVIQ is a 20-item self-reported instrument that includes four categories of questions: physical (4 items), psychological (9 items), social (4 items), and pain (3 items). Its score ranges from 0, the worst score, to 100, the best. There are five possible answers (from 1 to 5) to describe each symptom and the sensation of discomfort. The second version, the CIVIQ-2 (where 2 denotes the second draft of the same questionnaire), provides a global score covering all aspects of the questionnaire and weighs the categories equally.

    24 hours pre-operatively

  • QoL-CIVIQ2 1month post-op

    Quality of life assessment based on the CIVIQ-2 questionnaire 1 month post-operatively. Quality of life assessment based on the ChronIc Venous Insufficiency quality of life Questionnaire version 2 (CIVIQ-2) questionnaire preoperatively. The CIVIQ was developed and validated (relevance, acceptability, reliability, construct validity, and sensitivity) by French researchers in 1996. The CIVIQ is a 20-item self-reported instrument that includes four categories of questions: physical (4 items), psychological (9 items), social (4 items), and pain (3 items). Its score ranges from 0, the worst score, to 100, the best. There are five possible answers (from 1 to 5) to describe each symptom and the sensation of discomfort. The second version, the CIVIQ-2 (where 2 denotes the second draft of the same questionnaire), provides a global score covering all aspects of the questionnaire and weighs the categories equally.

    30 days post-operatively

Secondary Outcomes (18)

  • HCT preop

    24 hours pre-operatively

  • HCT postop

    24 hours post-operatively

  • Hgb preop

    24 hours pre-operatively

  • Hgb postop

    24 hours post-operatively

  • WBC preop

    24 hours pre-operatively

  • +13 more secondary outcomes

Study Arms (3)

Group A

ACTIVE COMPARATOR

Group A - great saphenous vein stripping with local adrenaline use for hemostasis

Procedure: Great saphenous vein stripping and varicectomiesDrug: Epinephrine Topical

Group B

SHAM COMPARATOR

Group B - great saphenous vein stripping with local normal saline use for hemostasis

Procedure: Great saphenous vein stripping and varicectomiesDrug: normal saline

Group C

SHAM COMPARATOR

Group C - great saphenous vein stripping with traditional hemostatic practice

Procedure: Great saphenous vein stripping and varicectomies

Interventions

Removal of the great saphenous vein (partially - from just below the knee up to the saphenofemoral junction) by two 3cm skin and subcutaneous fat incisions and the introduction of a conventional vein stripper device, under general or epidural/regional anesthesia. Removal of varicose veins of the lower limb by 0,5cm skin incisions and the use of a conventional phlebectomy stainless steel hook. Mechanical hemostasis by direct compression of the thigh for 10 minutes.

Also known as: Saphenectomy
Group AGroup BGroup C

Use of epinephrine/adrenaline solution 1:1000 topically

Also known as: Adrenaline solution 1:1000 topical/local use
Group A

Use of normal saline solution NaCl 0,9% topically

Also known as: NaCl 0,9% topical/local use
Group B

Eligibility Criteria

Age18 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age 18-80 years
  • CVI CEAP Class II or III
  • Informed consent signed

You may not qualify if:

  • Age \<18 or \>80 years
  • CVI CEAP Class I or IV (venous ulcers)
  • Allergy to adrenaline history
  • No informed consent signed

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Department of Vascular Surgery, Andreas Papandreou General Hospital

Rhodes, South Aegean, 85133, Greece

Location

Related Publications (5)

  • Furuya T, Tada Y, Sato O. A new technique for reducing subcutaneous hemorrhage after stripping of the great saphenous vein. J Vasc Surg. 1992 Sep;16(3):493-4. doi: 10.1016/0741-5214(92)90389-p. No abstract available.

    PMID: 1522653BACKGROUND
  • Nisar A, Shabbir J, Tubassam MA, Shah AR, Khawaja N, Kavanagh EG, Grace PA, Burke PE. Local anaesthetic flush reduces postoperative pain and haematoma formation after great saphenous vein stripping--a randomised controlled trial. Eur J Vasc Endovasc Surg. 2006 Mar;31(3):325-31. doi: 10.1016/j.ejvs.2005.08.006. Epub 2005 Oct 19.

    PMID: 16236532BACKGROUND
  • Pappa E, Kontodimopoulos N, Niakas D. Validating and norming of the Greek SF-36 Health Survey. Qual Life Res. 2005 Jun;14(5):1433-8. doi: 10.1007/s11136-004-6014-y.

    PMID: 16047519BACKGROUND
  • Andreozzi GM, Cordova RM, Scomparin A, Martini R, D'Eri A, Andreozzi F; Quality of Life Working Group on Vascular Medicine of SIAPAV. Quality of life in chronic venous insufficiency. An Italian pilot study of the Triveneto Region. Int Angiol. 2005 Sep;24(3):272-7.

    PMID: 16158038BACKGROUND
  • Kim H, Hwang K, Yun SM, Kim DJ. Usage of Epinephrine Mixed With Lidocaine in Plastic Surgery. J Craniofac Surg. 2020 May/Jun;31(3):791-793. doi: 10.1097/SCS.0000000000006156.

    PMID: 32028367BACKGROUND

MeSH Terms

Conditions

Venous InsufficiencyVaricose UlcerEcchymosisContusionsHematoma

Interventions

EpinephrineSaline Solution

Condition Hierarchy (Ancestors)

Vascular DiseasesCardiovascular DiseasesVaricose VeinsLeg UlcerSkin UlcerSkin DiseasesSkin and Connective Tissue DiseasesBlood Coagulation DisordersHematologic DiseasesHemic and Lymphatic DiseasesHemorrhagePathologic ProcessesPathological Conditions, Signs and SymptomsSkin ManifestationsSigns and SymptomsWounds, NonpenetratingWounds and Injuries

Intervention Hierarchy (Ancestors)

EthanolaminesAmino AlcoholsAlcoholsOrganic ChemicalsAminesBiogenic MonoaminesBiogenic AminesCatecholaminesCatecholsPhenolsBenzene DerivativesHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsCrystalloid SolutionsIsotonic SolutionsSolutionsPharmaceutical Preparations

Study Officials

  • Konstantinos Roditis, MD, MSc

    JDN-Hellas / Department of Vascular Surgery, Hellenic Red Cross Hospital

    PRINCIPAL INVESTIGATOR
  • Dimitrios Mavros, MD, MSc, PhD

    Department of Vascular Surgery, Andreas Papandreou General Hospital

    STUDY CHAIR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
MD, MSc, Chief Resident, JDN-Hellas Board Chairperson

Study Record Dates

First Submitted

February 9, 2021

First Posted

February 17, 2021

Study Start

September 10, 2015

Primary Completion

May 14, 2016

Study Completion

June 10, 2016

Last Updated

February 18, 2021

Record last verified: 2021-02

Data Sharing

IPD Sharing
Will not share

Locations