NCT05756491

Brief Summary

In Westernized countries, the prevalence of peripheral arterial disease (PAD) is estimated at 15-20% of subjects over 70 years of age and is increasing considerably because of the aging of the population and the increasing prevalence of diabetes and renal insufficiency. In response to this increase in incidence, vascular surgeons must develop innovative treatments that minimize the use of resources in a context of budgetary constraints, in patients who are increasingly well informed, while maintaining the safety and effectiveness of the procedures performed. The endovascular technique has several advantages. First, it is a minimally invasive treatment, most often performed under local anesthesia. Secondly, the duration of the procedure and the length of hospitalization are reduced. In addition, the peri-operative morbidity and mortality is extremely low. In France, for many years, public health policies have encouraged the development of outpatient hospitalization. Endovascular treatment allows the development of outpatient care. The French Society of Vascular and Endovascular Surgery (SCVE) was the first European society to publish recommendations concerning the outpatient management of endovascular treatment of PAD. These recommendations aim to promote the development of outpatient treatment by providing a framework for practitioners wishing to offer this type of management. Concerning the patient and according to the SCVE recommendations, all types of occlusive arterial lesions of the lower limbs can be managed on an outpatient basis and only patients with severe comorbidities are excluded from this type of hospitalization. In addition, various studies have shown the safety of outpatient hospitalization for PAD. The absence of an accompanying person on the night following the procedure is considered an exclusion criterion for outpatient care. The objective of this Stepped-wedge Cluster Randomized Controlled Trial is to increase the use of outpatient hospitalization for endovascular treatment of PAD by proposing a care pathway adapted to people without an accompanying person on the night of the procedure at home.

Trial Health

57
Monitor

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
2,000

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Apr 2023

Typical duration for not_applicable

Geographic Reach
1 country

20 active sites

Status
recruiting

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

First Submitted

Initial submission to the registry

January 20, 2023

Completed
2 months until next milestone

First Posted

Study publicly available on registry

March 6, 2023

Completed
1 month until next milestone

Study Start

First participant enrolled

April 11, 2023

Completed
3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 11, 2026

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 11, 2026

Completed
Last Updated

January 16, 2024

Status Verified

January 1, 2024

Enrollment Period

3 years

First QC Date

January 20, 2023

Last Update Submit

January 12, 2024

Conditions

Keywords

ambulatoryaccompanied patientunaccompanied patient

Outcome Measures

Primary Outcomes (1)

  • Outpatient Hospitalization Rate for Endovascular Treatment of PAD at the End of the Procedure Period

    30 month

Secondary Outcomes (5)

  • Number of postoperative complications requiring re-hospitalization

    1 month

  • Functional improvement at 1 month as assessed by the Rutherford classification

    1 month

  • Assessment of patient anxiety using the HAS anxiety questionnaire

    pre-procedure

  • Assessment of patient anxiety using the HAS anxiety questionnaire

    immediately after procedure

  • Assessment of patient anxiety using the HAS anxiety questionnaire

    Day 7

Study Arms (4)

Experimental: Group1

EXPERIMENTAL

In group 1: 5 centers will be randomized for the inclusion of unaccompanied patients for 24 months

Other: 24 months of inclusion of unaccompanied patients

Experimental: Group2

EXPERIMENTAL

In group 2: 5 other centers will be randomized for the inclusion of unaccompanied patients for 18 months

Other: 18 months of inclusion of unaccompanied patients

Experimental: Group3

EXPERIMENTAL

In group 3: 5 other centers will be randomized for the inclusion of unaccompanied patients for 12 months

Other: 12 months of inclusion of unaccompanied patients

Experimental: Group4

EXPERIMENTAL

In group 4: 5 other centers will be randomized for the inclusion of unaccompanied patients for 6 months

Other: 6 months of inclusion of unaccompanied patients

Interventions

inclusion for 6 months of accompanied patients in conventional outpatient care (observational period) and then inclusion for 24 months of unaccompanied with remonte surveillance patients and accompanied patients (interventional period)

Experimental: Group1

inclusion for 12 months of accompanied patients in conventional outpatient care (observational period) and then inclusion for 18 months of unaccompanied with remonte surveillance patients and accompanied patients (interventional period)

Experimental: Group2

inclusion for 18 months of accompanied patients in conventional outpatient care (observational period) and then inclusion for 12 months of unaccompanied with remonte surveillance patients and accompanied patients (interventional period)

Experimental: Group3

inclusion for 24 months of accompanied patients in conventional outpatient care (observational period) and then inclusion for 6 months of unaccompanied with remonte surveillance patients and accompanied patients (interventional period)

Experimental: Group4

Eligibility Criteria

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

You may qualify if:

  • Patient with symptomatic PAD (Rutherford 1-5) requiring endovascular revascularization that can be performed on an outpatient basis
  • Procedure listed in the Common Classification of Medical Procedures
  • Patient with a good understanding of the constraints of the study
  • Patient with an ASA score of 1 to 3 (stable)
  • Patient registered with the social security system
  • Patient living less than 1 hour by car from the care facility or from a care facility able to care for this type of patient
  • Patient willing to remain hospitalized if necessary
  • For accompanied patients only:
  • \- Patient does not object to the processing of his or her data
  • Only for isolated patients:
  • Patient with free, informed and written consent
  • Patient agreeing to wear the remote monitoring device at discharge from the outpatient revascularization hospitalization
  • Patient agreeing to the processing of his or her personal data with the remote monitoring provider
  • Patient not living in an area not served by a cell phone network (white zone)

You may not qualify if:

  • \- Disorders of hemostasis
  • Acute ischemia of the lower limbs
  • Patient already included in a type 1 interventional research protocol
  • Patient under guardianship or curatorship
  • Patient deprived of liberty
  • Patient under legal protection

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (20)

Chu Jean Minjoz

Besançon, 25030, France

RECRUITING

Centre Hospitalier de Béziers,

Béziers, 34500, France

RECRUITING

Hopital Universitaire Ambroise Paré,

Boulogne-Billancourt, 92100, France

RECRUITING

CHRU Cavale Blanche

Brest, 29200, France

RECRUITING

Chu Cote de Nacre

Caen, 14000, France

RECRUITING

Hôpital Universitaire Gabriel Montpied

Clermont-Ferrand, 63003, France

RECRUITING

Pôle médical du Grand large,

Décines-Charpieu, 69150, France

RECRUITING

Hopital Le Bocage,

Dijon, 21000, France

RECRUITING

Hopital Prive Dijon Bourgogne

Dijon, 21000, France

RECRUITING

Clinique Mutualiste Porte de L'Orient

Lorient, 56324, France

RECRUITING

Chu de Nantes

Nantes, 44000, France

RECRUITING

Hopital Prive Du Confluent

Nantes, 44000, France

RECRUITING

Chu de Nice,

Nice, 06000, France

RECRUITING

Hôpital Saint Joseph

Paris, 75014, France

RECRUITING

Polyclinique Francheville,

Périgueux, 24000, France

RECRUITING

Clinique de L'Europe

Rouen, 76100, France

RECRUITING

Centre Hospitalier Yves Le Foll-

Saint-Brieuc, 22027, France

RECRUITING

Centre Hospitalier Privé SAINT GREGOIRE

Saint-Grégoire, 35760, France

RECRUITING

Clinique Esquirol-Saint-Hilaire,

Saint-Hilaire, 47000, France

RECRUITING

Médipôle Lyon Villeurbanne,

Villeurbanne, 69100, France

RECRUITING

MeSH Terms

Conditions

Peripheral Arterial Disease

Condition Hierarchy (Ancestors)

AtherosclerosisArteriosclerosisArterial Occlusive DiseasesVascular DiseasesCardiovascular DiseasesPeripheral Vascular Diseases

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
PARALLEL
Model Details: standard care: accompanied patients Remote surveillance: unaccompanied patients
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

January 20, 2023

First Posted

March 6, 2023

Study Start

April 11, 2023

Primary Completion

April 11, 2026

Study Completion

April 11, 2026

Last Updated

January 16, 2024

Record last verified: 2024-01

Locations