NCT06656988

Brief Summary

The primary objective of the trial is to evaluate if an iodinated contrast medium sparing strategy using automated Carbon Dioxide (CO2) Injection prevents Major Adverse Kidney Events up to 90 days (MAKE90) in patients at moderately elevated risk for contrast-associated acute kidney injury (CA-AKI) undergoing infrainguinal peripheral vascular interventions (PVI).

Trial Health

80
On Track

Trial Health Score

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

Enrollment
1,960

participants targeted

Target at P75+ for phase_3

Timeline
33mo left

Started Apr 2025

Typical duration for phase_3

Geographic Reach
2 countries

11 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

Study Progress28%
Apr 2025Feb 2029

First Submitted

Initial submission to the registry

October 16, 2024

Completed
8 days until next milestone

First Posted

Study publicly available on registry

October 24, 2024

Completed
6 months until next milestone

Study Start

First participant enrolled

April 14, 2025

Completed
2.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 1, 2028

Expected
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

February 1, 2029

Last Updated

March 23, 2026

Status Verified

March 1, 2026

Enrollment Period

2.8 years

First QC Date

October 16, 2024

Last Update Submit

March 18, 2026

Conditions

Keywords

carbon dioxidecontrast mediumiodinated contrast mediumCA-AKIangiographyangioplasty

Outcome Measures

Primary Outcomes (1)

  • MAKE 90

    major adverse kidney events

    From the day of the peripheral vascular intervention (day 0) to day 90

Study Arms (2)

Standard angiography using iodinated Contrast Medium (CM)

ACTIVE COMPARATOR

For patients randomised in the control group, a planned infrainguinal peripheral vascular intervention (PVI, not subject to the trial) will be performed with iso-osmolar or low-osmolar iodinated CM as contrast agent. The trial sites may use iodinated CM as defined per local routine. In line with current recommendations , the use of high-osmolar CM will be prohibited in the trial.

Drug: Iodinated Contrast Media (ICM)

Contrast medium sparing strategy using CO2 injection as contrast agent, bailout option iodinated CM

EXPERIMENTAL

For patients randomised in the intervention group, a planned infrainguinal peripheral vascular intervention (PVI, not subject to the trial) will be performed with CO2 as contrast agent. For the CO2 injection the Angiodroid® Injector will be used according to the recent user manual. The use of the Angiodroid® system allows a fully automatic injection with digital control. Automatic CO2 injection enhances patient tolerability as the gas injection is performed in a less explosive, more controlled manner. Iodinated CM (as described in the above section) is used as bailout option in case of inadequate image quality or intraprocedural intolerance of CO2 angiography by the patient. The reasons for use and the amount of CM must be carefully recorded.

Drug: CO2

Interventions

CO2DRUG

CO2 will be used as contrast medium sparing strategy during peripheral angiography

Also known as: carbon dioxide
Contrast medium sparing strategy using CO2 injection as contrast agent, bailout option iodinated CM

Iodinated contrast medium will be used as in routine care during peripheral angiography

Standard angiography using iodinated Contrast Medium (CM)

Eligibility Criteria

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

You may qualify if:

  • Symptomatic peripheral arterial disease presenting with either acute symptoms (Rutherford clinical categories I-IIb) or chronic symptoms (Fontaine stages IIb-IV or Rutherford clinical categories 2-6)
  • Planned peripheral vascular intervention of infrainguinal arteries due to femoropopliteal and/or infrapopliteal lesions
  • Increased risk of CA-AKI identified by a baseline risk score of ≥ 5 points based on a published dedicated PVI risk score and a pre-angiographic estimated glomerular filtration rate (eGFR) \< 60 ml/min/1.73 m²
  • Both angiographic strategies seem feasible at the investigator's discretion
  • Age 18 years or older
  • Written informed consent

You may not qualify if:

  • Very agitated patients
  • Patients with planned full anaesthesia during procedure
  • Patients with a life-expectancy less than one year
  • Patients confined to bed that are completely non-ambulatory
  • Known acute renal failure or known unstable renal function as evidenced by a recent increase in serum creatinine (SCr) of \> 0.5 mg/dl or \> 25% within 7 days
  • Iodinated contrast medium exposure within 7 days prior to procedure with change in SCr ≥ 0.1 mg/dl on two SCr measures ≥ 24 h apart
  • Advanced chronic kidney disease (CKD) with an eGFR \< 30 ml/min/1.73m² and/or dialysis
  • Current use of nephrotoxic agents (aminoglycoside antibiotics, sulfonamides, amphotericin B, or pentamidine), or an active chemotherapy agent
  • Acute or chronic pulmonary disease requiring oxygen therapy
  • Patients with known patent foramen ovale or atrial septal defect
  • Patients with planned nitrous oxide anaesthesia during intervention
  • Patients with manifest hyperthyroidism or manifest thyrotoxicosis
  • Known allergies or hypersensitivity to iodinated contrast media that cannot be adequately pre-treated prior to index procedure
  • Patients with decompensated heart failure
  • Patients with manifest tetany
  • +6 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (11)

Tirol Kliniken Innsbruck

Innsbruck, Austria

RECRUITING

Universitätsklinik für Innere Medizin II

Vienna, Austria

RECRUITING

Kreiskrankenhaus Alsfeld

Alsfeld, Germany

RECRUITING

Universitäts-Herzzentrum Freiburg-Bad Krozingen

Bad Krozingen, Germany

RECRUITING

Universitätsklinikum Bonn

Bonn, 53127, Germany

NOT YET RECRUITING

Klinikum Chemnitz gGmbH

Chemnitz, 09116, Germany

NOT YET RECRUITING

DIAKO Krankenhaus gGmbH Flensburg

Flensburg, 24939, Germany

NOT YET RECRUITING

MVZ CCB Frankfurt und Main-Taunus GbR

Frankfurt a.M., Germany

RECRUITING

Universitätsklinikum Leipzig

Leipzig, Germany

RECRUITING

Klinikum rechts der Isar der Technischen Universität München

München, Germany

RECRUITING

GRN - Klinik Weinheim

Weinheim, Germany

RECRUITING

MeSH Terms

Conditions

Peripheral Vascular DiseasesKidney Diseases

Interventions

Carbon Dioxide

Condition Hierarchy (Ancestors)

Vascular DiseasesCardiovascular DiseasesUrologic DiseasesFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesMale Urogenital Diseases

Intervention Hierarchy (Ancestors)

Carbon Compounds, InorganicInorganic ChemicalsGasesOxidesOxygen Compounds

Study Officials

  • Sabine Steiner, Prof Dr

    University Leipzig

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Prof. Dr.

Study Record Dates

First Submitted

October 16, 2024

First Posted

October 24, 2024

Study Start

April 14, 2025

Primary Completion (Estimated)

February 1, 2028

Study Completion (Estimated)

February 1, 2029

Last Updated

March 23, 2026

Record last verified: 2026-03

Data Sharing

IPD Sharing
Will share

After publication of the major results and upon reasonable request from researchers performing an individual patient data meta-analysis, individual patient data that underlie published results will be shared after de-identification. This requires approval by the local Institutional Review Board (IRB) of the researcher requesting the data along with public registration of the meta-analysis. Summary statistics that go beyond the scope of published material will be made available to researchers for meta-analysis upon reasonable request and if the necessary data analysis is not unduly time-consuming. Together with publication of the main results, the statistical analysis plan will be made publicly available. The trial protocol will be published in a medical journal as soon as possible after approval of the trial.

Shared Documents
STUDY PROTOCOL
Time Frame
The study protocol is made publicly available with the approval via CTIS.
Access Criteria
Please contact the coordinating investigator.

Locations