320 Participants Needed

TEE vs Cardiac CTA for Blood Clot Prevention

Recruiting at 4 trial locations
AM
Overseen ByAmy McKnight, RN, BSN, BCCV
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Steven Filby, MD
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Cardiac CTA and Transesophageal echocardiography (TEE) for blood clot prevention?

Both Cardiac CTA and TEE are effective in detecting blood clots in the heart, with Cardiac CTA being a reasonable alternative to TEE when the goal is to rule out clots in specific heart areas. TEE has been shown to significantly impact the management of patients with stroke or embolism by identifying potential clot sources and guiding treatment decisions.12345

Is Transesophageal Echocardiography (TEE) safe for humans?

Transesophageal echocardiography (TEE) is generally considered a safe imaging method, though there are some risks, such as the rare occurrence of complications like embolization (blockage of a blood vessel) during the procedure.26789

How does the treatment TEE differ from other treatments for blood clot prevention?

Transesophageal echocardiography (TEE) is unique because it provides a detailed view of the heart and blood vessels from inside the esophagus, making it superior to other methods like transthoracic echocardiography (TTE) for detecting certain heart abnormalities that can lead to blood clots. It is particularly useful for identifying clots in the left atrium and left atrial appendage, which are critical areas for preventing strokes.156910

What is the purpose of this trial?

The current standard of care for patients who underwent left atrial appendage closure (LAAC) is to have follow-up transesophageal echocardiogram (TEE) for device surveillance. TEE is an ultrasound of the heart done by placing a probe in the esophagus under conscious sedation. It does not use contrast but can be cumbersome to patients as it involves placing a probe in the esophagus. Cardiac computerized tomography angiography (cardiac CTA) is a non-invasive imaging modality that involves the use of certain types of x-rays, contrast (dye) and special computers to generate accurate images of the heart. Participants in this study will undergo both TEE and CTA on the same day 90 days after their LAAC procedure.Participants will be in this research study for a period of 1 year, starting from the day of their scheduled LAAC procedure. Participants will undergo a TEE at 90 days after their procedure which is the standard of care imaging study after LAAC. As part of this study, participants will also undergo a cardiac CTA at 90 days as well. Participants will have a routine follow-up visit following device placement as per standard of care as well as a brief phone "check in" at 1 year.

Research Team

Steven Filby, MD - University Hospitals

Steven Filby, MD

Principal Investigator

University Hospitals Cleveland Medical Center

Eligibility Criteria

This trial is for patients who have had a procedure to close off a part of the heart called the left atrial appendage. They must be able to undergo both an ultrasound of the heart via the esophagus and a special type of X-ray imaging using contrast dye, scheduled for 90 days after their procedure.

Inclusion Criteria

My kidney function is at a safe level for the trial.

Exclusion Criteria

Non-English speaking subjects
I am under 18 years old.
Subjects with history of contrast allergy
See 2 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo both TEE and cardiac CTA 90 days after their LAAC procedure

3 months
1 visit (in-person)

Follow-up

Participants have a routine follow-up visit and a brief phone check-in at 1 year

1 year
1 visit (in-person), 1 visit (phone)

Treatment Details

Interventions

  • Cardiac CTA
  • Transesophageal echocardiography (TEE)
Trial Overview The study compares two types of heart imaging: transesophageal echocardiography (TEE), which involves an ultrasound probe in the esophagus, and cardiac CTA, a non-invasive X-ray with contrast dye. Both tests are done on day 90 post-procedure.
Participant Groups
1Treatment groups
Experimental Treatment
Group I: Left Atrial Appendage Occlusion (LAAC) with Watchman FLX.Experimental Treatment2 Interventions
Patients who are status post LAAC using the Watchman FLX.

Find a Clinic Near You

Who Is Running the Clinical Trial?

Steven Filby, MD

Lead Sponsor

Trials
1
Recruited
320+

University Hospitals Cleveland Medical Center

Lead Sponsor

Trials
348
Recruited
394,000+

Boston Scientific Corporation

Industry Sponsor

Trials
758
Recruited
867,000+
Michael F. Mahoney profile image

Michael F. Mahoney

Boston Scientific Corporation

Chief Executive Officer since 2016

MBA from Wake Forest University, BBA in Finance from the University of Iowa

Kenneth Stein profile image

Kenneth Stein

Boston Scientific Corporation

Chief Medical Officer since 2020

MD from Harvard Medical School, MMSc in Clinical Investigation from Harvard-MIT Division of Health Sciences and Technology

References

Roles of Transesophageal Echocardiography and Cardiac Computed Tomography for Evaluation of Left Atrial Thrombus and Associated Pathology: A Review and Critical Analysis. [2019]
Therapeutic implications of transesophageal echocardiography after transthoracic echocardiography on acute stroke patients. [2021]
Comparative assessment of left atrial appendage by transesophageal and combined two- and three-dimensional transthoracic echocardiography. [2019]
Transesophageal echocardiography impacts management and evaluation of patients with stroke, transient ischemic attack, or peripheral embolism. [2016]
Transesophageal echocardiography guidance for atrial-caval thrombus removal with the AngioVac system. [2020]
Transesophageal echocardiography: diagnostic and clinical applications in the evaluation of the stroke patient. [2019]
Transesophageal echocardiography (TEE) vs. transthoracic echocardiography (TTE) in assessing cardio-vascular sources of emboli in patients with acute ischemic stroke. [2019]
Acute Bilateral Internal Carotid Occlusion from Embolization of Left Atrial Thrombus During Transesophageal Echocardiography: Case Report. [2020]
[The use of echocardiographic studies in neurology]. [2015]
10.Russia (Federation)pubmed.ncbi.nlm.nih.gov
[Comparison of transesophageal and transthoracic echocardiography in cardiac surgical care]. [2016]
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