Active not recruitingOBSERVATIONAL

Cerebral Protection in Aortic Arch Surgery

Doctors are always working to make complex heart operations, especially those on the 'aortic arch', safer. These surgeries can sometimes lead to brain problems like stroke, which can have a big impact on a patient's life and recovery. This study is exploring new methods to detect very early signs of brain strain during these operations. Currently, the tools used don't always spot problems quickly enough. The research wants to develop a system that can continuously check the brain's health using tiny sensors (microdialysis) during surgery. The goal is to give doctors real-time information so they can adjust treatments immediately if needed. This early warning system could help prevent serious long-term complications, making these vital surgeries even more successful and improving patients' quality of life.

At a glance

Status

Active not recruiting

Sponsor

Barts & The London NHS Trust

Enrolment target

Start

19 Jul 2023

Estimated completion

19 Jul 2026

Aortic Aneurysm Aortic Dissection Aortic Arch Aortic Diseases

What is this study about?

When you have surgery on your aorta, especially the curved part called the aortic arch, it's a very big and detailed operation. These surgeries are often vital to fix serious conditions like an enlarged aorta (aneurysm) or a tear in its wall (dissection). While doctors have made great progress in making these operations safer, there's still a risk of brain-related problems afterwards, like having a stroke. These problems can be very difficult for patients and their families.

This study is focused on improving how doctors protect your brain during these important operations. Currently, doctors use some methods to monitor the brain, but they don't always catch early warning signs quickly enough. Think of it like a smoke detector that goes off only when the fire is big, rather than one that alerts you to the first hint of smoke.

The aim of this research is to find new, more sensitive ways to detect very early signs of stress or lack of oxygen in the brain during surgery. By developing a system that can give doctors rapid, up-to-the-minute information, they hope to be able to make quick adjustments to keep your brain as safe as possible. This could mean fewer patients experiencing serious brain complications after surgery, leading to better recoveries and an improved quality of life.

Key takeaways

Aims to make complex aortic arch surgeries safer for your brain.
Explores new ways to detect early brain issues during the operation.
Uses a special monitoring method called 'microdialysis' during surgery.
Could help prevent serious side effects like stroke.
Focuses on improving future patient care and outcomes.

Who may be eligible?

To be considered for this study, you would need to be an adult (18 years or older) who is scheduled to have aortic arch surgery.

You would also need to be able to understand what the study involves and agree to take part. This means people who might have difficulty understanding or communicating, for example due to a language barrier or being unconscious, would not be able to join.

Also, if you unfortunately passed away during surgery, or if you already had certain brain-related problems before the operation, you would not be included in this particular study.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you 18 years old or older?
Are you scheduled for aortic arch surgery?
Are you able to understand and agree to participate in the study?
Do you not have any existing neurological problems before your surgery?

Answer every question to see your result.

What does participation involve?

This study focuses on monitoring during your planned aortic arch surgery. It does not involve any extra visits or changes to your medication before or after the operation. If you take part, doctors will use a special monitoring technique called microdialysis during your surgery. This involves placing a very thin, flexible tube (similar to a tiny catheter) in a small part of your brain to collect fluid for analysis. This is done while you are already under anaesthetic for your main operation.

This fluid will be analysed to look for specific markers that tell us about your brain's health in real-time during the surgery. The monitoring will only happen during the operation itself. There are no additional long-term follow-up appointments specifically for this study beyond your standard post-surgery care. The total duration of your participation would be limited to the time you are in surgery.

Potential risks and benefits

The main benefit of this research is to gather information that could lead to better ways of protecting patients' brains during future aortic arch surgeries, potentially reducing serious complications like stroke. For patients taking part, the monitoring itself is not expected to offer direct personal benefit beyond what standard care provides, but your participation is valuable for advancing medical knowledge. As with any medical procedure, there are always potential, though rare, risks; the microdialysis procedure involves placing a tiny probe in the brain, but this is done by experienced surgeons during your main operation. You have the right to withdraw from the study at any time, even after agreeing to take part, without affecting your medical care.

Locations (1)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

St Bartholomew's Hospital
Verified postcode
London, United Kingdom

Common questions

What is aortic arch surgery?

It's a major operation to fix serious problems with the main artery that carries blood from your heart, specifically the curved part called the 'aortic arch'.

Why is brain protection important during this surgery?

Because there's a risk of complications like stroke during these complex operations, and this study aims to find better ways to keep your brain safe.

What is microdialysis?

It's a special technique that uses a tiny sensor to gently collect fluid samples from the brain during surgery, allowing doctors to check its health in real-time.

Will taking part in this study change my surgery?

No, it won't change your planned aortic arch surgery or medications. It only adds extra monitoring during the operation itself.

Will this monitoring help me directly?

While the study aims to improve future care for patients, the immediate benefit to you will be the extra information doctors get about your brain's health during surgery.