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Completed

NCT Number: NCT03871725

Sonodynamic Therapy in the Treatment of Carotid Atherosclerosis

Sonodynamic therapy (SDT) is a new treatment for carotid atherosclerotic plaque. The purpose of this study is to evaluate the safety and initial effectiveness of this technique.

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Key information

Age range

18 year–80 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1

Primary location

The First Affiliated Hospital of Harbin Medical University

Harbin, Heilongjiang, 150000, China

About this study

Carotid atherosclerotic plaque is an important cause of ischemic stroke. Treatments for patients with carotid plaque include lifestyle changes, medical management(such as control of hyperlipidemia, hypertension, and diabetes) and carotid revascularization(carotid endarterectomy or carotid artery stenting). Studies have suggested that plaque morphology and composition are important determinants of plaque stability, using serial MR imaging of the carotid artery allowed observation of changes in plaque composition. Contrast enhanced ultrasound (CEUS) is a well accepted technique for detection of intraplaque neovascularization(IPN) in carotid atherosclerotic disease. The purpose of this trial is to evaluate the safety and initial effectiveness of SDT. The SDT can induce macrophage elimination and inhibit matrix degradation, which will promote plaque lipid depletion, inflammation level decrease and changes in other plaque tissue components, leading to plaque stabilization and reduction.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age 18- 80 years
  • Carotid artery with 30%~70% stenosis by ultrasound and plaque thickness>2.5mm
  • Patients without transient ischemic attack, minor stroke or amaurosis fugax within 6 months
  • Patients' LDL-c level below 100 mg/dL(2.6mmol/L), well-controlled blood pressure(systolic BP<140 and diastolic BP<90 under resting conditions) and diabetes(HbA1c<7%)
  • Written informed consent

Exclusion criteria

  • Non-atherosclerotic carotid artery stenosis
  • Contraindication to MRI( uses pacemaker, has metallic implants, claustrophobia)
  • Acute MI, acute coronary syndrome or stroke within 4 weeks prior to visit
  • Severe cerebral artery stenosis, atrial fibrillation or MRI detected thrombosis that would cause stroke
  • Previous significant adverse reaction to a statin
  • Systemic disorders such as hepatic, renal, hematologic, and malignant disease
  • Medical history that might limit the individual's ability to take trial treatments for the duration of the study
  • Allergic to DVDMS or sonovue
  • Diagnosis of porphyria
  • Pregnant women and nursing mothers
  • History of bilateral carotid endarterectomy or has immediate plans for carotid endarterectomy
  • Patient who is attending other clinical trial

Treatment and study plan

Sonodynamic therapy (SDT)

Combination Product

Sinoporphyrin sodium (DVDMS) as sonosensitizer, is dissolved in 0.9% sodium solution for following skin test and intravenous injection. 0.01mg/ml DVDMS solution (0.1ml) is prepared for skin test followed by 0.04 mg/ml DVDMS solution intravenous injection (0.2mg/kg).The target atherosclerotic lesions are marked on the corresponding skin with ultrasound guidance and underwent ultrasound exposure after 4 hours incubation. The therapeutic ultrasonic transducer is fixed to the marked skin site for 15min of each lesion. Ultrasound parameters included intensity of 1.6W/cm2 for carotid lesions, resonance frequency: 1.0 MHz and duty factor: 30%.

Primary outcomes

  1. Change in plaque MaxWT, as assessed by MRI

    Time frame: Measured at Baseline, 1, 3, 6, and 9 months

    The changes in plaque MaxWT (maximum wall thickness) as assessed by MRI.

Secondary outcomes

  1. Change in IPH volume, as assessed by MRI

    Time frame: Measured at Baseline, 1, 3, 6, and 9 months

    The changes in intraplaque hemorrhage (IPH) volume as assessed by MRI.

  2. Change in LRNC volume, as assessed by MRI

    Time frame: Measured at Baseline, 1, 3, 6, and 9 months

    The changes in LRNC (lipid-rich necrotic core) volume as assessed by MRI.

  3. Change in plaque LM volume, as assessed by MRI

    Time frame: Measured at Baseline, 1, 3, 6, and 9 months

    The changes in LM (loose matrix) volume as assessed by MRI.

  4. Change in calcification volume, as assessed by MRI

    Time frame: Measured at Baseline, 1, 3, 6, and 9 months

    The changes in calcification (CA) volume as assessed by MRI.

  5. Change in plaque volume, as assessed by MRI

    Time frame: Measured at Baseline, 1, 3, 6, and 9 months

    The changes in plaque volume(mm3) as assessed by MRI

  6. Change in MVE, as assessed by CEUS

    Time frame: Measured at Baseline, 1, 3, 6, and 9 months

    The changes in normalised maximal video-intensity enhancement (MVE) are calculated to quantify the density of IPN as assessed by CEUS.

  7. MACCE

    Time frame: Measured at Baseline, 1, 3, 6, and 9 months

    incidence of major adverse cardiovascular and cerebrovascular events(MACCE)

  8. Incidence of adverse events

    Time frame: Measured at Baseline, 1, 3, 6, and 9 months

    Allergic to sunshine,hepatic or renal dysfunction,thyroid dysfunction

Sponsors and collaborators

Lead sponsor

First Affiliated Hospital of Harbin Medical University

Other

Registry information

Official study title

Sonodynamic Therapy Manipulates Atherosclerosis Regression Trial on Patients With Carotid Atherosclerotic Plaques

Acronym: SMART-C

Important dates

Study start
2019
Primary completion
2020
Study completion
2020
First posted
Mar 12, 2019
Registry last updated
Jul 10, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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