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Radiation CystitisHEMOCCNCT04701749

Study of the Effects of Anticoagulant Interruption Covered by Percutaneous Left Atrial Occlusion in Patients With Chronic Atrial Fibrillation and Radiation Cystitis at Risk of Bleeding

An observational study of Radiation Cystitis and Non-valvular Atrial Fibrillation, run by University Hospital, Clermont-Ferrand at 1 site in France.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

The etiology of the radiation cystitis is a pelvic irradiation generally performed as part of the treatment of prostate cancer. The incidence is 50,000 new cases per year. Approximately 35% of prostate cancer treatment is radiotherapy. The prevalence of haematuric radiation cystitis is 4-5% (about 800 patients). Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Percutaneous left atrial closure and No Percutaneous left atrial closure
Type of treatment
Medical device
How many people
40 participants
Where
1 siteFrance
Study dates
24 Feb 2021to Sep 2030
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Adult, Older adult

Study population: patients with at least one hematuria while on anticoagulant therapy for non-valvular atrial fibrillation

Who may be able to join

  • Patient over 18 years old benefiting a social security sheme.
  • Patient with hematuric radiation bladder associated with a non valvular anticoagulated atrial fibrillation.

Who cannot join

  • All the other hematuria's reasons
  • Other reason of anti platelet agent using than atrial fibrillation

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

France1 site, 1 recruiting
  • Chu Clermont Ferrand

    Clermont-Ferrand, 63003

    Lise Laclautre, promo_interne_drci@chu-clermontferrand.fr

    Laurent GUY

    Recruiting

Other trials in France

About this study

The etiology of the radiation cystitis is a pelvic irradiation generally performed as part of the treatment of prostate cancer. The incidence is 50,000 new cases per year. Approximately 35% of prostate cancer treatment is radiotherapy. The prevalence of haematuric radiation cystitis is 4-5% (about 800 patients).

One of the complications of radiation cystitis is persistent hematuria. There is currently no curative treatment for this hematuria. There are few treatment options with a random probability of improvement of this symptomatology. These haematurias are rarely resolved spontaneously and most of the time involve emergency room management with +/- invasive procedures, sometimes by hospitalisation, always with a significant psychological impact on the patient.

Read more

Furthermore, lifetime anticoagulant treatment considerably increases the likelihood of bladder bleeding. This is the case of patients being followed for Atrial Fibrillation Cardiac Arrhythmia (AFCA), which by definition carries a major cardioembolic risk, and who will be of particular interest in this study.

In recent years, cardiologists have developed an alternative to anticoagulants: left atrial appendage closure or left atrial occlusion (LAO) . This procedure consists of inserting a nitinol prosthesis in the left atrium, the site of more than 90% of thrombi formation in non-valvular atrial fibrillation. This minimally invasive procedure lasts about 15 minutes and is performed during a 48-hour hospitalization. Anticoagulants are stopped the day after the setting up procedure. Several studies have shown non-inferiority of atrial closure and anticoagulants to thromboembolic events in non-valvular atrial fibrillation. In addition, LAO allows the permanent discontinuation of anticoagulants, associated with the cessation of anticoagulant bleeding adverse events.

While studies have been conducted on the impact of this technique on patients monitored in cardiology, no studies evaluate the value of LAO in anticoagulated patients with a hematuric radiation cystitis. This tprocedure is already used in routine care for patients followed in urology, and has shown encouraging results, since 8 out of 10 patients saw a significant reduction in the number of haematurias, but it has never yet been scientifically proven to be effective, hence the aim of this study.

The interest of this study will therefore be :

  • To evaluate the potential benefit of left atrial appendage closure on the number of episodes of hematuria.
  • To evaluate the economic benefit in reducing the number of hospitalizations, surgeries and complications for hematuria as well as the discontinuation of anticoagulants.

As the patient's data must be retrieved regardless of the patient's subsequent management (with or without a cardiac procedure) within the framework of the HEMOCC protocol, it will be proposed to the patient as soon as he or she is consulting for haematuria on radiation cystitis. The patient will be followed for 3 years.

The mainly descriptive analyses will be collected in the form of a register and carried out by a biostatistician from Clermont-Ferrand University Hospital.

Read the detailed description

Prospective single-centre observational study involving the creation of a data registry of patients with anticoagulation-treated non-valvular atrial fibrillation with hematuria on radiation cystitis.

Patients who present a hematuria on radial bladder associated with anticoagulated atrial fibrillation will be recruited into the protocol by an urologist from Gabriel MONTPIED UHC once they have presented at least one episode of hematuria on radial bladder under anticoagulant treatment in the context of a non-valvular ACFA, and once they have given their agreement to participate in the HEMOCC research protocol.

A research associate will meet the patient to finalize the administrative and practical aspects of inclusion and the collection of retrospective data. Regardless of whether or not left atrial occlusion is performed, the patient's data included in the protocol will be collected.

The urologist will then refer the patient to Pr ESCHALIER's cardiology department for cardiological advice regarding an indication of percutaneous occlusion of the left atrium (running walk).

If LAO is indicated and the patient agrees to the procedure, then the procedure will be scheduled.

Being tested
Percutaneous left atrial closure, No Percutaneous left atrial closure
Keywords
radiation cystitis, Hematuria, Left atrial appendage closure or left atrial occlusion (LAO)
Medical subject headings
Hematuria

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Percutaneous left atrial closureDevice

    Percutaneous left atrial closure was performed under general anesthesia with angiographic control and transesophageal echocardiography. The procedure takes between 15 and 20 minutes. This begins with a right femoral venipuncture, progression of the guide in the right atrium allowing atrial trans-septal puncture to catheterize the left atrium. A nitinol prosthesis is implanted (Boston Watchman) at the ostium of the left auricle between the left superior pulmonary vein and the circumflex artery. After a tensile test verifying the stability of the prosthesis, the absence of peri-prosthetic leakage is verified by ETO and angiographic control. The patient is monitored 48 hours before discharge to eliminate the appearance of pericardial effusion and prosthetic embolization. Aspirin 75 mg monotherapy is started the same day with stopping anticoagulation.

  • No Percutaneous left atrial closureOther

    No Percutaneous left atrial closure

Study groups in NCT04701749
Study groupRoleWhat they receive
with atrial closureNot described
Receives: Device: Percutaneous left atrial closure
without atrial occlusionNot described
Receives: Other: No Percutaneous left atrial closure

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. number of episodes of hematuria following atrial occlusion and discontinuation of anticoagulants

    number of episodes of hematuria following atrial occlusion and discontinuation of anticoagulants collected with a data collection form

    Measured: Baseline (Month 0)

  2. number of episodes of hematuria following atrial occlusion and discontinuation of anticoagulants

    number of episodes of hematuria following atrial occlusion and discontinuation of anticoagulants collected with a data collection form

    Measured: Month 3

  3. number of episodes of hematuria following atrial occlusion and discontinuation of anticoagulants

    number of episodes of hematuria following atrial occlusion and discontinuation of anticoagulants collected with a data collection form

    Measured: Month 6

  4. number of episodes of hematuria following atrial occlusion and discontinuation of anticoagulants

    number of episodes of hematuria following atrial occlusion and discontinuation of anticoagulants collected with a data collection form

    Measured: Month 9

  5. number of episodes of hematuria following atrial occlusion and discontinuation of anticoagulants

    number of episodes of hematuria following atrial occlusion and discontinuation of anticoagulants collected with a data collection form

    Measured: Month 12

  6. number of episodes of hematuria following atrial occlusion and discontinuation of anticoagulants

    number of episodes of hematuria following atrial occlusion and discontinuation of anticoagulants collected with a data collection form

    Measured: Month 18

  7. number of episodes of hematuria following atrial occlusion and discontinuation of anticoagulants

    number of episodes of hematuria following atrial occlusion and discontinuation of anticoagulants collected with a data collection form

    Measured: Month 24

  8. number of episodes of hematuria following atrial occlusion and discontinuation of anticoagulants

    number of episodes of hematuria following atrial occlusion and discontinuation of anticoagulants collected with a data collection form

    Measured: Month 30

  9. number of episodes of hematuria following atrial occlusion and discontinuation of anticoagulants

    number of episodes of hematuria following atrial occlusion and discontinuation of anticoagulants collected with a data collection form

    Measured: Month 36

Secondary outcomes (27)
  1. Number of days hospitalizations for hematuria

    assessed by phone contact

    Measured: Baseline (Month 0)

  2. Number of days hospitalizations for hematuria

    assessed by phone contact

    Measured: Month 3

  3. Number of days hospitalizations for hematuria

    assessed by phone contact

    Measured: Month 6

  4. Number of days hospitalizations for hematuria

    assessed by phone contact

    Measured: Month 9

  5. Number of days hospitalizations for hematuria

    assessed by phone contact

    Measured: Month 12

  6. Number of days hospitalizations for hematuria

    assessed by phone contact

    Measured: Month 18

  7. Number of days hospitalizations for hematuria

    assessed by phone contact

    Measured: Month 24

  8. Number of days hospitalizations for hematuria

    assessed by phone contact

    Measured: Month 30

  9. Number of days hospitalizations for hematuria

    assessed by phone contact

    Measured: Month 36

  10. duration of hematuria episodes

    assessed by phone contact

    Measured: Baseline (Month 0)

  11. duration of hematuria episodes

    assessed by phone contact

    Measured: Month 3

  12. duration of hematuria episodes

    assessed by phone contact

    Measured: Month 6

  13. duration of hematuria episodes

    assessed by phone contact

    Measured: Month 9

  14. duration of hematuria episodes

    assessed by phone contact

    Measured: Month 12

  15. duration of hematuria episodes

    assessed by phone contact

    Measured: Month 18

  16. duration of hematuria episodes

    assessed by phone contact

    Measured: Month 24

  17. duration of hematuria episodes

    assessed by phone contact

    Measured: Month 30

  18. duration of hematuria episodes

    assessed by phone contact

    Measured: Month 36

  19. number of hematuria surveys

    assessed by phone contact

    Measured: Baseline (Month 0)

  20. number of hematuria surveys

    assessed by phone contact

    Measured: Month 3

  21. number of hematuria surveys

    assessed by phone contact

    Measured: Month 6

  22. number of hematuria surveys

    assessed by phone contact

    Measured: Month 9

  23. number of hematuria surveys

    assessed by phone contact

    Measured: Month 12

  24. number of hematuria surveys

    assessed by phone contact

    Measured: Month 18

  25. number of hematuria surveys

    assessed by phone contact

    Measured: Month 24

  26. number of hematuria surveys

    assessed by phone contact

    Measured: Month 30

  27. number of hematuria surveys

    assessed by phone contact

    Measured: Month 36

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Jan 2021
  2. Study start24 Feb 2021
  3. Primary completionSep 2030 (estimated)
  4. Study completionSep 2030 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
40 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04701749
Sponsor's protocol ID
RNI 2020 GUY
Other IDs
2020-A02246-33
Acronym
HEMOCC
Status last verified
Mar 2026
First submitted
6 Jan 2021
Last updated
19 Mar 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

An observational study of Radiation Cystitis and Non-valvular Atrial Fibrillation, run by University Hospital, Clermont-Ferrand at 1 site in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 19 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Lise Laclautre (334.73.754.963, promo_interne_drci@chu-clermontferrand.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

number of episodes of hematuria following atrial occlusion and discontinuation of anticoagulants (time frame: Baseline (Month 0)). The study lists 9 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Mar 2026.

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