Concordance for Transthyretin Amyloidosis Between Synovial Biopsy and Anterior Carpal Ligament Biopsy

Recruiting now · Not applicable

Conditions studied: Carpal Tunnel, Transthyretin Amyloidosis

In brief

Transthyretin amyloidosis (ATTR) is an underdiagnosed condition that can present early as carpal tunnel syndrome, sometimes preceding cardiac involvement by several years. The recent emergence of new treatments underscores the importance of early diagnosis. Synovial biopsy performed during open carpal tunnel surgery is considered the gold standard for local screening, but it is less accessible, more difficult, and riskier to perform via endoscopy-a minimally invasive surgical technique that is currently the standard at our center and is becoming increasingly widespread. The anterior annular ligament of the carpus constitutes an alternative tissue to the synovium, easily accessible via endoscopy, safe, and standardizable. In this study, the systematic performance of an annular ligament biopsy in conjunction with a synovial biopsy during endoscopic carpal tunnel surgery would allow for the evaluation of the diagnostic concordance of the ligament biopsy by comparing it to the results obtained using the gold standard method. This strategy would also provide an opportunity to analyze the feasibility of systematic screening for ATTR on the ligament during endoscopic procedures. This approach could offer a practical and innovative method for the early identification of at-risk patients and facilitate appropriate and timely management of the condition.

Key facts

Study ID

NCT07644325

Run by

Clinique Saint Jean, France

People needed

500

Starts

2026-05-27

Expected to finish

2027-05-27

Last updated by the study team

2026-06-12

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Adult patient with Health Insurance
• Clinical diagnosis + carpal tunnel EMG
• Validated indication for carpal tunnel surgery
• Signed informed consent
• Patient at risk for postoperative complications (bilateral carpal tunnel syndrome, heart failure, atrial fibrillation, elderly patients)

You may not qualify if…

• Need for open carpal tunnel surgery.
• Pregnant women
• Adults under guardianship

Where it is running

• Clinique St Jean Sud de france — Montpellier, France (enrolling)

Full record on ClinicalTrials.gov

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