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New treatment option for Juxtarenal Aortic Aneurysm
Official title Evaluation of the Cook Custom Aortic Endograft, the Zenith t-Branch Endovascular Graft, and Surgeon-Modified Endograft in Treating Aortic Pathologies
ClinicalTrials.gov ID: NCT02043691
What this study is testing
- What it's testing
- This is a single-center study to evaluate the safety and effectiveness of three investigational devices, the Cook Custom Aortic Endograft, the Zenith t-Branch Endovascular Graft, and the Surgeon-Modified Endografts in the treatment of Juxtarenal, Suprarenal, Thoracoabdominal, and Aortic Arch pathologies involving the at least one brachiocephalic artery or visceral vessels. The three investigational devices offer an endovascular approach to treat complex aortic pathologies that cannot be treated with commercially available devices.
A plain-language read of the study's public ClinicalTrials.gov listing. The study team confirms the details.
Who can take part
Ages 18 and older
You may be able to join if
- Juxtarenal, suprarenal, and thoracoabdominal aortic pathology as follows in hemodynamically stable patients:
- Intact or contained ruptured aortic or aortoiliac aneurysms (atherosclerotic/degenerative or saccular) involving or in close approximation to the...
- Diameter \> 5.5 cm if asymptomatic, or 5.0 cm with enlargement of \> 0.5 cm in 6 months.
- History of growth \> 0.5 cm per year
- Any size if ruptured or symptomatic
You likely can't join if
- Less than 18 years of age
- Life expectancy less than 12 months based on the surgeon's assessment
- Pregnant or breastfeeding or planning on becoming pregnant within 60 months
- Inability or refusal to give informed consent
- Unwilling or unable to comply with the follow-up schedule
- Less than 30 days beyond primary endpoint for other investigative drug or device study Medical Exclusion Criteria:
See the full eligibility criteria
Who can join
- Juxtarenal, suprarenal, and thoracoabdominal aortic pathology as follows in hemodynamically stable patients:
- Intact or contained ruptured aortic or aortoiliac aneurysms (atherosclerotic/degenerative or saccular) involving or in close approximation to the visceral segment of the aorta.
- Diameter \> 5.5 cm if asymptomatic, or 5.0 cm with enlargement of \> 0.5 cm in 6 months.
- History of growth \> 0.5 cm per year
- Any size if ruptured or symptomatic
- Penetrating aortic ulcer (PAU)
- \> 2.0 cm in depth
- Any size if contained ruptured or symptomatic
- Subacute (\>14 days) or chronic (\>20 days) aortic dissection with aneurysmal degeneration with at least one of the following:
- Total aortic diameter \> 5.5 cm if asymptomatic
- Total aortic diameter \> 4.5 cm if symptomatic
- Total aortic diameter \> 5.0 cm and history of growth \> 0.5 cm in 6 months
- Aortic Arch pathology:
- Aneurysm, Ascending thoracic aortic pseudoaneurysm, Type A thoracic aortic dissection, Retrograde type A thoracic aortic dissection between the Sinus of Valsalva and the innominate artery orifice (without involvement of...
- Suitable iliac artery and brachial artery access
- Absence of severe landing zone (\> 90 degree) angulation that would preclude necessary device delivery/seal/fixation.
- Suitable iliac artery access to accommodate device delivery system.
- Target arteries for arch branches:
- \< 24 mm diameter
- Adequate landing zone length to obtain proximal and distal seal.
- Free from dissection precluding adequate seal in distal landing zone of branch stent and severe tortuosity/thrombus/calcification.
- Aortic Arch Aneurysm
- Proximal aortic fixation zone:
- Native aorta or surgical graft
- Diameter: 20 - 42 mm
- Proximal neck length \> 20 mm
- Must occur distal to coronary arteries and any coronary artery bypass grafts that are considered patent and necessary for proper cardiac perfusion.
- Distal aortic fixation zone:
- Native aorta or surgical graft
- Diameter: 20 - 44 mm
- Distal neck length \> 20 mm. However, if dissection, distal graft may land in dissected aorta.
- Supra-aortic trunk (brachiocephalic) vessels (Any combination of arteries may be used for repair) A. Innominate artery
- Native vessel or surgical graft
- Diameter: 8 - 22 mm
- Length of sealing zone \> 10 mm
- Acceptable tortuosity B. Left (or right) common carotid artery
- Native vessel or surgical graft
- Diameter 5 - 20 mm
- Length of sealing zone \> 10 mm C. Left (or right) subclavian artery
- Native vessel or surgical graft
- Diameter 5 - 20 mm
- Length of sealing zone \> 10 mm
- Aortic Dissection
- Access into the true lumen from the groin and at least one supra-aortic trunk vessel.
- Seal zone in the target aorta (or surgical graft) that is proximal to the primary dissection, such that a stent-graft would be anticipated to seal off the dissection lumen.
- Seal zone in the target supra-aortic trunk vessels that is distal to the dissection, anticipated to seal off the dissection lumen or surgically created.
- True lumen size large enough to deploy the device and still gain access into the target branch. General
What rules you out
- Less than 18 years of age
- Life expectancy less than 12 months based on the surgeon's assessment
- Pregnant or breastfeeding or planning on becoming pregnant within 60 months
- Inability or refusal to give informed consent
- Unwilling or unable to comply with the follow-up schedule
- Less than 30 days beyond primary endpoint for other investigative drug or device study Medical Exclusion Criteria:
- Known allergy to the device components (i.e. stainless steel, polyester, solder, gold, or nitinol)
- History of anaphylactic reaction to contrast material that cannot be adequately premedicated
- Systemic or local infection that may increase the risk of endovascular graft infection.
- Baseline eGFR \< 30 mL/min (calculated by the Modification of Diet in Renal Disease formula) and not on hemo- or peritoneal dialysis. If the patient is currently on dialysis, or is currently planning on initiating...
- Body habitus that would inhibit X-ray visualization of the aorta.
- Major surgical or treatment procedure unrelated to the treatment of the aneurysm planned ≤ 30 days of the endovascular repair.
- Unstable angina, defined as a progressive increase in symptoms, new onset at rest or nocturnal angina, or onset of prolonged angina.
- Irreversible coagulopathy Anatomical Exclusion Criteria:
- Aortic transection due to acute trauma.
- Infectious ("mycotic") etiology of the aortic disease.
- Significant occlusive disease or tortuosity precluding delivery of the device components.
- Juxtarenal, Suprarenal, and Thoracoabdominal:
- Proximal Landing zone \< 20 mm in length. The proximal landing zone can be within zones 2 through 8, with least 20 mm of proximal seal and fixation in aorta or Dacron.
- Proximal neck, defined as the thoracic aorta distal to the native left carotid artery, measured outer wall to outer wall on a sectional image (CT) \> 41 mm in diameter or \< 18 mm in diameter
- Distal landing zone \< 20 mm in length if the landing zone is in the aorta, or \< 20 mm if the landing zone is in the iliac arteries or in Dacron (in the event the patient has had a previous or concomitant aortic or...
- Untreatable branch vessel stenosis.
- Anatomy that would not allow maintenance of at least one patent hypogastric artery.
- Signs that the inferior mesenteric artery (IMA) is indispensable (i.e. angiographic visualization or a large IMA, filling of superior mesenteric artery (SMA) via collaterals, stenosis of celiac or SMA or oblique views)...
- Branching, duplication, aneurysm or untreatable stenosis of the celiac, SMA or renal arteries that would preclude implantation of the investigational devices.
- Aortic arch:
- Proximal neck \> 44 mm or \< 28 mm in diameter
- Inadequate landing zone to allow adequate distal seal of exclusion of false lumen perfusion in dissection.
- Untreatable branch vessel stenosis.
- Significant occlusive disease, tortuosity, or calcification that would prevent endovascular access.
- Patients qualifying for an industry-sponsored study allowing for a similar repair will be enrolled in the industry-sponsored study.
The study team makes the final eligibility decision.
Where it's taking place
- Birmingham, Alabama, United States
Questions & answers
Do participants get paid in this trial?
This listing doesn't specify compensation. Many trials still reimburse travel or offer a stipend, so it's worth asking the study team when you connect.
Is it free to join, and do I need insurance?
Searching and applying through BridgeMD is free. In clinical trials the study-related treatment and visits are generally provided at no cost to you. You usually don't need insurance to take part - confirm specifics with the study team.
How long does this study last?
The listing doesn't state an exact length. The study team walks you through the schedule and number of visits before you decide to enroll.
Who can join this trial?
This study is enrolling all sexes, 18 years and older. The study team makes the final eligibility decision.
Where is this trial taking place?
Study sites include Birmingham, Alabama, United States. Enter your location above to see the nearest site and check your eligibility.
Explore other conditions
BridgeMD is an information and trial-matching tool - not medical advice, and not the study sponsor. Details come from ClinicalTrials.gov; the study team decides eligibility.