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A Pilot Study to Determine Optimal Procedure Steps to Obtain and Maintain Uterine Artery Occlusion With the D-UAO Device

Primary Purpose

Uterine Fibroids

Status
Terminated
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
GYNECARE GYNOCCLUDE™
Sponsored by
Ethicon, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Uterine Fibroids

Eligibility Criteria

25 Years - 55 Years (Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Age 25-55 years with regular menses and at least one symptom related to uterine fibroids (for example heavy bleeding).
  • Completed child-bearing.
  • At least one uterine fibroid of 3 cm diameter or greater with a prevailing pathology (e.g. as opposed to adenomyosis) of fibroids determined through abdominal/transvaginal ultrasound.
  • Confirmation of the ability to clearly visualise bilateral uterine arteries with 2/3DPD.
  • Dominant fibroid (defined as >3cm in diameter) must be well vascularised as determined by CE-MRI (for Group 2 and 3 patients only).
  • Able to tolerate the required prolonged supine position during treatment (approximately 6 hours).
  • Cervix suitable for tenaculum placement as determined by pelvic exam.
  • Normal Pap smear within the last 36 months.
  • Agrees to participate in the study, and following review of the patient information sheet documents this agreement by signing the Ethics Committee approved informed consent.

Exclusion Criteria:

  • Prior endometrial ablation, uterine artery embolization, or uterine artery ligation.
  • Pregnancy (As confirmed by a urine pregnancy test at screening and immediately prior to procedure).
  • One or more lower uterine segment fibroids determined through pelvic exam which in the examiner's opinion would prevent proper clamp application.
  • Any known contraindications to the contrast agent to be used for the CE-MRI as determined by the study radiologist (for Group 2 and 3 patients only).
  • Pelvic mass outside the uterus suggesting other disease processes.
  • An intrauterine device (IUD) in place during the day of procedure.
  • Hydronephrosis as determined by interpretation of a pre-procedure renal ultrasound.
  • No ureteral jets observed on ultrasound prior to clamping.
  • Presence of a pedunculated fibroid determined by ultrasound, hysteroscopy, or saline infused sonography or CE MRI.
  • Any current acute or chronic systemic infection or localized pelvic infection, including an unresolved urinary tract infection.
  • Clinical history of any thromboembolic disease.
  • History of gynecologic malignancy, atypical endometrial hyperplasia, or pelvic inflammatory disease.
  • Using anticoagulation therapy (except OTC treatments, e.g. aspirin), or has a known underlying bleeding disorder.
  • In the investigator's opinion, any medical condition or psychiatric illness that could potentially be life threatening or affect their ability to complete the study visits according to this protocol.

Sites / Locations

  • Allgemeines Krankenhaus, Abteilung für Gynäkologie und Geburtshilfe
  • Frauenklinik, Universitatsklinikum Erlangen
  • Vrije Universiteit medisch centrum (VU Medical Center), Dept of Obstetrics and Gynaecology
  • Ullevaal University Hospital, Department of Obstetrics & Gynaecology

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

GYNECARE GYNOCCLUDE™

Arm Description

GYNECARE GYNOCCLUDE™ Doppler Guided Uterine Artery Occlusion Device

Outcomes

Primary Outcome Measures

Optimal procedural steps
Establish and verify optimal procedural steps to obtain and maintain bilateral uterine artery occlusion using the GYNECARE GYNOCCLUDE™ Doppler Guided Uterine Artery Occlusion Device (D-UAO) for 6 hours, and confirm that these optimal procedural steps are reproducible by multiple surgeons

Secondary Outcome Measures

Fibroid devascularization
Evaluation of the actual and percentage change in the uterine volume, dominant fibroid volume, T2 frequency, contrast enhancement index in the dominant fibroid and the number of patient with complete infarction of all fibroid tissue obtained from a comparison of the baseline and 1 month contrast enhanced MRIs.
Safety
Incidence of patients with adverse events that result in the following: ureteral stenting, intra-operative or post operative blood transfusion, device related hospitalization >24hours, interventional treatment for fibroids within 1 month of the D-UAO procedure, DVT or PE, life threatening cardiac or respiratory arrest or other life threatening events

Full Information

First Posted
June 8, 2010
Last Updated
February 16, 2011
Sponsor
Ethicon, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01140555
Brief Title
A Pilot Study to Determine Optimal Procedure Steps to Obtain and Maintain Uterine Artery Occlusion With the D-UAO Device
Official Title
A Pilot Study to Determine the Optimal Procedure Steps to Obtain and Maintain Bilateral Uterine Artery Occlusion Using the GYNECARE GYNOCCLUDE™ Doppler Guided Uterine Artery Occlusion Device in Women With Uterine Fibroids
Study Type
Interventional

2. Study Status

Record Verification Date
February 2011
Overall Recruitment Status
Terminated
Why Stopped
Further internal evaluation of the device was required.
Study Start Date
April 2010 (undefined)
Primary Completion Date
June 2010 (Actual)
Study Completion Date
July 2010 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Ethicon, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This pilot study has a sequential design involving three groups to ensure appropriate development and evaluation of the optimal procedural steps of the D-UAO device and to confirm that those steps are reproducible in the hands of multiple surgeons.
Detailed Description
Group 1 - beginning with the use of the current instructions for use (IFU) will have adjustments made as necessary to the D-UAO procedural steps for uterine artery occlusion confirmed by 2/3-D Power Colour Doppler ultrasound (2/3DPD). Group 2 - verify that optimal D-UAO IFU procedural steps generated in Group 1 as confirmed by 2/3DPD. Group 3 - verify that the optimal D-UAO procedural steps are reproducible in the hands of multiple surgeons in addition to the group 1 investigators, as confirmed by 2/3DPD.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Uterine Fibroids

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
2 (Actual)

8. Arms, Groups, and Interventions

Arm Title
GYNECARE GYNOCCLUDE™
Arm Type
Experimental
Arm Description
GYNECARE GYNOCCLUDE™ Doppler Guided Uterine Artery Occlusion Device
Intervention Type
Device
Intervention Name(s)
GYNECARE GYNOCCLUDE™
Other Intervention Name(s)
D-UAO Device
Intervention Description
GYNECARE GYNOCCLUDE™ Doppler Guided Uterine Artery Occlusion Device
Primary Outcome Measure Information:
Title
Optimal procedural steps
Description
Establish and verify optimal procedural steps to obtain and maintain bilateral uterine artery occlusion using the GYNECARE GYNOCCLUDE™ Doppler Guided Uterine Artery Occlusion Device (D-UAO) for 6 hours, and confirm that these optimal procedural steps are reproducible by multiple surgeons
Time Frame
6 hrs
Secondary Outcome Measure Information:
Title
Fibroid devascularization
Description
Evaluation of the actual and percentage change in the uterine volume, dominant fibroid volume, T2 frequency, contrast enhancement index in the dominant fibroid and the number of patient with complete infarction of all fibroid tissue obtained from a comparison of the baseline and 1 month contrast enhanced MRIs.
Time Frame
Baseline and 1 month post procedure
Title
Safety
Description
Incidence of patients with adverse events that result in the following: ureteral stenting, intra-operative or post operative blood transfusion, device related hospitalization >24hours, interventional treatment for fibroids within 1 month of the D-UAO procedure, DVT or PE, life threatening cardiac or respiratory arrest or other life threatening events
Time Frame
Baseline through one month post procedure

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
25 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 25-55 years with regular menses and at least one symptom related to uterine fibroids (for example heavy bleeding). Completed child-bearing. At least one uterine fibroid of 3 cm diameter or greater with a prevailing pathology (e.g. as opposed to adenomyosis) of fibroids determined through abdominal/transvaginal ultrasound. Confirmation of the ability to clearly visualise bilateral uterine arteries with 2/3DPD. Dominant fibroid (defined as >3cm in diameter) must be well vascularised as determined by CE-MRI (for Group 2 and 3 patients only). Able to tolerate the required prolonged supine position during treatment (approximately 6 hours). Cervix suitable for tenaculum placement as determined by pelvic exam. Normal Pap smear within the last 36 months. Agrees to participate in the study, and following review of the patient information sheet documents this agreement by signing the Ethics Committee approved informed consent. Exclusion Criteria: Prior endometrial ablation, uterine artery embolization, or uterine artery ligation. Pregnancy (As confirmed by a urine pregnancy test at screening and immediately prior to procedure). One or more lower uterine segment fibroids determined through pelvic exam which in the examiner's opinion would prevent proper clamp application. Any known contraindications to the contrast agent to be used for the CE-MRI as determined by the study radiologist (for Group 2 and 3 patients only). Pelvic mass outside the uterus suggesting other disease processes. An intrauterine device (IUD) in place during the day of procedure. Hydronephrosis as determined by interpretation of a pre-procedure renal ultrasound. No ureteral jets observed on ultrasound prior to clamping. Presence of a pedunculated fibroid determined by ultrasound, hysteroscopy, or saline infused sonography or CE MRI. Any current acute or chronic systemic infection or localized pelvic infection, including an unresolved urinary tract infection. Clinical history of any thromboembolic disease. History of gynecologic malignancy, atypical endometrial hyperplasia, or pelvic inflammatory disease. Using anticoagulation therapy (except OTC treatments, e.g. aspirin), or has a known underlying bleeding disorder. In the investigator's opinion, any medical condition or psychiatric illness that could potentially be life threatening or affect their ability to complete the study visits according to this protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Robinson, M.D.
Organizational Affiliation
Ethicon, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Allgemeines Krankenhaus, Abteilung für Gynäkologie und Geburtshilfe
City
Linz
ZIP/Postal Code
A-4020
Country
Austria
Facility Name
Frauenklinik, Universitatsklinikum Erlangen
City
Erlangen
ZIP/Postal Code
91054
Country
Germany
Facility Name
Vrije Universiteit medisch centrum (VU Medical Center), Dept of Obstetrics and Gynaecology
City
Amsterdam
ZIP/Postal Code
1081 HV
Country
Netherlands
Facility Name
Ullevaal University Hospital, Department of Obstetrics & Gynaecology
City
Oslo
ZIP/Postal Code
N-0407
Country
Norway

12. IPD Sharing Statement

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A Pilot Study to Determine Optimal Procedure Steps to Obtain and Maintain Uterine Artery Occlusion With the D-UAO Device

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