Safety and Effectiveness Trial of the Ventana Fenestrated Stent Graft System
Primary Purpose
Abdominal Aortic Aneurysm
Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Ventana Fenestrated Stent Graft System
Sponsored by
About this trial
This is an interventional treatment trial for Abdominal Aortic Aneurysm focused on measuring Abdominal aortic aneurysm, Renal stent, Juxtarenal, Pararenal, Endovascular
Eligibility Criteria
Inclusion Criteria:
- Male or female at least 18 years old;
- Informed consent understood and signed and patient agrees to all follow-up visits;
- Have aortic aneurysm with maximum diameter ≥5.5cm, or between 4.5 and 5.5cm and rapidly expanding (>0.5cm in six months), or >50% larger than the normal aortic diameter
Anatomically eligible for the Bifurcated System per the FDA-approved indications for use (IFU) and for the Fenestrated Stent Graft System:
- Adequate iliac/femoral access compatible with the required delivery systems
- Non-aneurysmal infrarenal aortic neck <15mm in length;
- Most caudal renal artery to aortoiliac bifurcation length ≥70mm
- SMA to aortoiliac bifurcation length ≥90mm;
- Proximal non-aneurysmal aortic neck below the SMA with: diameter 18 to 34 mm; length ≥15 mm; angle ≤60° to the aneurysm sac;
- Angle ≤60° (clock face) between the SMA and CA
- Renal arteries both distal to the SMA by ≤35mm, within 30mm of each other axially, with 4 to 8mm lumen diameter, and with clock face angle of 90° to 210° to each other .Common iliac artery distal fixation site with: distal fixation length ≥15 mm; ability to preserve at least one hypogastric artery; diameter ≥10 mm and ≤23 mm; angle ≤90° to the aortic bifurcation.
- The Endologix Fenestrated Proximal Extension Stent must have the ability to overlap the bifurcated stent graft by at least 3cm.
- Aortic diameter at the most caudal renal artery of 18 to 36mm
Exclusion Criteria:
- Life expectancy <2 years as judged by the investigator;
- Psychiatric or other condition that may interfere with the study;
- Participating in the enrollment or 30-day follow-up phase of another clinical study;
- Known allergy to any device component;
- Coagulopathy or uncontrolled bleeding disorder;
- Contraindication to contrast media or anticoagulants;
- Ruptured, leaking, or mycotic aneurysm;
- Aortic dissection
- Serum creatinine (S-Cr) level >2.0 mg/dL;
- Traumatic vascular injury;
- Active systemic or localized groin infection;
- Connective tissue disease (e.g., Marfan's Syndrome);
- Recent (within prior three months) cerebrovascular accident or myocardial infarction;
- Prior renal transplant;
- Length of either renal artery to be stented <13mm;
- Significant occlusive disease of either renal artery (>70% stenosis);
- An essential accessory renal artery;
- Indispensable inferior mesenteric artery;
- Aneurysmal disease of the descending thoracic aorta;
- Clinically significant mural thrombus circumferentially in the suprarenal segment;
- Prior iliac artery stent implanted that may interfere with delivery system introduction;
- Unsuitable vascular anatomy;
- Pregnancy (female patient of childbearing potential only)
- Existing renal stent;
- Pre-planned need for concomitant procedure (e.g. surgical conduit for vascular access, hypogastric artery embolization/coil, renal artery angioplasty)
Sites / Locations
- University of Alabama at Birmingham
- Arizona Heart Institute
- John Muir Medical Center Concord, CA
- UCLA Medical Center
- VA Gainesville
- Emory University
- Indiana University
- Baptist East Hospital
- Massachusetts General Hospital
- Brigham and Women's Hospital
- William Beaumont Hospital
- Mayo Clinic
- Barnes-Jewish Hospital
- Dartmouth-Hitchcock Medical Center
- University of North Carolina
- Cleveland Clinic Foundation
- Hospital of the University of Pennsylvania
- UPMC
- Methodist Hospital
- Harborview Medical Center
- Charleston Area Medical Center
- Aurora St. Luke's Medical Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Ventana Fenestrated Stent Graft System
Arm Description
Ventana Fenestrated Stent Graft System
Outcomes
Primary Outcome Measures
Safety- Number of Major Adverse Events at 30 Days
Major Adverse Events = all cause death; bowel ischemia; myocardial infarction; paraplegia; renal failure; respiratory complications of stroke; blood loss >1000cc
Effectiveness
Treatment Success is defined as Procedural technical success and absence of aneurysm rupture, conversion to open repair, Type I endoleak after 30 days, Type III endoleak, clinically significant migration; aneurysm enlargement; or secondary intervention for resolution of endoleak, limb occlusion, migration, aneurysm sac expansion and/or a device defect.
Procedural Technical Success is defined as a subject with successful implant.
Clinically Significant Device Migration: Core Lab reported aortic stent graft movement >10mm
Type I/III/IV Endoleak: Core Lab reported endoleak: between the endograft and the vessel either at the proximal attachment point (Type IA), or at the distal attachment point (Type IB), or between endograft components (Type III) or transgraft (Type IV).
Type II Endoleak: Core Lab reported endoleak emanating from a patent collateral vessel (e.g., inferior mesenteric artery, lumbar artery).
Secondary Outcome Measures
Safety- Number of Major Adverse Events > 30 Days to 5 Years
Major Adverse Events = all cause death; bowel ischemia; myocardial infarction; paraplegia; renal failure; respiratory complications of stroke; blood loss >1000cc
Renal Dysfunction
Renal Dysfunction is calculated at greater than 30% reduction starting at baseline
Endoleaks
Endoleaks- Type IA, Type IB, Type II, Type IIIA, Type IIIB, Type IV, and Unknown Type
Type I/III/IV Endoleak: Core Lab reported endoleak: between the endograft and the vessel either at the proximal attachment point (Type IA), or at the distal attachment point (Type IB), or between endograft components (Type III) or transgraft (Type IV).
Type II Endoleak: Core Lab reported endoleak emanating from a patent collateral vessel (e.g., inferior mesenteric artery, lumbar artery).
Clinical Utility Outcomes
Clinical Utility Outcomes consist of: fluoroscopy time, Bifurcated device placement time, Renal Artery Cannulation time, F-EVAR time and total procedure time.
Time in ICU
Number of days spent in the intensive care unit (ICU)
Time to Hospital Discharge
Number of days from the index procedure to discharge from the hospital.
Device Patency
Device patency- Ventana & Bifurcated Occlusion, Left Renal Artery Occlusion, and Right Renal Artery Occlusion
Device Integrity
Device Integrity- Device Migration, Ventana Stent Fracture, Left Renal Stent Fracture, Right Renal Stent Fracture, and Stent Kinking/ Compression
Aneurysm Sac Morphology
Aneurysm Sac Morphology- Aneurysm Shape, Aneurysm Enlargement
Aneurysm Sac Diameter
Aneurysm Sac diameter changes
Clinical Utility Outcomes
Clinical Utility Outcomes consists of: contrast volume and estimated blood loss.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01491945
Brief Title
Safety and Effectiveness Trial of the Ventana Fenestrated Stent Graft System
Official Title
Prospective, Multicenter, Single Arm Safety and Effectiveness Trial of the Endologix Fenestrated Stent Graft System for the Endovascular Repair of Juxtarenal/Pararenal (JAA/PAA) Aneurysms
Study Type
Interventional
2. Study Status
Record Verification Date
September 2021
Overall Recruitment Status
Completed
Study Start Date
March 3, 2013 (Actual)
Primary Completion Date
April 2017 (Actual)
Study Completion Date
August 1, 2018 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Endologix
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this trial is to determine if the Ventana Fenestrated Stent Graft System is safe and effective for the endovascular repair of juxtarenal or pararenal aortic aneurysms.
Detailed Description
Study Objectives The objective of protocol CP-0004 is to study the safety and effectiveness of the Endologix Fenestrated System in the endovascular treatment of patients with juxtarenal and/or pararenal aortic aneurysms.
Study Design This clinical study is a prospective, non-randomized, multicenter study. The first patient enrolled at each site is designated as a 'Roll-In' group patient. Subsequently, enrolled patients are designated as 'Trial' group patients for primary endpoint analysis.
Primary Endpoint The primary safety endpoint is defined as the incidence of Major Adverse Events‡ (MAEs) within 30 days. The primary study effectiveness endpoint is Treatment Success at 1-year. This is defined as procedural technical success and the absence of aneurysm rupture; conversion to open surgical repair; Type I endoleak after 30 days; Type III endoleak; clinically significant migration; aneurysm enlargement; or secondary intervention for resolution of endoleak, limb occlusion, migration, aneurysm sac expansion and/or a device defect.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Abdominal Aortic Aneurysm
Keywords
Abdominal aortic aneurysm, Renal stent, Juxtarenal, Pararenal, Endovascular
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
76 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Ventana Fenestrated Stent Graft System
Arm Type
Experimental
Arm Description
Ventana Fenestrated Stent Graft System
Intervention Type
Device
Intervention Name(s)
Ventana Fenestrated Stent Graft System
Intervention Description
The Ventana Fenestrated Stent Graft System consists of the following:
bifurcated stent graft, Ventana fenestrated proximal extension stent graft, and Xpand renal stent grafts
Primary Outcome Measure Information:
Title
Safety- Number of Major Adverse Events at 30 Days
Description
Major Adverse Events = all cause death; bowel ischemia; myocardial infarction; paraplegia; renal failure; respiratory complications of stroke; blood loss >1000cc
Time Frame
30 Days
Title
Effectiveness
Description
Treatment Success is defined as Procedural technical success and absence of aneurysm rupture, conversion to open repair, Type I endoleak after 30 days, Type III endoleak, clinically significant migration; aneurysm enlargement; or secondary intervention for resolution of endoleak, limb occlusion, migration, aneurysm sac expansion and/or a device defect.
Procedural Technical Success is defined as a subject with successful implant.
Clinically Significant Device Migration: Core Lab reported aortic stent graft movement >10mm
Type I/III/IV Endoleak: Core Lab reported endoleak: between the endograft and the vessel either at the proximal attachment point (Type IA), or at the distal attachment point (Type IB), or between endograft components (Type III) or transgraft (Type IV).
Type II Endoleak: Core Lab reported endoleak emanating from a patent collateral vessel (e.g., inferior mesenteric artery, lumbar artery).
Time Frame
1 Year
Secondary Outcome Measure Information:
Title
Safety- Number of Major Adverse Events > 30 Days to 5 Years
Description
Major Adverse Events = all cause death; bowel ischemia; myocardial infarction; paraplegia; renal failure; respiratory complications of stroke; blood loss >1000cc
Time Frame
>30 Days to 5 Years
Title
Renal Dysfunction
Description
Renal Dysfunction is calculated at greater than 30% reduction starting at baseline
Time Frame
Discharge to 5 Years
Title
Endoleaks
Description
Endoleaks- Type IA, Type IB, Type II, Type IIIA, Type IIIB, Type IV, and Unknown Type
Type I/III/IV Endoleak: Core Lab reported endoleak: between the endograft and the vessel either at the proximal attachment point (Type IA), or at the distal attachment point (Type IB), or between endograft components (Type III) or transgraft (Type IV).
Type II Endoleak: Core Lab reported endoleak emanating from a patent collateral vessel (e.g., inferior mesenteric artery, lumbar artery).
Time Frame
30 Days to 5 Years
Title
Clinical Utility Outcomes
Description
Clinical Utility Outcomes consist of: fluoroscopy time, Bifurcated device placement time, Renal Artery Cannulation time, F-EVAR time and total procedure time.
Time Frame
At the time of the procedure
Title
Time in ICU
Description
Number of days spent in the intensive care unit (ICU)
Time Frame
In-Hospital
Title
Time to Hospital Discharge
Description
Number of days from the index procedure to discharge from the hospital.
Time Frame
Hospital Discharge (Post-Procedure)
Title
Device Patency
Description
Device patency- Ventana & Bifurcated Occlusion, Left Renal Artery Occlusion, and Right Renal Artery Occlusion
Time Frame
30 Days to 5 Years
Title
Device Integrity
Description
Device Integrity- Device Migration, Ventana Stent Fracture, Left Renal Stent Fracture, Right Renal Stent Fracture, and Stent Kinking/ Compression
Time Frame
30 Days to 5 Years
Title
Aneurysm Sac Morphology
Description
Aneurysm Sac Morphology- Aneurysm Shape, Aneurysm Enlargement
Time Frame
30 Days to 5 Years
Title
Aneurysm Sac Diameter
Description
Aneurysm Sac diameter changes
Time Frame
30 Days to 5 Years
Title
Clinical Utility Outcomes
Description
Clinical Utility Outcomes consists of: contrast volume and estimated blood loss.
Time Frame
At the time of the procedure
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or female at least 18 years old;
Informed consent understood and signed and patient agrees to all follow-up visits;
Have aortic aneurysm with maximum diameter ≥5.5cm, or between 4.5 and 5.5cm and rapidly expanding (>0.5cm in six months), or >50% larger than the normal aortic diameter
Anatomically eligible for the Bifurcated System per the FDA-approved indications for use (IFU) and for the Fenestrated Stent Graft System:
Adequate iliac/femoral access compatible with the required delivery systems
Non-aneurysmal infrarenal aortic neck <15mm in length;
Most caudal renal artery to aortoiliac bifurcation length ≥70mm
SMA to aortoiliac bifurcation length ≥90mm;
Proximal non-aneurysmal aortic neck below the SMA with: diameter 18 to 34 mm; length ≥15 mm; angle ≤60° to the aneurysm sac;
Angle ≤60° (clock face) between the SMA and CA
Renal arteries both distal to the SMA by ≤35mm, within 30mm of each other axially, with 4 to 8mm lumen diameter, and with clock face angle of 90° to 210° to each other .Common iliac artery distal fixation site with: distal fixation length ≥15 mm; ability to preserve at least one hypogastric artery; diameter ≥10 mm and ≤23 mm; angle ≤90° to the aortic bifurcation.
The Endologix Fenestrated Proximal Extension Stent must have the ability to overlap the bifurcated stent graft by at least 3cm.
Aortic diameter at the most caudal renal artery of 18 to 36mm
Exclusion Criteria:
Life expectancy <2 years as judged by the investigator;
Psychiatric or other condition that may interfere with the study;
Participating in the enrollment or 30-day follow-up phase of another clinical study;
Known allergy to any device component;
Coagulopathy or uncontrolled bleeding disorder;
Contraindication to contrast media or anticoagulants;
Ruptured, leaking, or mycotic aneurysm;
Aortic dissection
Serum creatinine (S-Cr) level >2.0 mg/dL;
Traumatic vascular injury;
Active systemic or localized groin infection;
Connective tissue disease (e.g., Marfan's Syndrome);
Recent (within prior three months) cerebrovascular accident or myocardial infarction;
Prior renal transplant;
Length of either renal artery to be stented <13mm;
Significant occlusive disease of either renal artery (>70% stenosis);
An essential accessory renal artery;
Indispensable inferior mesenteric artery;
Aneurysmal disease of the descending thoracic aorta;
Clinically significant mural thrombus circumferentially in the suprarenal segment;
Prior iliac artery stent implanted that may interfere with delivery system introduction;
Unsuitable vascular anatomy;
Pregnancy (female patient of childbearing potential only)
Existing renal stent;
Pre-planned need for concomitant procedure (e.g. surgical conduit for vascular access, hypogastric artery embolization/coil, renal artery angioplasty)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Daniel G Clair, MD
Organizational Affiliation
The Cleveland Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Alabama at Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35429
Country
United States
Facility Name
Arizona Heart Institute
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85016
Country
United States
Facility Name
John Muir Medical Center Concord, CA
City
Concord
State/Province
California
ZIP/Postal Code
94520
Country
United States
Facility Name
UCLA Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
VA Gainesville
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32608
Country
United States
Facility Name
Emory University
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Indiana University
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
Baptist East Hospital
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40207
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Brigham and Women's Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
William Beaumont Hospital
City
Royal Oak
State/Province
Michigan
ZIP/Postal Code
48073
Country
United States
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
Barnes-Jewish Hospital
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Dartmouth-Hitchcock Medical Center
City
Lebanon
State/Province
New Hampshire
ZIP/Postal Code
03756
Country
United States
Facility Name
University of North Carolina
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States
Facility Name
Cleveland Clinic Foundation
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Hospital of the University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
UPMC
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15232
Country
United States
Facility Name
Methodist Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Harborview Medical Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States
Facility Name
Charleston Area Medical Center
City
Charleston
State/Province
West Virginia
ZIP/Postal Code
25304
Country
United States
Facility Name
Aurora St. Luke's Medical Center
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53215
Country
United States
12. IPD Sharing Statement
Learn more about this trial
Safety and Effectiveness Trial of the Ventana Fenestrated Stent Graft System
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