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DEFLECT II: A Study to Evaluate the Safety and Performance of the TriGuard™HDH in Patients Undergoing TAVR

Primary Purpose

Aortic Valve Stenosis

Status
Completed
Phase
Not Applicable
Locations
Netherlands
Study Type
Interventional
Intervention
TriGuard™HDH
Sponsored by
Keystone Heart
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Aortic Valve Stenosis focused on measuring TAVR

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. The patient must be ≥ 18 years of age.
  2. The patient meets indications for transcatheter aortic valve replacement procedure.
  3. The patient is willing to comply with specified follow-up evaluations.
  4. The patient, or legally authorized representative, has been informed of the nature of the study, agrees to its provisions and has been provided written informed consent, approved by the appropriate Medical Ethics Committee (EC).

Exclusion Criteria:

  1. Patients undergoing transcatheter aortic valve replacement via the trans-axillary, subclavian, or direct aortic route
  2. Pregnant or nursing subjects and those who plan pregnancy in the period up to 1 year following index procedure. Female subjects of child-bearing potential must have a negative pregnancy test done within 7 days prior to index procedure per site standard test.
  3. Patients with known diagnosis of acute myocardial infarction (AMI) within 72 hours preceding the index procedure (according to definition) or AMI > 72 hours preceding the index procedure and creatine kinase and creatine kinase fraction have not returned to normal limits at the time of procedure.
  4. Patients who are currently experiencing clinical symptoms consistent with new onset AMI, such as nitrate-unresponsive prolonged chest pain.
  5. Patients with impaired renal function (estimated Glomerular Filtration Rate [Estimated Glomerular Filtration Rate] <30, calculated from serum creatinine by the Cockcroft-Gault formula).
  6. Patients with torturous/unsuitable anatomy as related to major cerebral arteries in the aortic arch that may interfere with device deployment or remain deployed.
  7. Patients with a platelet count <100.000 cells/mm³ or >700.000 cells/mm³ or a white blood cell <3000 cells/mm³ within 7 days prior to index procedure.
  8. Patients with a history of bleeding diathesis or coagulopathy or patients in whom anti-platelet and/or anticoagulant therapy is contraindicated, or will refuse transfusion.
  9. Patients who have received any organ transplant or are on a waiting list for any organ transplant.
  10. Poor fluoroscopic visualization due to obesity or other medical reason
  11. Hypotension requiring iv/ia medication or other therapy such as resuscitation and defibrillation
  12. Patients with known other medical illness or known history of substance abuse that may cause non-compliance with the protocol, confound the data interpretation or is associated with a life expectancy of less than one year.
  13. Patients with a known hypersensitivity or contraindication to aspirin, heparin/bivalirudin, clopidogrel/ticlopidine, nitinol, stainless steel alloy, latex, and/or contrast sensitivity that cannot be adequately pre-medicated.
  14. Patients with a history of a stroke or transient ischemic attack (TIA) within the prior 6 months.
  15. Patients with an active peptic ulcer or upper gastrointestinal (GI) bleeding within the prior 6 months.
  16. Patients presenting with cardiogenic shock.
  17. Patients with severe peripheral arterial disease that precludes the delivery sheath vascular access.
  18. Patients with severe calcification/atheroma, friable or mobile atherosclerotic plaque in the aortic arch
  19. Patients with contraindication to cerebral MRI.
  20. Patients going through unprotected (cerebral embolization) cardiovascular procedure prior, during or post transcatheter aortic valve replacement procedure, before the post-procedure diffusion-weighted magnetic resonance imaging evaluation
  21. Patients who have a planned treatment with any other investigational device or procedure during the study period.

Sites / Locations

  • UMC Utrecht

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

TriGuard™HDH

Arm Description

Patients undergoing TAVR will be treated wIth experimental device TriGuard™HDH

Outcomes

Primary Outcome Measures

Device performance
Device performance will be evaluated for the following functions: Access the aortic arch, Deploy the TriGuard™HDH from the delivery catheter, Position the TriGuard™HDH to cover the cerebral/carotid vessels, Retrieve the TriGuard™HDH system intact

Secondary Outcome Measures

Number of new cerebral lesions
The number of new cerebral lesions by diffusion-weighted MRI one week post procedure
Volume of new cerebral lesions
The volume of new cerebral lesions by diffusion weighted MRI one week post procedure

Full Information

First Posted
January 27, 2014
Last Updated
August 26, 2015
Sponsor
Keystone Heart
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1. Study Identification

Unique Protocol Identification Number
NCT02073851
Brief Title
DEFLECT II: A Study to Evaluate the Safety and Performance of the TriGuard™HDH in Patients Undergoing TAVR
Official Title
A Prospective, Single Arm Feasibility Pilot Study to Evaluate the Safety and Performance of the TriGuard™HDH Embolic Deflection Device in Patients Undergoing Transcatheter Aortic Valve Replacement (TAVR)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2015
Overall Recruitment Status
Completed
Study Start Date
January 2014 (undefined)
Primary Completion Date
August 2014 (Actual)
Study Completion Date
September 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Keystone Heart

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Pilot study enrolling up to 12 patients at a single investigational site in the Netherlands. Patients for TAVR will be enrolled to receive the Embolic Deflection Device throughout the duration of the TAVR procedure.
Detailed Description
Prospective, single center, single arm pilot study enrolling up to 12 patients at a single investigational site in the netherlands. Patients meeting eligibility criteria for TAVR and none of the exclusion criteria will be enrolled to receive the Embolic Deflection Device throughout the duration of the TAVR procedure.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Aortic Valve Stenosis
Keywords
TAVR

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
TriGuard™HDH
Arm Type
Experimental
Arm Description
Patients undergoing TAVR will be treated wIth experimental device TriGuard™HDH
Intervention Type
Device
Intervention Name(s)
TriGuard™HDH
Intervention Description
TriGuard™HDH Embolic Deflection Device in patients undergoing Transcatheter Aortic Valve Replacement (TAVR)
Primary Outcome Measure Information:
Title
Device performance
Description
Device performance will be evaluated for the following functions: Access the aortic arch, Deploy the TriGuard™HDH from the delivery catheter, Position the TriGuard™HDH to cover the cerebral/carotid vessels, Retrieve the TriGuard™HDH system intact
Time Frame
During TAVR procedure
Secondary Outcome Measure Information:
Title
Number of new cerebral lesions
Description
The number of new cerebral lesions by diffusion-weighted MRI one week post procedure
Time Frame
one week post procedure
Title
Volume of new cerebral lesions
Description
The volume of new cerebral lesions by diffusion weighted MRI one week post procedure
Time Frame
One week post procedure

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The patient must be ≥ 18 years of age. The patient meets indications for transcatheter aortic valve replacement procedure. The patient is willing to comply with specified follow-up evaluations. The patient, or legally authorized representative, has been informed of the nature of the study, agrees to its provisions and has been provided written informed consent, approved by the appropriate Medical Ethics Committee (EC). Exclusion Criteria: Patients undergoing transcatheter aortic valve replacement via the trans-axillary, subclavian, or direct aortic route Pregnant or nursing subjects and those who plan pregnancy in the period up to 1 year following index procedure. Female subjects of child-bearing potential must have a negative pregnancy test done within 7 days prior to index procedure per site standard test. Patients with known diagnosis of acute myocardial infarction (AMI) within 72 hours preceding the index procedure (according to definition) or AMI > 72 hours preceding the index procedure and creatine kinase and creatine kinase fraction have not returned to normal limits at the time of procedure. Patients who are currently experiencing clinical symptoms consistent with new onset AMI, such as nitrate-unresponsive prolonged chest pain. Patients with impaired renal function (estimated Glomerular Filtration Rate [Estimated Glomerular Filtration Rate] <30, calculated from serum creatinine by the Cockcroft-Gault formula). Patients with torturous/unsuitable anatomy as related to major cerebral arteries in the aortic arch that may interfere with device deployment or remain deployed. Patients with a platelet count <100.000 cells/mm³ or >700.000 cells/mm³ or a white blood cell <3000 cells/mm³ within 7 days prior to index procedure. Patients with a history of bleeding diathesis or coagulopathy or patients in whom anti-platelet and/or anticoagulant therapy is contraindicated, or will refuse transfusion. Patients who have received any organ transplant or are on a waiting list for any organ transplant. Poor fluoroscopic visualization due to obesity or other medical reason Hypotension requiring iv/ia medication or other therapy such as resuscitation and defibrillation Patients with known other medical illness or known history of substance abuse that may cause non-compliance with the protocol, confound the data interpretation or is associated with a life expectancy of less than one year. Patients with a known hypersensitivity or contraindication to aspirin, heparin/bivalirudin, clopidogrel/ticlopidine, nitinol, stainless steel alloy, latex, and/or contrast sensitivity that cannot be adequately pre-medicated. Patients with a history of a stroke or transient ischemic attack (TIA) within the prior 6 months. Patients with an active peptic ulcer or upper gastrointestinal (GI) bleeding within the prior 6 months. Patients presenting with cardiogenic shock. Patients with severe peripheral arterial disease that precludes the delivery sheath vascular access. Patients with severe calcification/atheroma, friable or mobile atherosclerotic plaque in the aortic arch Patients with contraindication to cerebral MRI. Patients going through unprotected (cerebral embolization) cardiovascular procedure prior, during or post transcatheter aortic valve replacement procedure, before the post-procedure diffusion-weighted magnetic resonance imaging evaluation Patients who have a planned treatment with any other investigational device or procedure during the study period.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Pieter Stella, Md.
Organizational Affiliation
UMC Utrecht
Official's Role
Principal Investigator
Facility Information:
Facility Name
UMC Utrecht
City
Utrecht
Country
Netherlands

12. IPD Sharing Statement

Learn more about this trial

DEFLECT II: A Study to Evaluate the Safety and Performance of the TriGuard™HDH in Patients Undergoing TAVR

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