Study of the Relay Pro® Thoracic Stent-Graft in Subjects With Traumatic Injury of the Descending Thoracic Aorta
Primary Purpose
Other Specified Injury of Thoracic Aorta
Status
Active
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Relay Pro Thoracic Stent-Graft System
Sponsored by
About this trial
This is an interventional treatment trial for Other Specified Injury of Thoracic Aorta focused on measuring Descending Thoracic Aorta, DTA, Transection, Traumatic Injury of the Descending Thoracic Aorta
Eligibility Criteria
Inclusion Criteria:
- Age greater than 18 years
- Subject must have a traumatic injury of the descending thoracic aorta that occurred no more than 30 days prior to the planned stent implant procedure
- Proximal and distal landing zones with diameter between 19 mm and 42 mm.
- Subject must have a proximal attachment zone distal to the left common carotid and a distal attachment zone proximal to the origin of the celiac artery.
The length of the attachment zones will depend on the intended stent graft diameter.
- The proximal attachment zone should be: i. 15 mm for 22 - 28 mm grafts with bare stent (20 mm for RelayPro grafts with non-bare stent). ii. 20 mm for 30 - 46 mm grafts with bare stent (25 mm for RelayPro grafts with non-bare stent).
- The distal attachment zone should be 20 mm for all Relay Pro grafts.
- Coverage of the left subclavian artery is permitted. Revascularization of the left subclavian artery may be considered in all cases by the treating physician and, especially, in anatomies where revascularization is determined to be clinically necessary
- Proximal and distal attachment zones containing a straight segment (non-tapered, non-reverse tapered, defined by <10% diameter change) with lengths equal to or greater than the required attachment length for the intended device.
- Adequate iliac or femoral artery access for introduction of the RelayPro delivery system. Alternative methods to gain proper access may be utilized (e.g., iliac conduit).
- Subject willing to comply with the follow-up evaluation schedule.
- Subject (or Legally Authorized Representative, LAR) agrees to sign an Informed Consent Form prior to treatment
Exclusion Criteria:
- Significant stenosis, calcification, thrombus, or tortuosity of intended fixation sites that would compromise fixation or seal of the device.
- Planned coverage of left carotid or celiac arteries; or anatomic variants that may compromise circulation to the carotid, vertebral, or innominate arteries after device placement, and are not amenable to subclavian revascularization
- Prior endovascular or surgical repair in the DTA. The device may not be placed within any prior endovascular or surgical graft.
- Concomitant aneurysm/disease of the ascending aorta, aortic arch, or abdominal, aorta requiring repair.
- Prior abdominal aortic aneurysm repair (endovascular or surgical) that was performed less than 6 months prior to the planned stent implant procedure.
- Untreatable allergy or sensitivity to contrast media or device components.
- Known or suspected connective tissue disorder.
- Blood coagulation disorder or bleeding diathesis for which the treatment cannot be suspended for one week pre- and/or post-repair.
- Coronary artery disease with unstable angina.
- Severe congestive heart failure (New York Heart Association functional class IV).
- Stroke and/or Myocardial Infarction within 3 months of the planned treatment date.
- Pulmonary disease requiring the routine (daily or nightly) need for oxygen therapy outside the hospital setting.
- Acute renal failure or chronic renal insufficiency, and not receiving dialysis.
- Hemodynamically unstable.
- Active systemic infection and/or mycotic aneurysms.
- Morbid obesity or other condition that may compromise or prevent the necessary imaging requirements.
- Injury Severity Score of 75.
- Less than two-year life expectancy.
- Current or planned participation in an investigational drug or device study that has not completed primary endpoint evaluation.
- Currently pregnant or planning to become pregnant during the course of the study.
- Medical, social, or psychological issues that Investigator believes may interfere with treatment or follow-up.
Sites / Locations
- University of California, Irvine
- Stanford Medicine
- Yale School of Medicine
- Grady Memorial Hospital
- Indiana University Health
- University of Iowa Hospital and Clinic
- University of Maryland Medical Center
- Beth Israel Deaconess Medical Center / Harvard Medical School
- St. Louis University
- Atrium Health
- University Hospitals
- University of Pennsylvania Medical Center / Penn Presbyterian
- Vanderbilt University Medical Center
- University of Virginia
- University of Washington
- Medical College of Wisconsin
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Relay Pro Thoracic Stent-Graft System
Arm Description
The Relay Pro arm includes subjects who receive the device to treat traumatic injury of the descending thoracic aorta with the RelayPro Thoracic Stent-Graft System
Outcomes
Primary Outcome Measures
Mortality post-procedure
All-cause mortality at 30 days post-procedure
Secondary Outcome Measures
Successful device delivery and deployment
Successful delivery and deployment of the device, including withdrawal of the delivery system, will be assessed with angiography during the index procedure at the Treatment Visit.
Loss of stent-graft patency
Loss of stent-graft patency through 5 years
Aortic rupture
Aortic rupture will be assessed at each follow-up visit with CT scans, or MRIs for subjects unable to tolerate contrast media
Stent fractures in the attachment zone
Stent fractures in the attachment zone will be assessed at each follow-up visit with CT scans, or MRIs for subjects unable to tolerate contrast media
Endoleaks
Persistence of blood flow outside the lumen of the stent-graft but within the native aorta or adjacent vascular segment being treated by the stent-graft
Compression of stent-graft
Extra-luminal compression of the stent-graft will be assessed at each follow-up visit with xrays, CT scans, or MRIs for subjects unable to tolerate contrast media
Erosion and/or extrusion
Erosion and extrusion will be assessed at each follow-up visit with CT scans, or MRIs for subjects unable to tolerate contrast media
Aortic expansion
Aortic expansion (> 5mm) compared to the first post-procedural CT
Endograft infection
Infection of stent-graft
Incidence of open or endovascular secondary interventions
Incidence of open or endovascular secondary interventions to treat malperfusion, rupture, aneurysm formation, or aortic expansion
Migration
Stent migration (> 10 mm) compared to the first post-procedural CT; formation, or aortic expansion
Major adverse events
death, stroke, paralysis formation, or aortic expansion
Aortic-related death
formation, or aortic expansion
Vascular access complications
The Time Frame for reporting is during the Treatment Visit. Data should be captured upon conclusion of the Treatment Visit. Outcome measures include successful delivery and deployment of the device, as well as withdrawal of the delivery system
All-cause mortality
All causes where subject death is the result of a serious and device- or procedure related adverse effect. Unrelated and accidental deaths, for example a subject death due to injuries sustained from a gunshot wound, would not be included in the evaluation.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03090230
Brief Title
Study of the Relay Pro® Thoracic Stent-Graft in Subjects With Traumatic Injury of the Descending Thoracic Aorta
Official Title
A Prospective, Multicenter, Non-Blinded, Non-Randomized Study of the RelayPro Thoracic Stent-Graft in Subjects With Traumatic Injury of the Descending Thoracic Aorta
Study Type
Interventional
2. Study Status
Record Verification Date
May 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
April 17, 2017 (Actual)
Primary Completion Date
November 2022 (Anticipated)
Study Completion Date
November 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Bolton Medical
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 study is to investigate the safety and effectiveness of the RelayPro Thoracic Stent-Grafts in subjects with traumatic injury of the descending thoracic aorta (DTA)
Detailed Description
This is a prospective, multicenter, non-blinded, non-randomized study of the RelayPro Thoracic Stent-Graft in subjects with traumatic injury of the DTA in subjects who are candidates for endovascular repair.The primary objective of the study is all-cause mortality at 30 days post procedure.
The secondary objectives of the trial will include descriptive analyses of procedural and post-procedural observations through 5 years of follow-up.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Other Specified Injury of Thoracic Aorta
Keywords
Descending Thoracic Aorta, DTA, Transection, Traumatic Injury of the Descending Thoracic Aorta
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
Subject must have a traumatic injury of the descending thoracic aorta that occurred no more than 30 days prior to the planned stent implant procedure. All subjects enrolled, will be included in the patient population for the primary analysis. All subjects implanted with the RelayPro Thoracic Stent-Graft will be included in the patient population for the secondary analyses.
Masking
None (Open Label)
Allocation
N/A
Enrollment
50 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Relay Pro Thoracic Stent-Graft System
Arm Type
Experimental
Arm Description
The Relay Pro arm includes subjects who receive the device to treat traumatic injury of the descending thoracic aorta with the RelayPro Thoracic Stent-Graft System
Intervention Type
Device
Intervention Name(s)
Relay Pro Thoracic Stent-Graft System
Intervention Description
RelayPro Thoracic Stent-Grafts are designed for the management of patients with aneurysms and penetrating ulcers within the descending thoracic aorta (DTA). The device is designed specifically for use in the thoracic aorta.
Primary Outcome Measure Information:
Title
Mortality post-procedure
Description
All-cause mortality at 30 days post-procedure
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Successful device delivery and deployment
Description
Successful delivery and deployment of the device, including withdrawal of the delivery system, will be assessed with angiography during the index procedure at the Treatment Visit.
Time Frame
During Implantation
Title
Loss of stent-graft patency
Description
Loss of stent-graft patency through 5 years
Time Frame
1 month, 6 months, 12 months, and annually through 5 years
Title
Aortic rupture
Description
Aortic rupture will be assessed at each follow-up visit with CT scans, or MRIs for subjects unable to tolerate contrast media
Time Frame
1 month, 6 months, 12 months, and annually through 5 years
Title
Stent fractures in the attachment zone
Description
Stent fractures in the attachment zone will be assessed at each follow-up visit with CT scans, or MRIs for subjects unable to tolerate contrast media
Time Frame
1 month, 6 months, 12 months, and annually through 5 years
Title
Endoleaks
Description
Persistence of blood flow outside the lumen of the stent-graft but within the native aorta or adjacent vascular segment being treated by the stent-graft
Time Frame
1 month, 6 months, 12 months, and annually through 5 years
Title
Compression of stent-graft
Description
Extra-luminal compression of the stent-graft will be assessed at each follow-up visit with xrays, CT scans, or MRIs for subjects unable to tolerate contrast media
Time Frame
1 month, 6 months, 12 months, and annually through 5 years
Title
Erosion and/or extrusion
Description
Erosion and extrusion will be assessed at each follow-up visit with CT scans, or MRIs for subjects unable to tolerate contrast media
Time Frame
1 month, 6 months, 12 months, and annually through 5 years
Title
Aortic expansion
Description
Aortic expansion (> 5mm) compared to the first post-procedural CT
Time Frame
1 month, 6 months, 12 months, and annually through 5 years
Title
Endograft infection
Description
Infection of stent-graft
Time Frame
1 month, 6 months, 12 months, and annually through 5 years
Title
Incidence of open or endovascular secondary interventions
Description
Incidence of open or endovascular secondary interventions to treat malperfusion, rupture, aneurysm formation, or aortic expansion
Time Frame
1 month, 6 months, 12 months, and annually through 5 years
Title
Migration
Description
Stent migration (> 10 mm) compared to the first post-procedural CT; formation, or aortic expansion
Time Frame
1 month, 6 months, 12 months, and annually through 5 years
Title
Major adverse events
Description
death, stroke, paralysis formation, or aortic expansion
Time Frame
1 month, 6 months, 12 months, and annually through 5 years
Title
Aortic-related death
Description
formation, or aortic expansion
Time Frame
1 month, 6 months, 12 months, and annually through 5 years
Title
Vascular access complications
Description
The Time Frame for reporting is during the Treatment Visit. Data should be captured upon conclusion of the Treatment Visit. Outcome measures include successful delivery and deployment of the device, as well as withdrawal of the delivery system
Time Frame
During the initial implant attempt
Title
All-cause mortality
Description
All causes where subject death is the result of a serious and device- or procedure related adverse effect. Unrelated and accidental deaths, for example a subject death due to injuries sustained from a gunshot wound, would not be included in the evaluation.
Time Frame
1 month, 6 months, 12 months, and annually through 5 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age greater than 18 years
Subject must have a traumatic injury of the descending thoracic aorta that occurred no more than 30 days prior to the planned stent implant procedure
Proximal and distal landing zones with diameter between 19 mm and 42 mm.
Subject must have a proximal attachment zone distal to the left common carotid and a distal attachment zone proximal to the origin of the celiac artery.
The length of the attachment zones will depend on the intended stent graft diameter.
The proximal attachment zone should be: i. 15 mm for 22 - 28 mm grafts with bare stent (20 mm for RelayPro grafts with non-bare stent). ii. 20 mm for 30 - 46 mm grafts with bare stent (25 mm for RelayPro grafts with non-bare stent).
The distal attachment zone should be 20 mm for all Relay Pro grafts.
Coverage of the left subclavian artery is permitted. Revascularization of the left subclavian artery may be considered in all cases by the treating physician and, especially, in anatomies where revascularization is determined to be clinically necessary
Proximal and distal attachment zones containing a straight segment (non-tapered, non-reverse tapered, defined by <10% diameter change) with lengths equal to or greater than the required attachment length for the intended device.
Adequate iliac or femoral artery access for introduction of the RelayPro delivery system. Alternative methods to gain proper access may be utilized (e.g., iliac conduit).
Subject willing to comply with the follow-up evaluation schedule.
Subject (or Legally Authorized Representative, LAR) agrees to sign an Informed Consent Form prior to treatment
Exclusion Criteria:
Significant stenosis, calcification, thrombus, or tortuosity of intended fixation sites that would compromise fixation or seal of the device.
Planned coverage of left carotid or celiac arteries; or anatomic variants that may compromise circulation to the carotid, vertebral, or innominate arteries after device placement, and are not amenable to subclavian revascularization
Prior endovascular or surgical repair in the DTA. The device may not be placed within any prior endovascular or surgical graft.
Concomitant aneurysm/disease of the ascending aorta, aortic arch, or abdominal, aorta requiring repair.
Prior abdominal aortic aneurysm repair (endovascular or surgical) that was performed less than 6 months prior to the planned stent implant procedure.
Untreatable allergy or sensitivity to contrast media or device components.
Known or suspected connective tissue disorder.
Blood coagulation disorder or bleeding diathesis for which the treatment cannot be suspended for one week pre- and/or post-repair.
Coronary artery disease with unstable angina.
Severe congestive heart failure (New York Heart Association functional class IV).
Stroke and/or Myocardial Infarction within 3 months of the planned treatment date.
Pulmonary disease requiring the routine (daily or nightly) need for oxygen therapy outside the hospital setting.
Acute renal failure or chronic renal insufficiency, and not receiving dialysis.
Hemodynamically unstable.
Active systemic infection and/or mycotic aneurysms.
Morbid obesity or other condition that may compromise or prevent the necessary imaging requirements.
Injury Severity Score of 75.
Less than two-year life expectancy.
Current or planned participation in an investigational drug or device study that has not completed primary endpoint evaluation.
Currently pregnant or planning to become pregnant during the course of the study.
Medical, social, or psychological issues that Investigator believes may interfere with treatment or follow-up.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ben Starnes, MD
Organizational Affiliation
University of Washington
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Ravi Rajani, MD
Organizational Affiliation
Emory University
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of California, Irvine
City
Irvine
State/Province
California
ZIP/Postal Code
92868
Country
United States
Facility Name
Stanford Medicine
City
Stanford
State/Province
California
ZIP/Postal Code
94305-5639
Country
United States
Facility Name
Yale School of Medicine
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06510
Country
United States
Facility Name
Grady Memorial Hospital
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30303
Country
United States
Facility Name
Indiana University Health
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
University of Iowa Hospital and Clinic
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Facility Name
University of Maryland Medical Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States
Facility Name
Beth Israel Deaconess Medical Center / Harvard Medical School
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
St. Louis University
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Atrium Health
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28203
Country
United States
Facility Name
University Hospitals
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Facility Name
University of Pennsylvania Medical Center / Penn Presbyterian
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Vanderbilt University Medical Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States
Facility Name
University of Virginia
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22908
Country
United States
Facility Name
University of Washington
City
Seattle
State/Province
Washington
ZIP/Postal Code
98105
Country
United States
Facility Name
Medical College of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Study of the Relay Pro® Thoracic Stent-Graft in Subjects With Traumatic Injury of the Descending Thoracic Aorta
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