GORE® CARDIOFORM Septal Occluder and Antiplatelet Medical Management for Reduction of Recurrent Stroke in Patients With Patent Foramen Ovale (PFO): the REDUCE Post Approval Study (REDUCE PAS)
Primary Purpose
Stroke, PFO - Patent Foramen Ovale
Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
PFO closure with GORE® CARDIOFORM Septal Occluder
Sponsored by
About this trial
This is an interventional prevention trial for Stroke focused on measuring Occluder, Patent Foramen Ovale, PFO, Stroke, Gore Septal Occluder
Eligibility Criteria
Inclusion Criteria:
- Diagnosed with an ischemic stroke presumed to be an embolic stroke of undetermined source (ESUS) verified by a neurologist within the last 365 days prior to enrollment.
- Presence of Patent Foramen Ovale (PFO), as determined initially by positive bubble study utilizing transesophageal echocardiography (TEE) and/or transcranial Doppler (TCD), demonstrating spontaneous right-to-left shunting or right-to-left shunting during Valsalva maneuver.
- Patient is able to tolerate antiplatelet therapy
- Note: Additional Inclusion Criteria may apply
Exclusion Criteria:
- History of or ongoing atrial fibrillation/flutter
- Other co-morbidities including, but not limited to, mural thrombus, dilated cardiomyopathy, cardiac prosthetics (valves), severe native valve disease (including mitral valve stenosis), severe ventricular wall motion abnormalities, aortic dissection, significant atherosclerosis, vasculitis, pre-existing non-vascular neurologic disorders, pulmonary arteriovenous malformations, prior intracranial hemorrhage, severe disability related to prior stroke, autoimmune disorders that would increase the risk of stroke or thromboembolism, or associated with increased risk of infection or procedural complications, in the opinion of the investigator, left ventricular ejection fraction of <40%, coexistent cause or intra-cardiac shunting (e.g. VSD or ASD)
- Previous Myocardial Infarction
- Rankin Scale sore greater than or equal to 3 at the time of procedure
- Active infection that cannot be treated successfully prior to enrollment
- Neurological deficits not due to stroke that may affect the patient's neurologic assessments
- Evidence of hypercoagulable state, Uncontrolled diabetes mellitus, uncontrolled systemic hypertension or pulmonary hypertension at the time of screening or procedure
- Sensitivity or contraindication to all proposed medical treatments or any device components
- Pregnant, lactating, or intent on becoming pregnant through 24 months after enrollment.
- Indications outside the parameters accepted for placement of GSO, including extensive congenital cardiac anomalies and defect diameters considered too large for closure with the device.
- Atrial septal anatomy that is expected to necessitate placement of more than one GORE® CARDIOFORM Septal Occluder
- Need for concomitant procedure(s) that may confound detection of adverse events related to device placement
- Note: Additional Exclusion Criteria may apply
Sites / Locations
- St. Mary's HospitalRecruiting
- Scripps Health La JollaRecruiting
- Loma Linda University HealthRecruiting
- University of California - San FranciscoRecruiting
- Santa Barbara Cottage HospitalRecruiting
- South Denver Cardiology AssociatesRecruiting
- Medical Center of the RockiesRecruiting
- Yale University School of MedicineRecruiting
- Naples Community HospitalRecruiting
- Cleveland Clinic FloridaRecruiting
- Emory UniversityRecruiting
- Rush University Medical CenterRecruiting
- Alexian Brothers Medical CenterRecruiting
- Northwestern UniversityRecruiting
- University of Iowa Hospitals & ClinicRecruiting
- Catholic Health Initiatives- Iowa Corp dba Iowa HeartRecruiting
- Massachusetts General HospitalRecruiting
- University of MichiganRecruiting
- William Beaumont Hospital
- Covenant Medical Center, Inc.Recruiting
- University of MinnesotaRecruiting
- Minneapolis Heart Institute Foundation - Abbott Northwestern HospitalRecruiting
- Research Foundation SUNY BuffaloRecruiting
- Columbia University Medical Center/NYPHRecruiting
- Atrium HealthRecruiting
- Providence Heart & Vascular InstituteRecruiting
- Lehigh Valley HospitalRecruiting
- Medical University of South CarolinaRecruiting
- Tennova Healthcare
- Vanderbilt University Medical CenterRecruiting
- Baylor College of Medicine-HoustonRecruiting
- The Methodist Hospital - HoustonRecruiting
- Methodist Healthcare Systems of San Antonio d/b/a Methodist HospitalRecruiting
- University of UtahRecruiting
- University of VirginiaRecruiting
- Sentara Cardiovascular Research InstituteRecruiting
- University of Washington
- Multicare Health Tacoma-Multicare Institute for Research & InnovationRecruiting
- Aurora Health Care, Metro Inc.Recruiting
- Medical College of Wisconsin, Inc.Recruiting
Arms of the Study
Arm 1
Arm Type
Other
Arm Label
GORE® CARDIOFORM Septal Occluder
Arm Description
Single Arm Commercially available GORE® CARDIOFORM Septal Occluder
Outcomes
Primary Outcome Measures
Proportion of subjects with recurrent ischemic stroke post study device implant (Primary Effectiveness Outcome)
Proportion of subjects with recurrent ischemic stroke post study device implant
Proportion of subjects with device- or procedure-related serious adverse events at 30 days (Primary Safety Endpoint)
Device- or procedure- related serious adverse events post study device implant
Secondary Outcome Measures
Effective PFO Closure defined as complete PFO closure or a trivial or small residual shunt by Echocardiographic assessment
Complete PFO closure or a trivial or small residual shunt
Proportion of subjects with complete PFO closure or a trivial or small residual shunt
Clinically Significant New Atrial Arrhythmia
Any new atrial fibrillation or flutter
Clinically Significant New Atrial Arrhythmia by Age
Any new atrial fibrillation or flutter in patients greater and less than 60 years of age
Residual Shunt Characterization via assessment of shunt in patients by Echo
Assessment of shunt in patients by Echo
Technical Success defined as successful delivery and retention of the GSO device based on physician reporting
Successful delivery and retention of the GSO device
Procedural Success defined as successful implantation of the GSO device with no reported in-hospital Serious Adverse Events (SAEs)
Successful implantation of the GSO device with no reported in-hospital SAEs
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03821129
Brief Title
GORE® CARDIOFORM Septal Occluder and Antiplatelet Medical Management for Reduction of Recurrent Stroke in Patients With Patent Foramen Ovale (PFO): the REDUCE Post Approval Study
Acronym
REDUCE PAS
Official Title
GORE® CARDIOFORM Septal Occluder and Antiplatelet Medical Management for Reduction of Recurrent Stroke in Patients With Patent Foramen Ovale (PFO): the REDUCE Post Approval Study
Study Type
Interventional
2. Study Status
Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 25, 2019 (Actual)
Primary Completion Date
December 2026 (Anticipated)
Study Completion Date
December 2029 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
W.L.Gore & Associates
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This study will assess the safety and effectiveness of GORE® CARDIOFORM Septal Occluder in a post approval setting and evaluate the quality of operator education and training and transferability of trial experience to a post-market setting.
Detailed Description
A maximum of 636 adult subjects will be enrolled at up to 40 U.S. centers. Subjects will have follow-up at 1 month, 6 months, 12 months and annually thereafter through 5 years post implant.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stroke, PFO - Patent Foramen Ovale
Keywords
Occluder, Patent Foramen Ovale, PFO, Stroke, Gore Septal Occluder
7. Study Design
Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
636 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
GORE® CARDIOFORM Septal Occluder
Arm Type
Other
Arm Description
Single Arm Commercially available GORE® CARDIOFORM Septal Occluder
Intervention Type
Device
Intervention Name(s)
PFO closure with GORE® CARDIOFORM Septal Occluder
Intervention Description
PFO closure with GORE® CARDIOFORM Septal Occluder in patients with ischemic stroke
Primary Outcome Measure Information:
Title
Proportion of subjects with recurrent ischemic stroke post study device implant (Primary Effectiveness Outcome)
Description
Proportion of subjects with recurrent ischemic stroke post study device implant
Time Frame
24 months
Title
Proportion of subjects with device- or procedure-related serious adverse events at 30 days (Primary Safety Endpoint)
Description
Device- or procedure- related serious adverse events post study device implant
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Effective PFO Closure defined as complete PFO closure or a trivial or small residual shunt by Echocardiographic assessment
Description
Complete PFO closure or a trivial or small residual shunt
Proportion of subjects with complete PFO closure or a trivial or small residual shunt
Time Frame
12 months
Title
Clinically Significant New Atrial Arrhythmia
Description
Any new atrial fibrillation or flutter
Time Frame
60 months
Title
Clinically Significant New Atrial Arrhythmia by Age
Description
Any new atrial fibrillation or flutter in patients greater and less than 60 years of age
Time Frame
60 months
Title
Residual Shunt Characterization via assessment of shunt in patients by Echo
Description
Assessment of shunt in patients by Echo
Time Frame
24 months
Title
Technical Success defined as successful delivery and retention of the GSO device based on physician reporting
Description
Successful delivery and retention of the GSO device
Time Frame
Index procedure
Title
Procedural Success defined as successful implantation of the GSO device with no reported in-hospital Serious Adverse Events (SAEs)
Description
Successful implantation of the GSO device with no reported in-hospital SAEs
Time Frame
Enrollment through discharge, approximately 1 day
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Diagnosed with an ischemic stroke presumed to be an embolic stroke of undetermined source (ESUS) verified by a neurologist within the last 365 days prior to enrollment.
Presence of Patent Foramen Ovale (PFO), as determined initially by positive bubble study utilizing transesophageal echocardiography (TEE) and/or transcranial Doppler (TCD), demonstrating spontaneous right-to-left shunting or right-to-left shunting during Valsalva maneuver.
Patient is able to tolerate antiplatelet therapy
Note: Additional Inclusion Criteria may apply
Exclusion Criteria:
History of or ongoing atrial fibrillation/flutter
Other co-morbidities including, but not limited to, mural thrombus, dilated cardiomyopathy, cardiac prosthetics (valves), severe native valve disease (including mitral valve stenosis), severe ventricular wall motion abnormalities, aortic dissection, significant atherosclerosis, vasculitis, pre-existing non-vascular neurologic disorders, pulmonary arteriovenous malformations, prior intracranial hemorrhage, severe disability related to prior stroke, autoimmune disorders that would increase the risk of stroke or thromboembolism, or associated with increased risk of infection or procedural complications, in the opinion of the investigator, left ventricular ejection fraction of <40%, coexistent cause or intra-cardiac shunting (e.g. VSD or ASD)
Previous Myocardial Infarction
Rankin Scale sore greater than or equal to 3 at the time of procedure
Active infection that cannot be treated successfully prior to enrollment
Neurological deficits not due to stroke that may affect the patient's neurologic assessments
Evidence of hypercoagulable state, Uncontrolled diabetes mellitus, uncontrolled systemic hypertension or pulmonary hypertension at the time of screening or procedure
Sensitivity or contraindication to all proposed medical treatments or any device components
Pregnant, lactating, or intent on becoming pregnant through 24 months after enrollment.
Indications outside the parameters accepted for placement of GSO, including extensive congenital cardiac anomalies and defect diameters considered too large for closure with the device.
Atrial septal anatomy that is expected to necessitate placement of more than one GORE® CARDIOFORM Septal Occluder
Need for concomitant procedure(s) that may confound detection of adverse events related to device placement
Note: Additional Exclusion Criteria may apply
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Tammy DeLozier
Phone
800-437-8181
Email
GSO1801@wlgore.com
Facility Information:
Facility Name
St. Mary's Hospital
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85745
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lucille Pena
First Name & Middle Initial & Last Name & Degree
Kapildeo Lotun, MD
Facility Name
Scripps Health La Jolla
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Heather Catchpole
First Name & Middle Initial & Last Name & Degree
Matthew Price, MD
Facility Name
Loma Linda University Health
City
Loma Linda
State/Province
California
ZIP/Postal Code
92354
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jason Hoff
First Name & Middle Initial & Last Name & Degree
Jason Hoff, MD
Facility Name
University of California - San Francisco
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Harsh Agrawal
Facility Name
Santa Barbara Cottage Hospital
City
Santa Barbara
State/Province
California
ZIP/Postal Code
93105
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Joseph Aragon
Facility Name
South Denver Cardiology Associates
City
Littleton
State/Province
Colorado
ZIP/Postal Code
80120
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lee MacDonald
Facility Name
Medical Center of the Rockies
City
Loveland
State/Province
Colorado
ZIP/Postal Code
80538
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Justin Strote
Facility Name
Yale University School of Medicine
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06510
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jeremy Asnes
Facility Name
Naples Community Hospital
City
Naples
State/Province
Florida
ZIP/Postal Code
34102
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kathy Byrd
First Name & Middle Initial & Last Name & Degree
Roberto Cubeddu, MD
Facility Name
Cleveland Clinic Florida
City
Weston
State/Province
Florida
ZIP/Postal Code
33331
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
David Snipelisky
Facility Name
Emory University
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Chandanreddy Devireddy
Facility Name
Rush University Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Clifford Kavinsky
Facility Name
Alexian Brothers Medical Center
City
Elk Grove Village
State/Province
Illinois
ZIP/Postal Code
60007
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Andrei Pop, MD
First Name & Middle Initial & Last Name & Degree
Andrei Pop, MD
Facility Name
Northwestern University
City
Evanston
State/Province
Illinois
ZIP/Postal Code
60208
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Keith Benzuly
Facility Name
University of Iowa Hospitals & Clinic
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Phillip Horwitz
Facility Name
Catholic Health Initiatives- Iowa Corp dba Iowa Heart
City
West Des Moines
State/Province
Iowa
ZIP/Postal Code
50266
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mark Tannenbaum
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ignacio Inglessis-Azuaje
First Name & Middle Initial & Last Name & Degree
Ignacio Inglessis-Azuaje
Facility Name
University of Michigan
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Stanley Chetcuti
Facility Name
William Beaumont Hospital
City
Royal Oak
State/Province
Michigan
ZIP/Postal Code
48073
Country
United States
Individual Site Status
Withdrawn
Facility Name
Covenant Medical Center, Inc.
City
Saginaw
State/Province
Michigan
ZIP/Postal Code
48602
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Bashar Al Jayyousi
First Name & Middle Initial & Last Name & Degree
Firas Alani
Facility Name
University of Minnesota
City
Edina
State/Province
Minnesota
ZIP/Postal Code
55435
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gregory Helmer
Facility Name
Minneapolis Heart Institute Foundation - Abbott Northwestern Hospital
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55407
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mario Goessl
Facility Name
Research Foundation SUNY Buffalo
City
Buffalo
State/Province
New York
ZIP/Postal Code
14203
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Vijay Iyer
Facility Name
Columbia University Medical Center/NYPH
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Robert Sommer
First Name & Middle Initial & Last Name & Degree
Robert Sommer
Facility Name
Atrium Health
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28203
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Matthew Schwartz
Facility Name
Providence Heart & Vascular Institute
City
Portland
State/Province
Oregon
ZIP/Postal Code
97225
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Brandon Jones
Facility Name
Lehigh Valley Hospital
City
Allentown
State/Province
Pennsylvania
ZIP/Postal Code
18103
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Bryan Kluck
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
John Rhodes
Facility Name
Tennova Healthcare
City
Knoxville
State/Province
Tennessee
ZIP/Postal Code
37934
Country
United States
Individual Site Status
Terminated
Facility Name
Vanderbilt University Medical Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Robert Piana
Facility Name
Baylor College of Medicine-Houston
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Guilherme Silva
Facility Name
The Methodist Hospital - Houston
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Chun Huie Lin
First Name & Middle Initial & Last Name & Degree
Chun Huie Lin
Facility Name
Methodist Healthcare Systems of San Antonio d/b/a Methodist Hospital
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jorge Alvarez
Facility Name
University of Utah
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84132
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Anwar Tandar
Facility Name
University of Virginia
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22908
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nishtha Sodhi
Facility Name
Sentara Cardiovascular Research Institute
City
Norfolk
State/Province
Virginia
ZIP/Postal Code
23455
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Paul Mahoney
Facility Name
University of Washington
City
Seattle
State/Province
Washington
ZIP/Postal Code
98195
Country
United States
Individual Site Status
Withdrawn
Facility Name
Multicare Health Tacoma-Multicare Institute for Research & Innovation
City
Tacoma
State/Province
Washington
ZIP/Postal Code
98405
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
William Dixon, MD
First Name & Middle Initial & Last Name & Degree
William Dixon, MD
Facility Name
Aurora Health Care, Metro Inc.
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53215
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tanvir Bajwa
Facility Name
Medical College of Wisconsin, Inc.
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Michael Cinquegrani
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
GORE® CARDIOFORM Septal Occluder and Antiplatelet Medical Management for Reduction of Recurrent Stroke in Patients With Patent Foramen Ovale (PFO): the REDUCE Post Approval Study
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