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Safety and Efficacy of a Multi-branched Thoracoabdominal Stent Graft System for Thoracoabdominal Aortic Aneurysm.

Primary Purpose

Thoracoabdominal Aortic Aneurysms

Status
Recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
Multi-Branched Thoracoabdominal Stent Graft System
Sponsored by
Lifetech Scientific (Shenzhen) Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Thoracoabdominal Aortic Aneurysms focused on measuring Guo's Visceral Arteries Reconstruction, Multi-branched Thoracoabdominal Stent Graft System, Thoracoabdominal Aortic Aneurysm

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. 18 years old ≤ age ≤ 80 years old;
  2. Diagnosed as thoracoabdominal aortic aneurysm (based on modified Crawford classification and 2019 European Guidelines for the Treatment of Aortic aneurysm) and should meet at least one of the following conditions;

    1. Maximum diameter of thoracoabdominal aortic aneurysm>50mm;
    2. The diameter has increased by more than 5mm in recent 6 months or the by more than 10mm in recent 1 year;
  3. anatomical criteria

    1. The proximal anchoring region (aorta or implanted graft) was 17~36 mm in diameter and ≥25 mm in length;
    2. Distal anchoring region (aorta or implanted graft): If the distal anchoring region is in the iliac artery, the anchoring region has a diameter range of 7~25 mm and a length of ≥15 mm; If the distal anchoring area is in the abdominal aorta, the diameter of the anchoring area ranges from 12~36mm and the length≥ 20mm;
    3. The diameter of the vessel anchoring area of the visceral branch ranges from 6~13 mm and the length ≥15 mm;
    4. The diameter of renal artery anchoring area ranges from 4.5~9mm, and the length ≥15 mm;
    5. Appropriate iliac, femoral and upper limb artery access;
  4. Patients who can understand the purpose of the trial, voluntarily participate and sign the informed consent, and are willing to complete the follow-up according to the requirements of the protocol;

Exclusion Criteria:

  1. Hemodynamically unstable patients with ruptured thoracoabdominal aortic aneurysms;
  2. Thoracoabdominal aortic dissection;
  3. Mycotic or infectious thoracoabdominal aortic aneurysm;
  4. Patients whose systemic or local infection may increase the risk of intravascular graft infection;
  5. Superior mesenteric, celiac, or renal artery occlusion;
  6. Requiring simultaneous coverage and embolization of bilateral internal iliac arteries;
  7. Severe stenosis, calcification, or mural thrombus in the anchoring area of the stent tend to have difficulty in attachment of the stent-graft or affect the patency of the stent;
  8. A history of acute coronary syndrome within 6 months; Acute coronary syndrome is defined as an acute ischemic syndrome of the heart resulting from the rupture or erosion of unstable intracoronary atherosclerotic plaques followed by fresh thrombosis, including ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction, and unstable angina pectoris.
  9. Transient ischemic attack (TIA) or ischemic/haemorrhagic stroke within 3 months;
  10. Preoperative liver renal function abnormalities (ALT or AST ≥ 5 times the upper limit of normal value), or serum creatinine ≥ 150 μmol/L;
  11. Severe pulmonary insufficiency who cannot tolerate general anaesthesia;
  12. Severe coagulation dysfunction;
  13. Undergone major surgical or interventionic surgery within 30 days before surgery;
  14. A history of allergy to contrast agents, anticoagulants, antiplatelet drugs, stents, and conveyor materials (nitinol, polyester, PTFE, nylon);
  15. Connective tissue diseases such as systemic lupus erythematosus, Marfan's syndrome, Adam's syndrome, or Behcet's disease;
  16. takayasu arteritis;
  17. Serious vital organ dysfunction or other serious disease;
  18. Planning pregnancy, pregnancy, or breastfeeding;
  19. Patients who participated in other clinical trials and was not discontinued or withdrawn within the first 3 months of the screening period of this trial.
  20. Life expectancy less than 1 year;
  21. Patients who, in the judgment of the investigator, are not eligible for endotherapy.

Sites / Locations

  • Chinese PLA General HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Intervention arm

Arm Description

Patients with thoracoabdominal aortic aneurysms, and passed the screening and signed the informed consent form.

Outcomes

Primary Outcome Measures

Primary safety endpoint: The incidence of Major Adverse events (MAE) within 30 days after procedure.
Major Adverse Event (MAE) was defined as all-cause death, liver failure, intestinal necrosis, kidney failure, stroke, permanent paraplegia, myocardial infarction, and respiratory failure.
Primary efficacy endpoint: Success rate of thoracoabdominal aortic aneurysm treatment 12 months after procedure.
Successful treatment of thoracoabdominal aortic aneurysm is a composite index that needs to meet the following indicators at the same time: Immediate technical success (immediate technical success refers to the successful delivery system to a predetermined location, the successful deployment of the system and the safe withdrawal of the delivery system from the body and no type I/III endoleak), no secondary surgical intervention related to thoracoabdominal aortic aneurysms 12 months after procedure (due to aneurysm rupture, continuous enlargement, stent displacement, type I/III endoleak, branch stenosis/ Second surgery caused by occlusion) .

Secondary Outcome Measures

aneurysmal enlargement at 6 and 12 months postoperatively
aneurysmal enlargement defined as a maximum aortic diameter increase of > 5 mm relative to preoperative computed tomography angiography (CTA)
type I/III endoleak at 6 and 12 months postoperatively
stent graft migration at 6 and 12 months postoperatively
renovisceral artery patency rate at 6 and 12 months postoperatively
reintervention secondary to TAAA progression at 6 months, 12 months, and 2-5 years postoperatively.
delivery system-related complications during the procedure and within 30 days postoperatively, including conversion to open surgery, and any hemorrhage, hematoma, or pseudoaneurysm of the arterial access
all-cause mortality at 6 months, 12 months, and 2-5 years postoperatively
TAAA-related mortality at 6 months, 12 months, and 2-5 years postoperatively
device-related adverse events at 6 months, 12 months, and 2-5 years postoperatively
severe adverse events resulting in death or serious deterioration of health at 6 months, 12 months, and 2-5 years postoperatively

Full Information

First Posted
September 7, 2021
Last Updated
February 14, 2022
Sponsor
Lifetech Scientific (Shenzhen) Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05054985
Brief Title
Safety and Efficacy of a Multi-branched Thoracoabdominal Stent Graft System for Thoracoabdominal Aortic Aneurysm.
Official Title
Guo's Renovisceral Artery Reconstruction-1: a Prospective, Multicenter, Single-arm Clinical Trial to Evaluate the Safety and Efficacy of a Multi-branched Stent Graft System for Thoracoabdominal Aortic Aneurysm (GUARANTEE Study)
Study Type
Interventional

2. Study Status

Record Verification Date
February 2022
Overall Recruitment Status
Recruiting
Study Start Date
November 12, 2021 (Actual)
Primary Completion Date
December 31, 2024 (Anticipated)
Study Completion Date
December 31, 2028 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Lifetech Scientific (Shenzhen) Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Evaluation of the safety and efficacy of a multi-branched thoracoabdominal stent graft system for thoracoabdominal aortic aneurysm.
Detailed Description
The study is mainly for patients with thoracoabdominal aortic aneurysms, and all subjects who signed the informed consent and passed the screening will be enrolled. Patients who meet all the inclusion criteria and don't meet the exclusion criteria will be implanted with multi-branched thoracoabdominal stent graft system. Patients will be followed up at discharge, 1 month, 6 months, 12 months after the implantation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Thoracoabdominal Aortic Aneurysms
Keywords
Guo's Visceral Arteries Reconstruction, Multi-branched Thoracoabdominal Stent Graft System, Thoracoabdominal Aortic Aneurysm

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Intervention arm
Arm Type
Experimental
Arm Description
Patients with thoracoabdominal aortic aneurysms, and passed the screening and signed the informed consent form.
Intervention Type
Device
Intervention Name(s)
Multi-Branched Thoracoabdominal Stent Graft System
Intervention Description
Patients who meet all the inclusion criteria and don't meet the exclusion criteria will be implanted with multi-branched thoracoabdominal stent graft system .
Primary Outcome Measure Information:
Title
Primary safety endpoint: The incidence of Major Adverse events (MAE) within 30 days after procedure.
Description
Major Adverse Event (MAE) was defined as all-cause death, liver failure, intestinal necrosis, kidney failure, stroke, permanent paraplegia, myocardial infarction, and respiratory failure.
Time Frame
Within 30 days after procedure
Title
Primary efficacy endpoint: Success rate of thoracoabdominal aortic aneurysm treatment 12 months after procedure.
Description
Successful treatment of thoracoabdominal aortic aneurysm is a composite index that needs to meet the following indicators at the same time: Immediate technical success (immediate technical success refers to the successful delivery system to a predetermined location, the successful deployment of the system and the safe withdrawal of the delivery system from the body and no type I/III endoleak), no secondary surgical intervention related to thoracoabdominal aortic aneurysms 12 months after procedure (due to aneurysm rupture, continuous enlargement, stent displacement, type I/III endoleak, branch stenosis/ Second surgery caused by occlusion) .
Time Frame
12 months after procedure.
Secondary Outcome Measure Information:
Title
aneurysmal enlargement at 6 and 12 months postoperatively
Description
aneurysmal enlargement defined as a maximum aortic diameter increase of > 5 mm relative to preoperative computed tomography angiography (CTA)
Time Frame
6 and 12 months postoperatively
Title
type I/III endoleak at 6 and 12 months postoperatively
Time Frame
6 and 12 months postoperatively
Title
stent graft migration at 6 and 12 months postoperatively
Time Frame
6 and 12 months postoperatively
Title
renovisceral artery patency rate at 6 and 12 months postoperatively
Time Frame
6 and 12 months postoperatively
Title
reintervention secondary to TAAA progression at 6 months, 12 months, and 2-5 years postoperatively.
Time Frame
6 months, 12 months, and 2-5 years postoperatively.
Title
delivery system-related complications during the procedure and within 30 days postoperatively, including conversion to open surgery, and any hemorrhage, hematoma, or pseudoaneurysm of the arterial access
Time Frame
during the procedure and within 30 days postoperatively
Title
all-cause mortality at 6 months, 12 months, and 2-5 years postoperatively
Time Frame
6 months, 12 months, and 2-5 years postoperatively
Title
TAAA-related mortality at 6 months, 12 months, and 2-5 years postoperatively
Time Frame
6 months, 12 months, and 2-5 years postoperatively
Title
device-related adverse events at 6 months, 12 months, and 2-5 years postoperatively
Time Frame
6 months, 12 months, and 2-5 years postoperatively
Title
severe adverse events resulting in death or serious deterioration of health at 6 months, 12 months, and 2-5 years postoperatively
Time Frame
6 months, 12 months, and 2-5 years postoperatively

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 18 years old ≤ age ≤ 80 years old; Diagnosed as thoracoabdominal aortic aneurysm (based on modified Crawford classification and 2019 European Guidelines for the Treatment of Aortic aneurysm) and should meet at least one of the following conditions; Maximum diameter of thoracoabdominal aortic aneurysm>50mm; The diameter has increased by more than 5mm in recent 6 months or the by more than 10mm in recent 1 year; anatomical criteria The proximal anchoring region (aorta or implanted graft) was 17~36 mm in diameter and ≥25 mm in length; Distal anchoring region (aorta or implanted graft): If the distal anchoring region is in the iliac artery, the anchoring region has a diameter range of 7~25 mm and a length of ≥15 mm; If the distal anchoring area is in the abdominal aorta, the diameter of the anchoring area ranges from 12~36mm and the length≥ 20mm; The diameter of the vessel anchoring area of the visceral branch ranges from 6~13 mm and the length ≥15 mm; The diameter of renal artery anchoring area ranges from 4.5~9mm, and the length ≥15 mm; Appropriate iliac, femoral and upper limb artery access; Patients who can understand the purpose of the trial, voluntarily participate and sign the informed consent, and are willing to complete the follow-up according to the requirements of the protocol; Exclusion Criteria: Hemodynamically unstable patients with ruptured thoracoabdominal aortic aneurysms; Thoracoabdominal aortic dissection; Mycotic or infectious thoracoabdominal aortic aneurysm; Patients whose systemic or local infection may increase the risk of intravascular graft infection; Superior mesenteric, celiac, or renal artery occlusion; Requiring simultaneous coverage and embolization of bilateral internal iliac arteries; Severe stenosis, calcification, or mural thrombus in the anchoring area of the stent tend to have difficulty in attachment of the stent-graft or affect the patency of the stent; A history of acute coronary syndrome within 6 months; Acute coronary syndrome is defined as an acute ischemic syndrome of the heart resulting from the rupture or erosion of unstable intracoronary atherosclerotic plaques followed by fresh thrombosis, including ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction, and unstable angina pectoris. Transient ischemic attack (TIA) or ischemic/haemorrhagic stroke within 3 months; Preoperative liver renal function abnormalities (ALT or AST ≥ 5 times the upper limit of normal value), or serum creatinine ≥ 150 μmol/L; Severe pulmonary insufficiency who cannot tolerate general anaesthesia; Severe coagulation dysfunction; Undergone major surgical or interventionic surgery within 30 days before surgery; A history of allergy to contrast agents, anticoagulants, antiplatelet drugs, stents, and conveyor materials (nitinol, polyester, PTFE, nylon); Connective tissue diseases such as systemic lupus erythematosus, Marfan's syndrome, Adam's syndrome, or Behcet's disease; takayasu arteritis; Serious vital organ dysfunction or other serious disease; Planning pregnancy, pregnancy, or breastfeeding; Patients who participated in other clinical trials and was not discontinued or withdrawn within the first 3 months of the screening period of this trial. Life expectancy less than 1 year; Patients who, in the judgment of the investigator, are not eligible for endotherapy.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Wei Guo, Professor
Phone
13910758706
Ext
86
Email
pla301dml@vip.sina.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Wei Guo, Professor
Organizational Affiliation
Chinese PLA General Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Chinese PLA General Hospital
City
Beijing
State/Province
Beijing
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Wei Guo
First Name & Middle Initial & Last Name & Degree
Wei Guo

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
The data will be shared for scientific purposes after the completion of the clinical trial. However, patients' electronic records and any CTA files are outside the scope of our data sharing policy. Researchers wanting to request data can submit a detailed application to the investigators. Data will be released depending on the scientific quality of the submitted request.
Citations:
PubMed Identifier
35321900
Citation
Ge Y, Zhang H, Rong D, Liu F, Jia X, Xiong J, Ma X, Wang L, Fan T, Guo W. Protocol for GUo's renovisceral Artery reconstruction-1: a prospective, multicentre, single-arm clinical trial to evaluate the safety and efficacy of a multibRANched sTEnt graft systEm for thoracoabdominal aortic aneurysm (GUARANTEE study). BMJ Open. 2022 Mar 23;12(3):e059401. doi: 10.1136/bmjopen-2021-059401.
Results Reference
derived

Learn more about this trial

Safety and Efficacy of a Multi-branched Thoracoabdominal Stent Graft System for Thoracoabdominal Aortic Aneurysm.

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