A Prospective, Multi-Center Study of the Bard® Denali™ Retrievable Inferior Vena Cava Filter System
Primary Purpose
Pulmonary Embolism
Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Denali inferior vena cava filter
Sponsored by
About this trial
This is an interventional treatment trial for Pulmonary Embolism focused on measuring Pulmonary embolism (PE), Deep vein thrombosis (DVT), Vena cava, Vena cava filter, Inferior vena cava, Venous thromboembolic disease (VTED)
Eligibility Criteria
Inclusion Criteria:
- The subject or their legally authorized representative demonstrates understanding of the nature of the study and voluntarily provides written informed consent prior to any data collection or study procedures.
- The subject is ≥ 21 years old, must be either a male or non-pregnant female with an expected lifespan sufficient to allow for completion of all study procedures. A negative pregnancy test result (urine or blood) is required prior to implant. If an enrolled female becomes pregnant prior to study completion, participation in the study will be terminated.
- Based on Investigator judgment, the subject is at increased risk of PE requiring vena caval interruption. Note: Subjects diagnosed with acute DVT and/or PE must have objective confirmation based on imaging evidence of at least one of those diagnoses.
- Patients without PE or venous thromboembolic disease (VTED) who are at risk of PE may be enrolled in this trial. However, enrollment of these patients will be limited to a maximum of 40% of the total sample size.
- Based on Investigator's judgment, the subject has patent venous anatomy suitable for femoral or jugular/subclavian access for filter placement (e.g. no excessive tortuosity).
- The IVC is ≤ 28 mm in diameter at the intended implantation site based on radiographic imaging evidence.
- Based on Investigator's judgment, the filter can be safely placed such that the position of the filter tip is 1 cm below the lowest renal vein.
- Retrieval of the filter is expected within 180 days post placement. At the six month follow up, if the Investigator determines that the filter continues to be clinically indicated, the filter may be left in place until the risk of PE has passed or left in permanently. All patients not having their filter retrieved at six months will continue be followed to 24 months or one month post filter retrieval, whichever comes first.
- The subject has patent venous anatomy suitable for jugular access for retrieval of the filter based on imaging evidence within 48 hours prior to the filter placement procedure. Imaging mode will be at physician's discretion.
- The subject is willing to comply with the protocol requirements and specified follow-up evaluations.
Exclusion Criteria:
- The subject has a previously implanted filter in the IVC or superior vena cava (SVC).
- The subject has a duplicated or left-sided IVC.
- The subject has a severe spinal deformity that would impede access to the IVC for the filter placement or filter retrieval procedures.
- The subject has a serum creatinine ≥ 2 mg/dl (and not on dialysis) within seven days of study enrollment. Patients on dialysis are allowed to participate in this trial.
- The subject has a known uncorrectable bleeding diathesis or active coagulopathy.
- The subject has a life expectancy of < 25 months.
- The subject has a known allergy or sensitivity to nickel or titanium.
- The subject has a known allergy or sensitivity to iodinated contrast media, which cannot be adequately pre-medicated. NOTE: Alternative contrast agents are not permitted for the purposes of this study.
- The subject is currently participating in an investigational drug or another device study.
Sites / Locations
- University of Alabama Birmingham Medical Center
- St. Joseph's Hospital and Medical Center
- Hartford Hospital
- Yale University School of Medicine
- Lakeland Regional Medical Center
- Baptist Hospital of Miami
- Florida Hospital
- Tampa General Hospital
- Doctor's Hospital
- Northwestern Memorial Hospital
- University of Chicago
- HeartCare Midwest
- Kansas University Medical Center
- North Memorial Hospital
- Washington University in St. Louis
- Carolinas Medical Center
- The Cleveland Clinic
- Riverside Methodist Hospital
- Toledo Hospital
- Penn State Milton S. Hershey Medical Center
- The Hospital of the University of Pennsylvania
- Virginia Commonwealth University
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Denali inferior vena cava filter
Arm Description
All subjects enrolled will receive the Denali vena cava filter.
Outcomes
Primary Outcome Measures
Technical Success of Placement
Technical success of filter placement is defined as the deployment of the filter such that the physician judges the location to be suitable to provide sufficient mechanical protection against Pulmonary Embolism.
Clinical Success of Placement
Is the one-sided lower limit of the 95% confidence interval for the observed clinical success rate at least 80%? Clinical success of filter placement is defined as freedom from subsequent Pulmonary Embolism (PE), filter embolization, caval occlusion, filter and procedure related death, insertion adverse events (AEs), and technical failure of placement.
Technical Success of Retrieval
Technical success for retrieval is defined as retrieval of the filter such that the entire filter is retrieved intact.
Clinical Success of Retrieval
Clinical success for retrieval is defined as successful technical retrieval of the filter without retrieval complications requiring intervention. Only the 121 successful retrievals are counted here.
Secondary Outcome Measures
Rate of Recurring Pulmonary Embolism
Rate of recurrent Pulmonary Embolism while the filter is indwelling or one month post-retrieval.
Rate of New or Worsening Deep Vein Thrombosis
Rate of new or worsening Deep Vein Thrombosis (DVT) from placement to the six month follow-up. Worsening DVT is defined as an extension of existing DVT to a new venous segment on ultrasound in patients that had DVT at the baseline visit.
Filter Fracture
Rate of filter fracture
Filter Migration
Rate of filter indwell complications of: migration >2cm.
Filter Tilt at Placement
Rate of filter indwell complications of: tilt >15°
Filter Tilt at Retrieval
Rate of filter indwell complications of: tilt >15°
Filter Penetration >3mm at Placement
Filter Penetration >3mm at Retrieval
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01305564
Brief Title
A Prospective, Multi-Center Study of the Bard® Denali™ Retrievable Inferior Vena Cava Filter System
Official Title
A Prospective, Multi-Center Study of the Bard® Denali™ Retrievable Inferior Vena Cava Filter
Study Type
Interventional
2. Study Status
Record Verification Date
February 2016
Overall Recruitment Status
Completed
Study Start Date
June 2011 (undefined)
Primary Completion Date
June 2015 (Actual)
Study Completion Date
July 2015 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
C. R. Bard
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The Bard® Denali™ Retrievable Inferior Vena Cava (IVC) study is a prospective, multi-center study which is intended to provide evidence of safety of the placement and retrieval of the Bard® Denali™ Retrievable Inferior Vena Cava Filter in subjects requiring IVC interruption to protect against pulmonary embolism (PE).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pulmonary Embolism
Keywords
Pulmonary embolism (PE), Deep vein thrombosis (DVT), Vena cava, Vena cava filter, Inferior vena cava, Venous thromboembolic disease (VTED)
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
200 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Denali inferior vena cava filter
Arm Type
Experimental
Arm Description
All subjects enrolled will receive the Denali vena cava filter.
Intervention Type
Device
Intervention Name(s)
Denali inferior vena cava filter
Other Intervention Name(s)
DL900J, DL900F
Intervention Description
The Denali inferior vena cava filter is a mechanical filtration device consisting of two levels of filtration (upper arms, lower legs), a retrieval hook to allow for retrieval using a standard snare, cranial and caudal anchors, and penetration limiters. The Denali filter is made from a laser cut nitinol tube.
Primary Outcome Measure Information:
Title
Technical Success of Placement
Description
Technical success of filter placement is defined as the deployment of the filter such that the physician judges the location to be suitable to provide sufficient mechanical protection against Pulmonary Embolism.
Time Frame
6 months
Title
Clinical Success of Placement
Description
Is the one-sided lower limit of the 95% confidence interval for the observed clinical success rate at least 80%? Clinical success of filter placement is defined as freedom from subsequent Pulmonary Embolism (PE), filter embolization, caval occlusion, filter and procedure related death, insertion adverse events (AEs), and technical failure of placement.
Time Frame
6 months
Title
Technical Success of Retrieval
Description
Technical success for retrieval is defined as retrieval of the filter such that the entire filter is retrieved intact.
Time Frame
24 months
Title
Clinical Success of Retrieval
Description
Clinical success for retrieval is defined as successful technical retrieval of the filter without retrieval complications requiring intervention. Only the 121 successful retrievals are counted here.
Time Frame
24 months
Secondary Outcome Measure Information:
Title
Rate of Recurring Pulmonary Embolism
Description
Rate of recurrent Pulmonary Embolism while the filter is indwelling or one month post-retrieval.
Time Frame
24 months
Title
Rate of New or Worsening Deep Vein Thrombosis
Description
Rate of new or worsening Deep Vein Thrombosis (DVT) from placement to the six month follow-up. Worsening DVT is defined as an extension of existing DVT to a new venous segment on ultrasound in patients that had DVT at the baseline visit.
Time Frame
6 months
Title
Filter Fracture
Description
Rate of filter fracture
Time Frame
6 months
Title
Filter Migration
Description
Rate of filter indwell complications of: migration >2cm.
Time Frame
6 months
Title
Filter Tilt at Placement
Description
Rate of filter indwell complications of: tilt >15°
Time Frame
Post-placement imaging
Title
Filter Tilt at Retrieval
Description
Rate of filter indwell complications of: tilt >15°
Time Frame
Pre-retrieval imaging
Title
Filter Penetration >3mm at Placement
Time Frame
Post-placement
Title
Filter Penetration >3mm at Retrieval
Time Frame
Pre-retrieval
10. Eligibility
Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
The subject or their legally authorized representative demonstrates understanding of the nature of the study and voluntarily provides written informed consent prior to any data collection or study procedures.
The subject is ≥ 21 years old, must be either a male or non-pregnant female with an expected lifespan sufficient to allow for completion of all study procedures. A negative pregnancy test result (urine or blood) is required prior to implant. If an enrolled female becomes pregnant prior to study completion, participation in the study will be terminated.
Based on Investigator judgment, the subject is at increased risk of PE requiring vena caval interruption. Note: Subjects diagnosed with acute DVT and/or PE must have objective confirmation based on imaging evidence of at least one of those diagnoses.
Patients without PE or venous thromboembolic disease (VTED) who are at risk of PE may be enrolled in this trial. However, enrollment of these patients will be limited to a maximum of 40% of the total sample size.
Based on Investigator's judgment, the subject has patent venous anatomy suitable for femoral or jugular/subclavian access for filter placement (e.g. no excessive tortuosity).
The IVC is ≤ 28 mm in diameter at the intended implantation site based on radiographic imaging evidence.
Based on Investigator's judgment, the filter can be safely placed such that the position of the filter tip is 1 cm below the lowest renal vein.
Retrieval of the filter is expected within 180 days post placement. At the six month follow up, if the Investigator determines that the filter continues to be clinically indicated, the filter may be left in place until the risk of PE has passed or left in permanently. All patients not having their filter retrieved at six months will continue be followed to 24 months or one month post filter retrieval, whichever comes first.
The subject has patent venous anatomy suitable for jugular access for retrieval of the filter based on imaging evidence within 48 hours prior to the filter placement procedure. Imaging mode will be at physician's discretion.
The subject is willing to comply with the protocol requirements and specified follow-up evaluations.
Exclusion Criteria:
The subject has a previously implanted filter in the IVC or superior vena cava (SVC).
The subject has a duplicated or left-sided IVC.
The subject has a severe spinal deformity that would impede access to the IVC for the filter placement or filter retrieval procedures.
The subject has a serum creatinine ≥ 2 mg/dl (and not on dialysis) within seven days of study enrollment. Patients on dialysis are allowed to participate in this trial.
The subject has a known uncorrectable bleeding diathesis or active coagulopathy.
The subject has a life expectancy of < 25 months.
The subject has a known allergy or sensitivity to nickel or titanium.
The subject has a known allergy or sensitivity to iodinated contrast media, which cannot be adequately pre-medicated. NOTE: Alternative contrast agents are not permitted for the purposes of this study.
The subject is currently participating in an investigational drug or another device study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
William Stavropoulos, MD
Organizational Affiliation
The Hospital of the University of Pennsylvania
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Alabama Birmingham Medical Center
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35249
Country
United States
Facility Name
St. Joseph's Hospital and Medical Center
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85013
Country
United States
Facility Name
Hartford Hospital
City
Hartford
State/Province
Connecticut
ZIP/Postal Code
06102
Country
United States
Facility Name
Yale University School of Medicine
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06510
Country
United States
Facility Name
Lakeland Regional Medical Center
City
Lakeland
State/Province
Florida
ZIP/Postal Code
33805
Country
United States
Facility Name
Baptist Hospital of Miami
City
Miami
State/Province
Florida
ZIP/Postal Code
33176
Country
United States
Facility Name
Florida Hospital
City
Orlando
State/Province
Florida
ZIP/Postal Code
32803
Country
United States
Facility Name
Tampa General Hospital
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States
Facility Name
Doctor's Hospital
City
Augusta
State/Province
Georgia
ZIP/Postal Code
30909
Country
United States
Facility Name
Northwestern Memorial Hospital
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
University of Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
HeartCare Midwest
City
Peoria
State/Province
Illinois
ZIP/Postal Code
61637
Country
United States
Facility Name
Kansas University Medical Center
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Facility Name
North Memorial Hospital
City
Robbinsdale
State/Province
Minnesota
ZIP/Postal Code
55422
Country
United States
Facility Name
Washington University in St. Louis
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Carolinas Medical Center
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28203
Country
United States
Facility Name
The Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Riverside Methodist Hospital
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43214
Country
United States
Facility Name
Toledo Hospital
City
Toledo
State/Province
Ohio
ZIP/Postal Code
43614
Country
United States
Facility Name
Penn State Milton S. Hershey Medical Center
City
Hershey
State/Province
Pennsylvania
ZIP/Postal Code
17033
Country
United States
Facility Name
The Hospital of the University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Virginia Commonwealth University
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23219
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Learn more about this trial
A Prospective, Multi-Center Study of the Bard® Denali™ Retrievable Inferior Vena Cava Filter System
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