HORIZON CE Pivotal Study to Treat Abdominal Aortic Aneurysm

This is an interventional treatment trial for Infrarenal Abdominal Aortic Aneurysms focused on measuring Abdominal Aortic Aneurysm, AAA, Abdominal Aortoiliac Aneurysm, Endovascular Aortic Repair, EVAR Read More

Inclusion Criteria:

1. Male and female age ≥ 18.

2. Presence of at least one of the following:

   i. Abdominal aortic aneurysm ≥ 5.0cm in diameter (perpendicular to the line of flow).

   ii. Abdominal aortic aneurysm 4.5-5.5cm in diameter which increased in size - ≥ 0.5cm over 6 months or 1.0cm over one year.

   iii. Abdominal aortic aneurysm >50% larger than the normal aortic diameter.

3. Patient is considered an appropriate candidate for an elective surgery, as evaluated by Physical Status Classification System I, II or III (American Society of Anesthesiologists).
4. Femoral artery diameter of ≥6mm, documented by CTA or MRA that allows endovascular access to the aneurismal site with a 14 Fr delivery catheter.
5. Access vessels morphology suitable for endovascular repair in terms of tortuosity, calcification and angulation, documented by CTA or MRA.
6. To be eligible to receive the Horizon having the following characteristics, as demonstrated on CTA or MRA imaging:

I. Infrarenal aortic diameter of 18-28 mm II. Aortic length (lower renal artery to lowest point of aortic bifurcation) of 115-150 mm III. Iliac artery diameter of 10-19 mm IV. Proximal aortic neck length ≥ 15 mm V. Proximal aortic neck angulation ≤ 60° VI. Diameter measured 20mm above aortic bifurcation floor should be ≥ 20mm VII. Aortic bifurcation angulation of ≥ 70°. 7. Patient understands and is voluntarily willing to participate as evidenced by personally signing the Informed Consent document.

Exclusion Criteria:

1. If female and of childbearing potential , patients who are:

   1. pregnant (as determined by a positive pregnancy test performed between 10 to 5 days before implantation date), or
   2. intend to become pregnant during the study period, or
   3. do not accept to use adequate double barrier contraception methods for the entire study duration to avoid pregnancy
2. Life expectancy of less than 1 year.
3. Any medical condition that, according to the investigator's decision, might expose the patient to increased risk by the investigational device or procedure.
4. Patient is in need for an emergent surgery for a ruptured aneurysm.
5. Patient with an increased risk for aneurysm rupture, such as, saccular aneurysm, aneurysm with isolated wall protrusion and penetrating ulcers of the aorta.
6. A dissecting, acutely ruptured, or leaking aneurysm, or an acute vascular injury due to trauma.
7. Presence of thrombus or atheroma in proximal aortic neck covering >50% of the endoluminal surface.
8. Presence of diffuse atherosclerotic disease in either common iliac artery that reduces the iliac artery diameter to <6mm.
9. Congenital vascular disease in which the placement of the stent graft will cause occlusion of major arterial flow.
10. Aneurysm with any of the following characteristics: suprarenal, isolated ilio-femoral, mycotic, inflammatory or para-anastomotic pseudoaneurysm.
11. Patient has an untreated thoracic aneurysm > 5.5 cm in diameter.
12. Patient has an aneurysm that involves the part of the aorta at the ostia of the renal arteries.
13. Patient has a reversed conical neck defined as a > 4mm distal increase over a 10 mm length.
14. Patient has ectatic iliac arteries requiring bilateral exclusion of hypogastric blood flow.
15. Patient whose arterial access site is not anticipated to accommodate the 14 Fr diameter of the Horizon™ Delivery System, due to size, tortuosity or hostile groins (scarring, obesity, or previous failed puncture).
16. Patient underwent major surgery or interventional procedure in the last three months.
17. Patient is suffering from unstable angina.
18. Patient has had a myocardial infarction (MI) or cerebral vascular accident (CVA) within 3 months prior to the planned implantation.
19. Patient has a known hypersensitivity or contraindication to anticoagulants, antiplatelets, or contrast media, which is not amenable to pre-treatment.
20. Contraindication to undergoing angiography.
21. Patients with known hypersensitivity or allergy to device materials - Nitinol and Polyester.
22. Morbid obesity or other clinical conditions that severely inhibit x-ray visualization of the aorta.
23. Connective tissue disease (e.g., Marfan's or Ehler's-Danlos syndromes).
24. Patient has a history of bleeding diathesis or coagulopathy.
25. Active systemic infection at the time of the index procedure documented by either one of the following: pain, fever, drainage, positive culture and/or leukocytosis (WBC > 11,000 mm3).
26. Acute renal failure documented by either one of the following: Creatinine > 2.00 mg/dl or > 182 pmol/L; patient on dialysis.
27. Any other medical, social, or psychological issues that in the opinion of the investigator preclude them from receiving this treatment, or the procedures and evaluations pre- and post- treatment.

28. Active participation in another research study involving an investigational device or new drug.

    -