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NEXUS™ Aortic Arch Stent Graft System First In Man Study

Primary Purpose

Thoracic Aortic Arch Disease, Thoracic Aortic Aneurysm

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Stent Graft Placement (Nexus)
Sponsored by
Endospan Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Thoracic Aortic Arch Disease focused on measuring TAA

Eligibility Criteria

18 Years - 95 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Male and female age ≥ 18.
  • Any Thoracic Aorta pathology requiring landing in the Aortic Arch (zone 0, zone 1, zone2), e.g. aneurysm, dissection, false/Pseudo aneurysm.
  • In patient with a thoracic aneurysm: dilatation of the aortic arch larger than 5.5cm in diameter, or symptomatic aneurysm of the aortic arch, or aortic diameter growth rate > 5mm per 6 months
  • 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).
  • Femoral artery diameter as documented by CTA or MRA that allows endovascular access to the diseased site with a 20-22Fr delivery catheter.
  • Access vessels morphology suitable for endovascular repair in terms of tortuosity, calcification and angulation, documented by CTA, MRA.
  • Access vessel (femoral/iliac) diameter > 7 mm
  • Ascending Aorta landing zone length > 30 mm
  • Brachial/Axial Artery diameter > 3 mm
  • Patient understands and is voluntarily willing to participate as evidenced by personally signing the Informed Consent document, and willingness to comply with follow-up schedule

Exclusion Criteria:

  • Female is of childbearing potential
  • Life expectancy of less than 1 year
  • Any medical condition that, according to the investigator's decision, might expose the patient to increased risk by the investigational device or procedure.
  • Acutely ruptured or instable aneurysm or an acute vascular injury due to trauma or infected penetrating ulcers of the aorta.
  • Patient with an increased risk for aneurysm rupture during the procedure.
  • Patient whose arterial access site is not anticipated to accommodate the access of the Nexus™ Delivery System, due to size, tortuosity or hostile groins (scarring, obesity, or previous failed puncture)
  • Patients with severe atherosclerosis or intraluminal thrombus of the aorta or in the BCT
  • Patient is suffering from unstable angina or NYHA classification III and IV and/or ASA classification IV and above.
  • Patient has had a myocardial infarction (MI) or cerebral vascular accident (CVA) within 3 months prior to the planned implantation
  • Patient has a known hypersensitivity or contraindication to anticoagulants, antiplatelets, or contrast media, which is not amenable to pre-treatment.
  • Patient with a contraindication to undergo angiography
  • Patient with known sensitivities or allergies to the device materials- Nitinol and polyester
  • Clinical conditions that severely inhibit x-ray visualization of the Aorta.
  • Connective tissue disease (e.g., Marfan's or Ehler's-Danlos syndromes)
  • Patient has history of bleeding diathesis or coagulopathy that may limit the use of dual antiplatelet or anticoagulant therapy by the decision of the investigator
  • Patient has an active systemic infection at the time of the procedure documented by pain, fever, drainage, positive culture and/or leukocytosis (WBC > 11,000 mm3).
  • Patients who have the condition that threatens to infect the stent graft.
  • Acute renal failure; chronic renal failure (excluding dialysis); Creatinine > 2.00 mg/dl or > 182 umol/L
  • Patient underwent major surgery or interventional procedure in the last three months.
  • 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.
  • Active participation in another clinical trial that is reasonable to conflict with the NexusTM study.

Sites / Locations

  • Faculty Hospital Hradec Kralove
  • San Filippo Neri Hospital
  • Klinic Hirslanden
  • Zurich University Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Thoracic Aortic Disease Single Arm Study

Arm Description

Thoracic Aortic Disease treated by Stent Graft Placement

Outcomes

Primary Outcome Measures

Safety: Device related mortality at 30 days post implantation

Secondary Outcome Measures

Safety: Device related re-intervention within 1 year from implantation

Full Information

First Posted
February 11, 2015
Last Updated
September 20, 2023
Sponsor
Endospan Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT02365454
Brief Title
NEXUS™ Aortic Arch Stent Graft System First In Man Study
Official Title
Feasibility Clinical Study to Evaluate the Safety and Performance of the NEXUS™ Aortic Arch Stent Graft System
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Completed
Study Start Date
August 2014 (Actual)
Primary Completion Date
November 2018 (Actual)
Study Completion Date
June 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Endospan Ltd.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
A multicenter, prospective, open-label, non-randomized, interventional clinical study, sponsored by Endospan Ltd. Patients will be followed-up for five years.
Detailed Description
The purpose of the study is to evaluate the safety and performance of the Nexus™ Aortic Arch Stent Graft System for the endovascular treatment of thoracic aortic pathologies requiring landing in the Aortic Arch (zone 0, zone 1, zone 2). The Nexus™ Aortic Arch Stent Graft System is indicated for the endovascular treatment of thoracic aortic pathologies involving the aortic arch (such as aneurisms and dissections). The Nexus™ is intended to exclude the lesion from the blood circulation in patients diagnosed with thoracic aortic pathology and who have appropriate anatomy to accommodate the Nexus™ system in an endovascular procedure. The primary objectives of the study are to evaluate the safety and performance of the Nexus™ Aortic Arch Aneurysm Stent Graft System.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Thoracic Aortic Arch Disease, Thoracic Aortic Aneurysm
Keywords
TAA

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Thoracic Aortic Disease Single Arm Study
Arm Type
Experimental
Arm Description
Thoracic Aortic Disease treated by Stent Graft Placement
Intervention Type
Device
Intervention Name(s)
Stent Graft Placement (Nexus)
Intervention Description
The Nexus stent graft is introduced through a groin to the diseased location at the Aortic Arch. Depending on the patients anatomy and other medical considerations the physician may decide that blood flow to the sub-clavian artery and possibly also to the left carotid artery is required to be maintained via "surgical bypass grafting", either immediately, or a few days, before the implantation. In addition to the incision for introducing the investigational stent graft, two smaller access sites are required, one at the groin on the opposite side and on into the Right Arm to the Brachial Artery. This endovascular procedure will likely require full anesthesia. The entire procedure is assisted by an angiography imaging system.
Primary Outcome Measure Information:
Title
Safety: Device related mortality at 30 days post implantation
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Safety: Device related re-intervention within 1 year from implantation
Time Frame
1 year
Other Pre-specified Outcome Measures:
Title
Performance: Assess the rate of successful disease treatment at 30 days post implantation
Time Frame
30 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
95 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female age ≥ 18. Any Thoracic Aorta pathology requiring landing in the Aortic Arch (zone 0, zone 1, zone2), e.g. aneurysm, dissection, false/Pseudo aneurysm. In patient with a thoracic aneurysm: dilatation of the aortic arch larger than 5.5cm in diameter, or symptomatic aneurysm of the aortic arch, or aortic diameter growth rate > 5mm per 6 months 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). Femoral artery diameter as documented by CTA or MRA that allows endovascular access to the diseased site with a 20-22Fr delivery catheter. Access vessels morphology suitable for endovascular repair in terms of tortuosity, calcification and angulation, documented by CTA, MRA. Access vessel (femoral/iliac) diameter > 7 mm Ascending Aorta landing zone length > 30 mm Brachial/Axial Artery diameter > 3 mm Patient understands and is voluntarily willing to participate as evidenced by personally signing the Informed Consent document, and willingness to comply with follow-up schedule Exclusion Criteria: Female is of childbearing potential Life expectancy of less than 1 year Any medical condition that, according to the investigator's decision, might expose the patient to increased risk by the investigational device or procedure. Acutely ruptured or instable aneurysm or an acute vascular injury due to trauma or infected penetrating ulcers of the aorta. Patient with an increased risk for aneurysm rupture during the procedure. Patient whose arterial access site is not anticipated to accommodate the access of the Nexus™ Delivery System, due to size, tortuosity or hostile groins (scarring, obesity, or previous failed puncture) Patients with severe atherosclerosis or intraluminal thrombus of the aorta or in the BCT Patient is suffering from unstable angina or NYHA classification III and IV and/or ASA classification IV and above. Patient has had a myocardial infarction (MI) or cerebral vascular accident (CVA) within 3 months prior to the planned implantation Patient has a known hypersensitivity or contraindication to anticoagulants, antiplatelets, or contrast media, which is not amenable to pre-treatment. Patient with a contraindication to undergo angiography Patient with known sensitivities or allergies to the device materials- Nitinol and polyester Clinical conditions that severely inhibit x-ray visualization of the Aorta. Connective tissue disease (e.g., Marfan's or Ehler's-Danlos syndromes) Patient has history of bleeding diathesis or coagulopathy that may limit the use of dual antiplatelet or anticoagulant therapy by the decision of the investigator Patient has an active systemic infection at the time of the procedure documented by pain, fever, drainage, positive culture and/or leukocytosis (WBC > 11,000 mm3). Patients who have the condition that threatens to infect the stent graft. Acute renal failure; chronic renal failure (excluding dialysis); Creatinine > 2.00 mg/dl or > 182 umol/L Patient underwent major surgery or interventional procedure in the last three months. 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. Active participation in another clinical trial that is reasonable to conflict with the NexusTM study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mario Lachat, Prof. MD
Organizational Affiliation
Klinic Hirslanden, Switzerland
Official's Role
Principal Investigator
Facility Information:
Facility Name
Faculty Hospital Hradec Kralove
City
Hradec Králové
ZIP/Postal Code
500 05
Country
Czechia
Facility Name
San Filippo Neri Hospital
City
Rome
ZIP/Postal Code
00135
Country
Italy
Facility Name
Klinic Hirslanden
City
Zürich
State/Province
Witellikerstrasse 40
ZIP/Postal Code
CH-8032
Country
Switzerland
Facility Name
Zurich University Hospital
City
Zurich
ZIP/Postal Code
8091
Country
Switzerland

12. IPD Sharing Statement

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