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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04471909
Other study ID # CIP-009
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date October 20, 2020
Est. completion date October 2029

Study information

Verified date March 2024
Source Endospan Ltd.
Contact Jessica Kleine
Phone +1 (612) 280-0208
Email j.kleine@endospan.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Prospective, non-randomized, multi-center clinical investigation of the NEXUS™ Aortic Arch Stent Graft System (NEXUSTM) for the treatment of thoracic aortic lesions involving the aortic arch with a proximal landing zone, native or previously implanted surgical graft, in the ascending aorta and with a brachiocephalic trunk native landing zone.


Recruitment information / eligibility

Status Recruiting
Enrollment 110
Est. completion date October 2029
Est. primary completion date August 2024
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: 1. Male and female age = 18. 2. Proximal/ascending native or previously implanted surgical graft landing zone of appropriate length 3. Proximal/ascending native or previously implanted surgical graft landing zone of appropriate diameter 4. Distal/descending native landing zone of appropriate length 5. Distal/descending native landing zone of appropriate diameter 6. Brachiocephalic trunk native landing zone of appropriate length 7. Brachiocephalic trunk native landing zone of appropriate diameter 8. Appropriate take off angle between the Brachiocephalic Artery and the Aortic Arch perpendicular 9. Appropriate aortic arch perpendicular diameter 10. Chronic dissection with at least one of the following conditions: 1. An aortic aneurysm with a maximum diameter = 55 mm 2. Rapidly expanding false lumen (growth of > 0.5 cm/6 months) 3. Compressed true lumen associated with end organ malperfusion 4. Symptomatic 11. Aneurysm with at least one of the following conditions: 1. Dilatation of the aortic arch larger than 5 cm in diameter for subject with fusiform aneurysm 2. Dilatation of the aortic arch is 1.5 times the normal diameter for subjects ascending or descending 3. Dilation of the aortic arch larger than 2.5 cm for subject with saccular aneurysm 4. Symptomatic aneurysm of the aortic arch 5. Aortic diameter growth rate > 5mm per 6 months 6. Postoperative pseudoaneurysm expanding from anastomotic suture lines 12. Penetrating aortic ulcer with at least one of the following: 1. Symptomatic 2. Ulcer demonstrates expansion 13. Intramural hematoma with at least one of the following: 1. Symptomatic (persistent pain) 2. Transverse or longitudinal expansion on serial imaging 14. In the event of a lesion in the ascending aortic, the proximal/ascending native or previously implanted surgical graft the landing zone must be appropriate 15. Femoral / iliac artery diameter as documented by CTA or MRA that allows endovascular access to the diseased site with a 20 Fr. delivery catheter. 16. Access vessels morphology suitable for endovascular repair in terms of tortuosity, calcification and angulation, documented by CTA/MRA. 17. Brachial/Axial Artery diameter that allows endovascular access suitable for 7 Fr. 18. Subject is considered an appropriate candidate for an elective surgery. 19. Subject is considered to be at high risk for open repair, as determined by the investigator. 20. Access vessels, iliac/femoral & brachial/axillary compatible with vascular access techniques (femoral cutdown or percutaneous), devices, and /or accessories. 21. Subject is willing and able to comply with procedures specified in the protocol and is able to return for follow-up visits as specified by the protocol. Exclusion Criteria: 1. Acute dissection 2. Lesions that can be safely treated with TEVAR landing in zone 2 (with or w/o LSA vascularization) 3. Required emergent treatment, e.g., trauma, rupture 4. Acute vascular injury of the aorta due to trauma 5. Aortic rupture or unstable aneurysm 6. Received a previous stent or stent graft in the treated area (including planned landing area) 7. Required surgical or endovascular treatment of an infra-renal aneurysm at time of implantation 8. Planned major surgical or interventional procedure at time of screening, to be performed after the NEXUS™ implantation. 9. Any major surgical or interventional procedure 6 weeks before the NEXUS™ implantation, exclusive of planned procedures that are needed for the safe and effective placement of the stent graft (e.g. supra-aortic bypass). 10. Subject has had a myocardial infarction (MI) or cerebral vascular accident (CVA) within 90 days prior to the planned implantation 11. Subjects with severe aortic valvular insufficiency as determined by echocardiography 12. Mechanical valve that preclude safe delivery of NEXUS™ 13. Known Connective tissue disease (e.g., Marfan's or Ehler's-Danlos syndromes) 14. Subject has an active systemic infection at the time of the procedure documented by pain, fever, drainage, positive culture 15. Pregnant 16. Life expectancy of less than 2 years 17. Unsuitable vascular anatomy 18. Subject who have a previously implanted surgical wrap of the ascending aorta 19. Any medical condition that, according to the investigator's decision, might expose the subject to increased risk by the investigational device or procedure. 20. An aneurysm that is mycotic, inflammatory or suspected to be infected. 21. Subject with hostile groins/axilla (scarring, obesity, or previous failed puncture) unless conduit are used. 22. Subjects with severe atherosclerosis, severe calcification or extensive intraluminal thrombus of the aorta or in the brachiocephalic trunk 23. Subject is suffering from unstable angina or NYHA classification III and IV. 24. Subject has a known hypersensitivity or contraindication to anticoagulants, antiplatelets, or contrast media, which is not amenable to pre-treatment. 25. Subject with a contraindication to undergo angiography 26. Subject with known sensitivities or allergies to the device materials (including Nitinol [NiTi], polyester fabric [PET], tantalum [TA]) 27. Clinical conditions that severely inhibit x-ray visualization of the Aorta. 28. Subject has history of bleeding diathesis or coagulopathy that may limit the use of dual antiplatelet or anticoagulant therapy by the decision of the investigator 29. Acute renal failure; chronic renal failure (excluding dialysis); Creatinine > 2.00 mg/dl 30. 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. 31. Active participation in another clinical study that has not completed primary endpoint(s) evaluation or that clinically interferes with the endpoints in this study, or subject is planning to participate in such study prior to the completion of this study.

Study Design


Intervention

Device:
NEXUS Aortic Stent Graft System
Arch Stent Graft, whose cranial narrow end is intended to be deployed into the Brachiocephalic artery and whose distal end is intended to be deployed into the Descending Thoracic Aorta. Ascending Stent Graft intended to be deployed in the Ascending Aorta. OPTIONAL: Descending Extension can be used in case the aortic lesion elongates further distally and out of the covered length offered by the Arch Stent Graft. Multiple Descending Extensions can be used if needed to cover the entire length of the lesion.

Locations

Country Name City State
New Zealand Auckland City Hospital Auckland Grafton
United States University of Michigan Ann Arbor Michigan
United States Emory University Atlanta Georgia
United States University of Colorado Aurora Colorado
United States University of Maryland Baltimore Maryland
United States University of Alabama Birmingham Birmingham Alabama
United States Tufts Medical Center Boston Massachusetts
United States Ascension St. Vincent Carmel Indiana
United States University of North Carolina Chapel Hill North Carolina
United States Medical University of South Carolina Charleston South Carolina
United States Atrium Health Charlotte North Carolina
United States The University of Chicago Chicago Illinois
United States The Lindner Research Center Cincinnati Ohio
United States University Hospital Cleveland Ohio
United States Duke University Medical Center Durham North Carolina
United States Hartford Healthcare Hartford Connecticut
United States Ballad Health Kingsport Tennessee
United States University of California San Diego Medical Center La Jolla California
United States Vanderbilt University Medical Center Nashville Tennessee
United States Northwell Health Lenox Hill Hospital New York New York
United States The Mount Sinai Medical Center New York New York
United States Sentara Norfolk General Hospital Norfolk Virginia
United States MedStar Washington Hospital Northwest Washington
United States Advent Health Orlando Orlando Florida
United States University of Pennsylvania Philadelphia Pennsylvania
United States Baylor Scott and White Plano Texas
United States Oregon Health Portland Oregon
United States Carilion Clinic Roanoke Virginia
United States Washington University School of Medicine Saint Louis Missouri
United States Stanford University School of Medicine Stanford California
United States Lankenau Medical Center Wynnewood Pennsylvania

Sponsors (1)

Lead Sponsor Collaborator
Endospan Ltd.

Countries where clinical trial is conducted

United States,  New Zealand, 

Outcome

Type Measure Description Time frame Safety issue
Primary Device Technical Failure Failure to accurately deliver, track and deploy all required endovascular device components at the intended implantation site and failure to retrieve the device delivery systems without the need for unplanned additional procedures
Device occlusion
Failed exclusion of primary entry tear
Additional unanticipated surgical or interventional procedure related to the device or procedure, to prevent life-threatening or permanent disabling event.
30 Days
Primary Clinical Failure Subjects experiencing early mortality or at least one of the following MAEs through 30-Day of Phase 1 Procedure and 30-Day of Index Procedure: Disabling stroke, permanent paralysis/paraplegia, renal failure, aortic rupture, development of new dissections in the thoracic aorta or brachiocephalic artery. 30 Days
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