Aortic Aneurysm, Thoracic Clinical Trial
Official title:
Evaluation of the Valiant Mona LSA Thoracic Stent Graft System in Thoracic Aortic Aneurysms and Chronic Dissections
To ensure adequate seal of currently available stent grafts, a proximal 20 mm of healthy aorta is recommended. Extending the proximal landing zone into the arch by intentional covering of the left subclavian artery (LSA) without revascularization expose to serious neurologic complications. Serious risks are also known to accompany subclavian revascularization. The Valiant Mona LSA Thoracic Stent Graft System (Medtronic,Santa Rosa, Calif) consists of a main stent graft and a branch stent graft designed to maintain LSA patency. The purpose of this study is to characterize the safety and effectiveness of this device for the treatment of Aneurysms and chronic Type B dissections of the arch.
Stent graft coverage of the left subclavian artery (LSA) may be required to achieve an
adequate landing zone in up to 40% of descending thoracic aneurysms (DTAs). To ensure
adequate seal of currently available off-the-shelf stent grafts, 20 mm of healthy aorta is
recommended between the proximal neck of the aneurysm and the leading edge of the stent
graft. Stent graft placement can be facilitated by extending the proximal landing zone into
the arch and covering the LSA; however, there may be a higher risk of serious neurologic
outcomes (cerebral and paraplegia), although this is still a matter of debate. Serious risks
are also known to accompany subclavian revascularization, which may involve bypass or
transposition. The Valiant Mona LSA Thoracic Stent Graft System (Medtronic,Santa Rosa, Calif)
consists of a main stent graft and a branch stent graft designed to maintain LSA patency
while diverting circulation through the encroaching aneurysm.
The purpose of the feasibility study is to characterize the safety of the Valiant Mona LSA
Thoracic Stent Graft System, including an assessment of the safety and effectiveness of the
device acutely and at the 1-month visit in the identified subject population (Aneurysms and
chronic, Type B dissections). A follow up of this population will be annually during 5 years.
This pilot, non-randomized, single-arm prospective study will concern 20 patients. Inclusion
criteria required patients with a thoracic aortic aneurysm (TAA) or dissection with an
indication of a stent-Graft insertion. Primary end points will be aneurysm-related mortality,
stroke, paraplegia, left arm/hand ischemia, and treatment success. Technical success will be
assessed by imaging at 1 month, 6 months then annually during 5 years.
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