Aortic Aneurysm Clinical Trial
— SEMPEROfficial title:
Evaluation of the Safety and Efficacy of Multiple Overlapping Uncovered Stents for Endovascular Pararenal Aortic Aneurysm Repair
Complex aortic aneurysms involving major branches have been difficult endovascularly. The primary purposes of this study is to evaluate the safety, feasibility, and efficacy of multiple overlapping uncovered stents in treating aortic aneurysm while preserving major visceral branches, including the celiac artery (CA), superior mesenteric artery (SMA) and renal artery (RA).
Status | Recruiting |
Enrollment | 50 |
Est. completion date | October 2020 |
Est. primary completion date | October 2020 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years to 90 Years |
Eligibility |
Inclusion Criteria: - Age>18 years - Life expectancy = 12 months - The patient or his legal representative has signed the informed consent form - Contraindicated for open surgery, declared inoperable by surgeon and anesthetist (statement signed by each doctor) and must have at least one of the following: 1. Age>80 years 2. ASA =3 3. history of thoracic surgery or surgery of abdominal aorta 4. coronary artery disease (history of angina myocardial infarction) with positive functional testing and coronary lesions for which revascularization is impossible or not indicated 5. heart failure 6. LVEF < 40% 7. chronic respiratory failure defined by one of the following criteria: 1. FEV1 <1.2 L/sec; 2. VC <50% of the predicted value according to age, sex and weight; 3. Arterial blood gas analysis in the absence of oxygen: PaCO2>45 mmHg or PaO2 < 60 mmHg; 4. Oxygen therapy. 8. renal insufficiency if creatininaemia> 200 micromol/L before injection of contrast product; 9. hostile abdomen, including presence of ascites or other signs of portal hypertension; 10. obesity. - Conventional tubular stent-graft is not suitable due to complicated aneurysm anatomy, such as being adjacent to (proximal or distal landing zone < 15mm) or involving vital branches, including the celiac artery, superior mesenteric artery, or renal artery. - Adequate arterial anatomy of aneurismal lesion access. Exclusion Criteria: - Medical contraindications to a local or general anesthesia and angiography; - Life expectancy less than one year, or clinical follow-up impossible; - Congenital disorders of blood coagulation; - Intercurrent infection; - Allergy to aspirin, clopidogrel, or contrast agents; - Patient (s) included in another clinical study; - Patient pregnant or breastfeeding. |
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
China | Division of Vascular Surgery, Changhai Hospital | Shanghai |
Lead Sponsor | Collaborator |
---|---|
Changhai Hospital |
China,
Benndorf G, Campi A, Schneider GH, Wellnhofer E, Unterberg A. Overlapping stents for treatment of a dissecting carotid artery aneurysm. J Endovasc Ther. 2001 Dec;8(6):566-70. — View Citation
Geremia G, Haklin M, Brennecke L. Embolization of experimentally created aneurysms with intravascular stent devices. AJNR Am J Neuroradiol. 1994 Aug;15(7):1223-31. — View Citation
Hurst RW, Haskal ZJ, Zager E, Bagley LJ, Flamm ES. Endovascular stent treatment of cervical internal carotid artery aneurysms with parent vessel preservation. Surg Neurol. 1998 Oct;50(4):313-7; discussion 317. — View Citation
Klein GE, Szolar DH, Raith J, Frühwirth H, Pascher O, Hausegger KA. Posttraumatic extracranial aneurysm of the internal carotid artery: combined endovascular treatment with coils and stents. AJNR Am J Neuroradiol. 1997 Aug;18(7):1261-4. — View Citation
Oztürk MH, Eyüboglu I, Pulathan Z, Dinç H. Spontaneous thrombosis of a saccular iliac artery aneurysm induced by overlapping self-expandable bare metallic stents. Diagn Interv Radiol. 2010 Dec;16(4):308-11. doi: 10.4261/1305-3825.DIR.2422-08.0. Epub 2009 Oct 19. — View Citation
Ruiz-Juretschke F, Castro E, Mateo Sierra O, Iza B, Manuel Garbizu J, Fortea F, Villoria F. Massive epistaxis resulting from an intracavernous internal carotid artery traumatic pseudoaneurysm: complete resolution with overlapping uncovered stents. Acta Neurochir (Wien). 2009 Dec;151(12):1681-4. doi: 10.1007/s00701-009-0294-5. Epub 2009 Apr 7. — View Citation
Sfyroeras GS, Dalainas I, Giannakopoulos TG, Antonopoulos K, Kakisis JD, Liapis CD. Flow-diverting stents for the treatment of arterial aneurysms. J Vasc Surg. 2012 Sep;56(3):839-46. doi: 10.1016/j.jvs.2012.04.020. Epub 2012 Jul 26. Review. — View Citation
Uchino H, Asano T, Nakayama N, Kuroda S, Houkin K. [Flow diversion by double-overlapping-stent for fusiform vertebral artery aneurysm: a case report]. No Shinkei Geka. 2011 Jan;39(1):59-63. Japanese. — View Citation
Zhang YX, Lu QS, Feng JX, Zhao ZQ, Bao JM, Feng R, Feng X, Jing ZP. Endovascular management of pararenal aortic aneurysms with multiple overlapping uncovered stents. J Vasc Surg. 2013 Sep;58(3):616-23. doi: 10.1016/j.jvs.2013.02.248. Epub 2013 May 25. — View Citation
Zhang YX, Lu QS, Jing ZP. Innovative sandwich technique in treating a symptomatic saccular suprarenal aneurysm involving the celiac trunk. Vasc Endovascular Surg. 2013 Feb;47(2):102-5. doi: 10.1177/1538574412471210. Epub 2012 Dec 27. — View Citation
Zhang YX, Lu QS, Jing ZP. Multilayer stents, a new progress in the endovascular treatment of aneurysms. Chin Med J (Engl). 2013 Feb;126(3):536-41. Review. — View Citation
* Note: There are 11 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Number of patients with aneurysm exclusion | Aneurysm exclusion means that the aneurysm shrinks or stays stable over time. | 12 months | No |
Secondary | Number of patent major branches within the coverage zone | Major branches include the celiac artery, superior mesenteric artery, or renal artery. | 12 months | No |
Secondary | Number of patients with serious adverse events | Adverse events include aneurysm-related, procedure-related, and stent-related complications or mortality | 12 months | Yes |
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