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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT00736086
Other study ID # AVD-640-0057
Secondary ID
Status Completed
Phase Phase 4
First received August 13, 2008
Last updated August 14, 2008
Start date March 2006
Est. completion date December 2006

Study information

Verified date August 2008
Source Abbott Vascular
Contact n/a
Is FDA regulated No
Health authority United States: Institutional Review Board
Study type Observational

Clinical Trial Summary

To evaluate early ambulation in patients who receive the StarClose™ VCS post-percutaneous diagnostic procedure.


Description:

To evaluate the StarClose™ VCS in the femoral artery in subjects who are ambulated early post-percutaneous cardiac or peripheral vascular, diagnostic catheterization procedure. The clinical use of vascular closure devices for rapid hemostasis after femoral access was first reported in 1991. 18 participants may be ambulated almost immediately after diagnostic coronary angiography and discharged many hours earlier than currently practiced in most centers utilizing a supine restriction period of 6 hours after diagnostic catheterization.14 After coronary interventions, participant comfort is additionally increased by immediate sheath removal.

This early ambulation study is an evaluation of a clip-based technology, which achieves vascular hemostasis with the use of a novel extravascular Nitinol clip to provide an immediate mechanical closure that does not depend upon the body's clotting system. The procedures will be performed in participants who meet specific entrance criteria.


Recruitment information / eligibility

Status Completed
Enrollment 165
Est. completion date December 2006
Est. primary completion date November 2006
Accepts healthy volunteers No
Gender Both
Age group 18 Years to 85 Years
Eligibility Inclusion:

- Subject must be 18-85.

- Subject must be an acceptable candidate for an elective,non-emergent diagnostic procedure performed percutaneously via the common femoral artery through either a 5F or 6F procedural sheath.

- Subject is an acceptable candidate for emergent vascular surgery.

- Subject agrees to follow-up evaluations to assess for complications related to femoral access site.

- If among the 50 ultrasound sub-study Subjects enrolled,Subject agrees to have an ultrasound of femoral artery performed post-procedure during the 30 ± 7 days follow-up visit.

- Subject or legal representative has been informed of the nature of the study and agrees to provisions and has provided written informed consent as approved by the Institutional Review Board of respective clinical site.

Exclusion:

- History of bleeding diathesis or coagulopathy including hemophilia, von Willebrand's disease, and/or a current, known platelet count <100,000 cells/mm3, or baseline INR > 1.7.

- Body Mass Index (BMI) ³ 35 kg/m2.

- Presence of significant anemia (Hgb < 10 g/dL, Hct < 30%).

- Advanced Subject refusal of blood transfusions, should transfusion become necessary.

- Participation in another trial of an investigational drug or device that has not yet completed follow-up requirements.

- Pregnant or lactating female.

- Clinically severe peripheral vascular disease in the ipsilateral limb, defined as severe claudication (walking < 100 feet), weak or absent pulses, or lower extremity vascular graft.

- History of ipsilateral femoral arterial puncture within previous three months or history of vascular closure device deployment in ipsilateral femoral artery at any time.

- Subject has unilateral or bilateral lower extremity amputation(s).

- Subject is unable to routinely walk at least 20 feet without assistance.

- Subject has an active systemic or cutaneous infection or inflammation.

- Subject has a pre-existing severe non-cardiac systemic disease or illness with a life expectancy of < 30 days.

- Subject has already participated in this Study.

- Subject has known allergy to nitinol.

Access Site Exclusion-(*Evaluated via Limited Femoral Angiogram)

- Pseudoaneurysm or AV fistula present in ipsilateral femoral artery prior to arterial closure.*

- Puncture distal to the common femoral artery bifurcation or above the inguinal ligament which is typically defined by the inferior border of the inferior epigastric artery on sheath angiogram or the upper third of the femoral head by plain fluoroscopy.*

- The arterial lumen diameter at the arteriotomy site is < 5mm by visual estimate.*

- Angiographic evidence of calcified lesions at the arteriotomy site.*

- Difficulty inserting the introducer sheath at the start of the catheterization procedure due to vessel scarring or tortuosity, or anterior/posterior wall femoral artery punctures or greater than 2 ipsilateral arterial puncture attempts at the time of the percutaneous procedure.

- Known iliac or femoral stenosis >50% or previous bypass surgery or stent placement in the vicinity of the puncture site.

- Planned percutaneous procedure (diagnostic or intervention) in ipsilateral femoral artery prior to the 30-day follow-up evaluation.

- Subject has intra-procedural bleeding around the access site.

- Presence or previous use of an intra-aortic balloon pump through the existing arterial puncture site.

Procedural Exclusion:

- Low molecular weight heparin administration within 8 hours of enrollment.

- For cases where anticoagulants are used, ACT level > 350 seconds at time of enrollment.

- Subject is determined to require treatment that will extend hospitalization (e.g. ---Subject is undergoing CABG surgery or staged PTCA).

- Persistent hypertension (SBP >180 or DBP >110 mm Hg) unresponsive to medical -therapy at time of enrollment.

- Placement of an ipsilateral femoral venous sheath during procedure.

- Presence of clinically significant hematoma (> 6 cm) in ipsilateral femoral artery prior to arterial closure.

- Placement of introducer sheath < 5F or > 6F during procedure.

Study Design

Time Perspective: Prospective


Intervention

Device:
Vessel Closure (StarClose™)


Locations

Country Name City State
United States Fuqua Heart Center/ Piedmont Hospital Atlanta Georgia
United States Bay Regional Medical Center Bay City Michigan
United States New York Methodist Hospital Brooklyn New York
United States Buffalo Heart group Buffalo New York
United States North Ohio Research LTD Elyria Regional Medical Elyria Ohio
United States The Care Group LLC (St. Vincent's Hospital) Indianapolis Indiana
United States St. Luke's Hospital Kansas City Missouri
United States Scripps Memorial Hospital La Jolla California
United States Minneapolis Heart Institute Foundation/Abbott Northwestern Hospital Minneapolis Minnesota
United States Heart Care Midwest (OSF/St Francis) Peoria Illinois
United States Drexel University College of Medicine Hahnemann Philadelphia Pennsylvania

Sponsors (1)

Lead Sponsor Collaborator
Abbott Vascular

Country where clinical trial is conducted

United States, 

References & Publications (27)

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Bertrand ME, Legrand V, Boland J, Fleck E, Bonnier J, Emmanuelson H, Vrolix M, Missault L, Chierchia S, Casaccia M, Niccoli L, Oto A, White C, Webb-Peploe M, Van Belle E, McFadden EP. Randomized multicenter comparison of conventional anticoagulation versus antiplatelet therapy in unplanned and elective coronary stenting. The full anticoagulation versus aspirin and ticlopidine (fantastic) study. Circulation. 1998 Oct 20;98(16):1597-603. — View Citation

Bogart DB, Bogart MA, Miller JT, Farrar MW, Barr WK, Montgomery MA. Femoral artery catheterization complications: a study of 503 consecutive patients. Cathet Cardiovasc Diagn. 1995 Jan;34(1):8-13. — View Citation

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Christensen B, Lacarella C, Manion R, Bruhn-Ding B, Meyer S, Wilson R. Sandbags do not prevent complications after catheterization. Circulation 90:I-205, 1994.

Cragg AH, Nakagawa N, Smith TP, Berbaum KS. Hematoma formation after diagnostic angiography: effect of catheter size. J Vasc Interv Radiol. 1991 May;2(2):231-3. — View Citation

Dick RJ, Popma JJ, Muller DW, Burek KA, Topol EJ. In-hospital costs associated with new percutaneous coronary devices. Am J Cardiol. 1991 Oct 1;68(9):879-85. — View Citation

Duffin DC, Muhlestein JB, Allisson SB, Horne BD, Fowles RE, Sorensen SG, Revenaugh JR, Bair TL, Lappe DL. Femoral arterial puncture management after percutaneous coronary procedures: a comparison of clinical outcomes and patient satisfaction between manual compression and two different vascular closure devices. J Invasive Cardiol. 2001 May;13(5):354-62. — View Citation

Ernst S, Kloss R, Schräder R, Kaltenbach M, Sigwart U, Sanborn TA. Immediate sealing of arterial puncture sites after catheterization and PTCA using a vascular hemostasis device with collagen: an international study. Circulation 84:I-272, 1991.

Goods CM, Liu MW, Jain SP, Mathur A, Yadav JS, Al-Shalbi KF, Dean LS, Iyer SS, Parks JM, Roubin GS. Low molecular weight heparin versus standard heparin in participants at high risk for stent thrombosis: Clinical outcomes. Circulation 94:I-684, 1996.

Hoffer EK, Bloch RD. Percutaneous arterial closure devices. J Vasc Interv Radiol. 2003 Jul;14(7):865-85. Review. — View Citation

Kapadia SR, Raymond R, Knopf W, Jenkins S, Chapekis A, Ansel G, Rothbaum D, Kussmaul W, Teirstein P, Reisman M, Casale P, Oster L, Simpfendorfer C. The 6Fr Angio-Seal arterial closure device: results from a multimember prospective registry. Am J Cardiol. 2001 Mar 15;87(6):789-91, A8. — View Citation

Kiemeneij F, Laarman GJ, Odekerken D, Slagboom T, van der Wieken R. A randomized comparison of percutaneous transluminal coronary angioplasty by the radial, brachial and femoral approaches: the access study. J Am Coll Cardiol. 1997 May;29(6):1269-75. — View Citation

Krause PB, Klein LW. Utility of a percutaneous collagen hemostasis device: to plug or not to plug? J Am Coll Cardiol. 1993 Nov 1;22(5):1280-2. — View Citation

Krone RJ, Johnson L, Noto T. Five year trends in cardiac catheterization: a report from the Registry of the Society for Cardiac Angiography and Interventions. Cathet Cardiovasc Diagn. 1996 Sep;39(1):31-5. — View Citation

Kussmaul WG 3rd, Buchbinder M, Whitlow PL, Aker UT, Heuser RR, King SB, Kent KM, Leon MB, Kolansky DM, Sandza JG Jr. Rapid arterial hemostasis and decreased access site complications after cardiac catheterization and angioplasty: results of a randomized trial of a novel hemostatic device. J Am Coll Cardiol. 1995 Jun;25(7):1685-92. — View Citation

Leon MB, Baim DS, Popma JJ, Gordon PC, Cutlip DE, Ho KK, Giambartolomei A, Diver DJ, Lasorda DM, Williams DO, Pocock SJ, Kuntz RE. A clinical trial comparing three antithrombotic-drug regimens after coronary-artery stenting. Stent Anticoagulation Restenosis Study Investigators. N Engl J Med. 1998 Dec 3;339(23):1665-71. — View Citation

Lincoff AM, Tcheng JE, Miller DP, Booth JE, Montague EA, Topol EJ. Marked enhancement of clinical efficacy of platelet GP IIb/IIIa blockade with c7E3Fab (Abciximab) linked to reduction in bleeding complications: Outcome in the EPILOG and EPIC trials. Circulation 94:I-375, 1996.

Pracyk JB, Wall TC, Longabaugh JP, Tice FD, Hochrein J, Green C, Cox G, Lee K, Stack RS, Tcheng JE. A randomized trial of vascular hemostasis techniques to reduce femoral vascular complications after coronary intervention. Am J Cardiol. 1998 Apr 15;81(8):970-6. — View Citation

Resar JR, Prewitt KC, Wolff MR, Blumenthal R, Raqueno JV, Brinker JA. Percutaneous transluminal coronary angioplasty through 6F diagnostic catheters: a feasibility study. Am Heart J. 1993 Jun;125(6):1591-6. — View Citation

Shammas NW, Rajendran VR, Alldredge SG, Witcik WJ, Robken JA, Lewis JR, McKinney D, Hansen CA, Kabel ME, Harris M, Jerin MJ, Bontu PR, Dippel EJ, Labroo A. Randomized comparison of Vasoseal and Angioseal closure devices in patients undergoing coronary angiography and angioplasty. Catheter Cardiovasc Interv. 2002 Apr;55(4):421-5. — View Citation

Silber S, Dörr R, Mühling H, König U. Sheath pulling immediately after PTCA: comparison of two different deployment techniques for the hemostatic puncture closure device: a prospective, randomized study. Cathet Cardiovasc Diagn. 1997 Aug;41(4):378-83. — View Citation

Silber S. Hemostasis success rates and local complications with collagen after femoral access for cardiac catheterization: analysis of 6007 published patients. Am Heart J. 1998 Jan;135(1):152-6. Review. — View Citation

Silber S. Rapid hemostasis of arterial puncture sites with collagen in patients undergoing diagnostic and interventional cardiac catheterization. Clin Cardiol. 1997 Dec;20(12):981-92. Review. — View Citation

Waksman R, King SB 3rd, Douglas JS, Shen Y, Ewing H, Mueller L, Ghazzal ZM, Weintraub WS. Predictors of groin complications after balloon and new-device coronary intervention. Am J Cardiol. 1995 May 1;75(14):886-9. — View Citation

Waksman R, Scott NA, Ghazzal ZM, Mays R, Frerichs FA, Petersen JY, King SB 3rd. Randomized comparison of flexible versus nonflexible femoral sheaths on patient comfort after angioplasty. Am Heart J. 1996 Jun;131(6):1076-8. — View Citation

Ward SR, Casale P, Raymond R, Kussmaul WG 3rd, Simpfendorfer C. Efficacy and safety of a hemostatic puncture closure device with early ambulation after coronary angiography. Angio-Seal Investigators. Am J Cardiol. 1998 Mar 1;81(5):569-72. — View Citation

* Note: There are 27 references in allClick here to view all references

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