Physician Modified Endovascular Grafts

Learn more about:
Related Clinical Trial
Comparative Study of a Software With the Gold Standard Limiting AAA With Metformin (LIMIT) Trial Deep Learning Applied to Plain Abdominal Radiographic Surveillance After Endovascular Aneurysm Repair (EVAR) of Abdominal Aortic Aneurysm (AAA) Carbon Dioxide Guided Angiography in Endovascular Abdominal Aortic Aneurysm Repair MuLtibranchEd Graft for OPen RepAir of ThoRacoabdominal Aneurysms Aneurysm Diameter and Surgical Outcome Evaluation of the Long Term Efficacy of Endovascular Treatment of Type 2 Endoleaks Point-of-care Ultrasound in Finland BNP and Vascular Surgery Understanding the Role of Autoimmune Disorders on the Initial Presentation of Cardiovascular Disease Heart Rate and Initial Presentation of Cardiovascular Diseases (Caliber) Social Deprivation and Initial Presentation of 12 Cardiovascular Diseases: a CALIBER Study The Effects of Anesthesia on Patients Undergoing Surgery for Repair of a Thoracoabdominal Aneurysm. The Role of Alcohol Consumption in the Aetiology of Different Cardiovascular Disease Phenotypes: a CALIBER Study Body Mass Index and Initial Presentations of Cardiovascular Diseases Totally Percutaneous Approach to Endovascular Treatment of Aortic Aneurysms (PEVAR-PRO) Haemostasis Management of Abdominal Aortic Procedures Overlay of 3D Scans on Live Fluoroscopy for Endovascular Procedures in the Hybrid OR Evaluation of the Safety and Efficacy of the Multilayer Stent Serum Uric Acid Levels and Onset of Cardiovascular Diseases: a CALIBER Study Ethnicity and Onset of Cardiovascular Disease: A CALIBER Study Fenestrated AAA Endovascular Graft Post-Approval Study Preconditioning Shields Against Vascular Events in Surgery Zenith Low Profile AAA Endovascular Graft (ZLP) Clinical Study Terumo Aortic Global Endovascular Registry A Study of Remote Ischaemic Preconditioning in Patients With Atherosclerosis Undergoing Vascular Surgery Preconditioning Shields Against Vascular Events in Surgery Risk Factors in the Initial Presentation of Specific Cardiovascular Disease Syndromes White Blood Cell Counts and Onset of Cardiovascular Diseases: a CALIBER Study Contrast-enhanced Ultrasound in Follow-up After Endovascular Aneurysm Repair Use of Fish Oil to Reduce Inflammation During Endovascular Abdominal Aortic Repair Contrast Enhanced Ultrasound, Endoleak Detection Following EVAR v1.3 Glycemic Control to Prevent Cardiac Morbidity in Vascular Surgery Performance and Safety of a Second Generation Antimicrobial Graft in Abdominal Position AneuFix – Prophylactic Sac Filling ANEUFIX for Endoleak Type II Repair Endurant Evo US Clinical Trial The Use of Carbon Dioxide as a Contrast Media for Performing Endovascular Procedures A Study of the Safety of Targeted AAA Screening Zenith® Low Profile AAA Endovascular Graft Zenith® Low Profile AAA Endovascular Graft Zenith(R) Low Profile AAA Endovascular Graft Clinical Study Hemodynamic Changes After Aortic Aneurysm Treatment With Stent-Graft Zenith® AAA Endovascular Graft Clinical Study Talent Converter Post-Approval Study Arterial Stiffness, Blood Pressure and Cardiac Output Study LIFE Study: Least Invasive Fast-Track EVAR DynaCT in Preoperative Imaging Before Insertion of Stentgraft TriVascular European Union (EU) Abdominal Stent Graft Trial Percutaneous Endovascular Aneurysm Repair (PEVAR) Trial Biomarkers of Aneurysm Wall Strength Post Implant Syndrome After EVAR and EVAS (INSPIRE Study) Control Post Endovascular Treatment of Aortic Aneurisms Through Magnetic Resonance and Ultrasound (SAFEVAR) Estimation of Biomechanical Aortic Wall Properties in Healthy and Aneurysmal Aortas Using Novel Imaging Techniques ANEUFIX for Endoleaks Type II TriVascular Canadian LIFE Study: Least Invasive Fast-Track EVAR (Endovascular Aneurysm Repair) Screening Cardiovascular Patients for Aortic aNeurysms (SCAN) Emergency Department Ultrasound in Renal Colic Endurant Evo International Clinical Trial Physician Modified Endovascular Grafts Talent Aortic Cuff Stent Graft System Compassionate Use Registry Fusion of CT Angiography With 3D Contrast Ultrasound as a Method for Follow up for Endovascular Aneurysm Repair Evaluation of a New Imagingtechnologie for Thrombosis The Effect of Surgery on Central Aortic Pressure & haEmodynamics Study Image Fusion of Preprocedural CTA With Real Time Fluoroscopy to Enhance EVAR Repair Post-operative CT Follow up After Nellix Endoprosthesis Implantation Endovascular Exclusion of TAAA/AAA Utilizing Fenestrated/Branched Stent Grafts Zenith® p-Branch™: Single-Center Study Observatory of Screening Aneurysms of the Abdominal Aorta During Echocardiography. National Epidemiological Survey Female Aneurysm Screening STudy The Pivotal Study of the Aptus Endovascular AAA Repair System Endovascular Treatment of Aorto-iliac Disease Using in Situ Fenestration Interest of a Post-operative Ultrasound With Systematic Use of Ultrasonic Contrast in the Follow-up of Aortic Endoprosthesis: Prospective Study at the University Hospital of Nice Zenith® Fenestrated Abdominal Aortic Aneurysm (AAA) Endovascular Graft Continued Access Study Endovascular Aneurysm Repair (EVAR) Gate Study Powerlink Bifurcated Stent Graft Long-Term Follow-up Study Screening Cardiovascular Patients for Aortic Aneurysms Zenith(R) Fenestrated Abdominal Aortic Aneurysm (AAA) Endovascular Graft Clinical Study Global Fenestrated Anaconda Clinical sTudy TriVascular Post-Market Registry Vasovist Endoleak Study AAA Registry: Clinical Outcomes of Highly Angulated anatomY Treated With the Aorfix™ Stent Graft Italian Multicenter Database for Open Conversions After EVAR Evaluation of the Endovascular Repair for Aortic Aneurysm (EVAR) Program at LHSC Preoperative Methylprednisolone in Endovascular Aortic Repair Prospective Aortic Biobank of POP-STAR E-tegra Stent Graft System in the Treatment of Infra-renal Abdominal Aortic Aneurysms EValuation of Systemic Atherothrombosis in Patients With ARTerial Disease of the Lower Limbs A Clinical Study to Evaluate the Safety and Performance of the Modular AAA Stent-Graft System Prospective Aneurysm Trial: High Angle Aorfix™ Bifurcated Stent Graft The Vascutek Custom Fenestrated Anaconda Post-Market Surveillance Study Advanced MRI in AAA Korean Registry of Percutaneous EVAR With INCRAFT Stent Graft for the Treatment of Abdominalaortic Aneurysm (K-INCRAFT) Safety and Efficacy of the SETA LATECBA Stent Graft for EVAR in Subjects With AAA UVA Brain and Aortic Aneurysm Study Acute Technical Outcomes of the Talent Abdominal Aortic Aneurysm (AAA) Stent-Graft Versus Cook Zenith Stent-Graft South American Abdominal Stent Graft Trial Zenith® Spiral-Z® AAA Iliac Leg Graft Post-market Registry AneuRx Post Market Study in the Treatment of AAA Predicting Aneurysm Growth and Rupture With Longitudinal Biomarkers The Boston Scientific ENOVUS Trial The (PIVOTAL) Study Suprarenal Proximal Cuff Study for Treatment of Abdominal Aortic Aneurysm Relation betwEen Abdominal Aorta and Carotid Artery Responses to SymPathetic stimulatiON uSing duplEx Ultrasound ARBITER-II: Aorfix™ Bifurcated Safety and Performance Trial: Phase II, Angulated Vessels Evaluation of Predictors of Aortic Aneurysm Growth and Rupture Compassionate Use of the Incraft® AAA Stent Graft System Aortic Distensibility Randomized Preventive Vascular Screening Trial of 65-74 Year Old Men in the Central Region of Denmark CRD007 for the Treatment of Abdominal Aorta Aneurysm (The AORTA Trial) ACT Guided Heparinization During Open Abdominal Aortic Aneurysm Repair. Cross-sectional Study of Prevalence Rate of Abdominal Aortic Aneurysm in OSAHS Patients From BTCH Mechanism and Prevention of Remote Organ Injury Following Ruptured Aortic Aneurysm Study of Abdominal Aortic Stent Grafts in the Treatment of Infrarenal Abdominal Aortic Aneurysms Study on Anti-inflammatory Effect of Anti-hypertensive Treatment in Patients With Small AAA’s and Mild Hypertension DynaCT Imaging in EVAR: Comparing Clinical Benefit of DynaCT to Multidetector CT as the Current Gold Standard. Zenith® LP Abdominal Aortic Aneurysm (AAA) Post-Market Registry Endovascular Exclusion of Thoracoabdominal and/or Paravisceral Abdominal Aortic Aneurysm Safety and Efficacy of Allogeneic MSCs in Promoting T-regulatory Cells in Patients With Small Abdominal Aortic Aneurysms Post-Market Study to Assess Outcomes of Patients Treated With AFX System Compared to Other EVAR Devices Dutch Randomised Endovascular Aneurysm Management (DREAM-) Trial Metformin Therapy in Non-diabetic AAA Patients Tonometry(1) and Duplex Ultrasound(2) to Predict CV Events in to be Treated Patients With an AAA Tonometry and Duplex Ultrasound to Predict AAA Progression and CV Events in Aneurysm Patients (1-2-3 Trial) Endoprosthesis Treatment Effects on Human Abdominal Aorta Aneurysms (AAA) Metabolic Activity Surviving Aneurysm Surgery: A Pilot Study on Exercise Training in Abdominal Aortic Aneurysm Patients Treovance Stent-Graft With Navitel Delivery System for Patients With Infrarenal Abdominal Aortic Aneurysms Cyclosporine A in Patients With Small Diameter Abdominal Aortic Aneurysms Intraoperative Assessment of Pulsatile Aneurysm Wall Motion During Endovascular Aneurysm Repair Curcumin to Prevent Complications After Elective Abdominal Aortic Aneurysm (AAA) Repair Post Implantation Syndrome and Administration on NSAIDs in Patients Undergoing EVAR for AAA LUCY Study: TriVascular Evaluation of Females Who Are Underrepresented Candidates for Abdominal Aortic Aneurysm Repair Elective Abdominal Aortic Aneurism – Open Versus Endovascular Repair TriVascular Evaluation of Females Who Are Underrepresented Candidates for Abdominal Aortic Aneurysm Repair in Europe Statin Use in Abdominal Aortic Aneurysm Repair GORE® EXCLUDER® Endoprosthesis French Mandatory Registry Endovascular Exclusion of Abdominal Aortic Aneurysms in High Risk Patients Aneurysma Hernia Study – Incidence of Incisional Hernias After Abdominal Aortic Aneurysm Repair Predictors of AAA Expansion and/or Rupture Non-invasive Monitoring of Endovascular Repair of Abdominal Aortic Aneurysm (VBA) Comparison of Beta-blocker Versus Angiotensin Receptor Blocker for Suppression of Aneurysm Expansion in Patients With Small Abdominal Aortic Aneurysm and Hypertension (BASE Trial) Preferences for Open Vs. Endovascular Repair for Abdominal Aortic Aneurysm Pharmacokinetics of CRD007 in Patients With Abdominal Aorta Aneurisms. Study of the Endovascular QUANTUM LP™ Stent Graft System in Abdominal Aortic Aneurysms (AAA) Immediate Management of the Patient With Rupture : Open Versus Endovascular Repair Study of the Glycocalyx in Abdominal Aortic Aneurysm Effect of Pre-operative Exercise in Abdominal Aortic Aneurysms (AAA) Patients. Validation of Fenestrations Positioning by Numerical Simulation Prevalence and Screening of Abdominal Aortic Aneurysms Among Men With Coronary Artery Disease START – Early Thrombocyte Administration to Patients With Ruptured Abdominal Aortic Aneurism Intraoperative Perfusion Patterns of the Sigmoid Colon During Elective Open Abdominal Aortic Aneurysm Repair The Inter and Intra Reliability of Cardiopulmonary Exercise Testing in Abdominal Aortic Aneurysm Patients Prevalence of Carotid Artery Stenosis and Abdominal Aortic Aneurysms in Brussels: a Population-based Screening Study. Screening of Abdominal Aortic Aneurysms Among Male Patients With TIA Symptoms The Nellix® EndoVascular Aneurysm Sealing System for the Treatment of Infrarenal Abdominal Aortic Aneurysms Screening of Abdominal Aortic Aneurysms Among Men With Coronary Artery Disease Cordis Bilateral AAA Device Compared to Open Surgical Repair of Abdominal Aortic Aneurysms (ARIBA) A Large Surgical Registry for Abdominal Aortic Aneurysms (AAA) Circulating microRNAs and Degenerative Abdominal Aorta Aneurysm Follow-up After Endovascular Repair of Abdominal Aortic Aneurysm Abdominal Aortic Aneurysms and Pseudoexfoliation Syndrome The Efficacy of Ticagrelor on Abdominal Aortic Aneurysm (AAA) Expansion Physician-Sponsored IDE for Talent Endoluminal Spring Graft System in Patients With Abdominal Aortic Aneurysms (AAA) Impact of Limb Remote Ischemic Preconditioning on Mortality and Quality of Life During Abdominal Aortic Aneurysm Repair Magnetic Resonance Elastography in Patients With Abdominal Aortic Aneurysms 34mm Cuff Study for Endovascular Repair of Abdominal Aortic Aneurysms Metformin for Abdominal Aortic Aneurysm Growth Inhibition Clinical Study of Abdominal Aortic Aneurysm Exclusion (TALENT Abdominal) A Phase I Evaluation of the Safety of the TriVascular Stent-Graft System in the Treatment of Abdominal Aortic Aneurysms Screening for Abdominal Aortic Aneurysm and Abdominal Aortic Atherosclerosis by Hand-Held Ultrasonography Clinical Study of the Treovance Stent-Graft for Patients With Abdominal Aortic Aneurysms Development of Novel Imaging Markers Predicting the Progression of Abdominal Aortic Aneurysm Using 3D Computed Tomography Structured Exercise Programme and Abdominal Aortic Aneurysm Surgery Study of the Effectiveness of Telmisartan in Slowing the Progression of Abdominal Aortic Aneurysms Evaluation of Effect of Angiotensin-converting Enzyme (ACE) Inhibitors on Small Aneurysm Growth Rate A Prospective Analysis on the Expansion Rates of Abdominal Aortic Aneurysms Reduction of Myocardial Infarction by Preconditioning in Patients With Ruptured Abdominal Aortic Aneurysm Magnetic Resonance Imaging To Predict Outcomes In Aortic Aneurysms Abdominal Aortic Aneurysm Sac Healing and Prevention of Endoleaks A MULTICENTER, OPEN LABEL, PROSPECTIVE, NON-RANDOMIZED STUDY OF INCRAFT™ IN SUBJECTS WITH ABDOMINAL AORTIC ANEURYSMS (INNOVATION) Abdominal Aortic Aneurysm Surgery and Thrombosis Ultra-sound for AAA Screening in Smoking Israeli Arab Men Prophylactic Mesh Implantation After Abdominal Aortic Aneurysm Repair Compassionate Use Treatment for a Single Patient With a Custom Made Branched/Fenestrated Endovascular Device for the Treatment of Complex Abdominal Aortic Aneurysm Comparison of Methods to Improve Abdominal Aortic Aneurysm (AAA) Screening Rates in the Primary Care Setting. Safety Study for the Treatment of Abdominal Aortic Aneurysms Prevention of Incisional Hernia After Elective Open Abdominal Aortic Aneurysm (AAA) Repair Sodium Fluoride Imaging of Abdominal Aortic Aneurysms Biomarker Profiling in Abdominal Aortic Aneurysm Patients Vascutek Anaconda™ Abdominal Aortic Aneurysm (AAA) Post-Market Surveillance Registry Limb Remote Ischemic Preconditioning Reduces Heart and Lung Injury After Abdominal Aortic Aneurysm Repair China Post-market Study of the INCRAFT® AAA Stent Graft System in Subjects With Abdominal Aortic Aneurysms (INITIATION) Screening for Thoracic Aortic Aneurysm Among a Cohort of Patients With a Degenerative Abdominal Aortic Aneurysm A Multicenter, Open Label, Prospective, Non-randomized Study of the InCraft® Stent Graft System in Subjects With Abdominal Aortic Aneurysms (INSPIRATION) Prevention of Endoleaks Using Autologous Platelet Gel on Unruptured Abdominal Aortic Aneurysms Screening for Abdominal Aortic Aneurysm in 65 Year Old Males in Oslo European (EU) Post Approval Study of the INCRAFT® AAA Stent Graft System in Subjects With Abdominal Aortic Aneurysms Prevention of Type II Endoleaks During Endovascular Treatment of Abdominal Aortic Aneurysm: Endovascular Treatment Versus Combination With Coil Embolisation of the Aneurysmal Sac HORIZON CE Pivotal Study to Treat Abdominal Aortic Aneurysm Screening Programme for Abdominal Aortic Aneurysm by Hand-Held-Ultrasonography in Primary Health Care ACZ885 for the Treatment of Abdominal Aortic Aneurysm Measurement of Maximum Diameter of Native Abdominal Aortic Aneurysm by Angio-CT Intact Abdominal Aortic Aneurysm Repair in Portugal The Altura Abdominal Aortic Aneurysm (AAA) Endograft Safety and Feasibility Study

Brief Title

Physician Modified Endovascular Grafts

Official Title

Physician Modified Endovascular Grafts for the Treatment of Elective, Symptomatic or Ruptured Juxtarenal Aortic Aneurysm: An Investigator Initiated Study

Brief Summary

      The primary objectives of this study are to determine whether physician modified endovascular
      grafts are a safe and effective method of treating patients with elective, symptomatic or
      ruptured juxtarenal aortic aneurysms in those patients considered to be unsuitable candidates
      for open surgical repair and have no other options for treatment.
    

Detailed Description

      15,000 Americans die suddenly each year from rupture of an aneurysm in the aorta,which is the
      ninth leading cause of death in men over age 55. Aortic aneurysms are four times more common
      in men than in women and usually occur in those over age 50. Approximately one percent of men
      between the ages of 55 and 64 will have a significant aneurysm, and the likelihood increases
      to about four to six percent of those men over the age of 75. In a recent population-based
      study of Medicare beneficiaries, 83.2% of patients undergoing endovascular repair of their
      aortic aneurysm were male. Furthermore, 11.9% of patients were 67 to 69 years of age, 26.8%
      70 to 74, 35.7% 75 to 79, 15.8% 80 to 84 and 9.8% > 85 years of age. Ninety-six percent of
      patients were White, 3% Black and the rest either Hispanic or "Other". We have reason to
      believe that the current population of patients in the Pacific Northwest harboring abdominal
      aortic aneurysms match these statistics. Thus, women and minorities will definitely be
      under-represented in this study primarily due to the epidemiology of the disease process.

      Our institution treats a large number of patients with aortic pathology including a large
      number of patients with symptomatic or ruptured abdominal aortic aneurysms. We recently
      published our results on the implementation of a protocol for managing these patients with
      endovascular techniques and have been able to reduce the mortality rate in half for the first
      time in over 30 years. Unfortunately, not all patients presenting with symptomatic or
      ruptured aortic aneurysms are candidates for endovascular repair. Reasons for exclusion
      predominantly involve lack of a suitable proximal aortic neck. Solutions to this problem
      involve multi-branched or "fenestrated" endografts which are being assessed in other clinical
      trials. However, grafts in these trials require between 6 and 12 weeks to manufacture and
      deliver to the investigational site.

      On-site physician modification has also been described but is currently considered outside
      the Instructions For Use for the intended devices. Our institution's quality improvement
      department recently performed an objective review of 47 consecutive PMEG cases in patients
      presenting with asymptomatic, symptomatic or ruptured aortic aneurysms with highly
      encouraging results (See Many patients in our region do not have access to clinical trials
      involving emerging aortic endovascular therapies, and some have no other option due to urgent
      presentation or poor open surgical candidacy. For these important reasons, we seek to
      evaluate the safety and efficacy of PMEG using FDA-approved, off-the-shelf device in order to
      increase the applicability of these technologies to more patients and thus save more lives.
    


Study Type

Interventional


Primary Outcome

Safety and efficacy

Secondary Outcome

 Effectiveness

Condition

Abdominal Aortic Aneurysms

Intervention

Fenestrated Endovascular Graft

Study Arms / Comparison Groups

 Fenestrated procedure
Description:  Fenestrated device with fenestrations for bilateral renal ateries and SMA. May include all three fenestrations or only one

Publications

* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.

Recruitment Information


Recruitment Status

Device

Estimated Enrollment

300

Start Date

March 2011

Completion Date

January 2030

Primary Completion Date

January 2025

Eligibility Criteria

        Inclusion Criteria:

        All patients must meet all of the following inclusion criteria to be eligible for
        enrollment into this study:

          1. Patient is > 18 years of age

          2. Patients who are male or non-pregnant female (females of child bearing potential must
             have a negative pregnancy test prior to enrollment into the study)

          3. Patient or Legally Authorized Representative has signed an Institutional Review Board
             (IRB) approved Informed Consent Form

          4. Patient is considered by the treating physician NOT to be a candidate for elective
             open surgical repair of the Juxtarenal AAA (i.e., category III or greater per American
             Society of Anesthesiology (ASA) classification; please refer to Appendix III: ASA
             Classification System). ASA category IV patients may be enrolled provided their life
             expectancy is greater than 1 year.

          5. Patient has a juxtarenal abdominal aortic aneurysm that meets at least one of the
             following:

               -  Abdominal aortic aneurysm >5.5 cm in diameter

               -  Aneurysm has increased in size by 0.5 cm in last 6 months.

               -  Maximum diameter of aneurysm exceeds 1.5 times the transverse dimension of an
                  adjacent non-aneurysmal aortic segment

          6. Patient has patent iliac or femoral arteries that will allow endovascular access with
             the physician modified endovascular graft.

          7. Patient has a suitable non-aneurysmal proximal aortic neck length of > 2 mm inferior
             to the most distal renal artery ostium.

          8. Patient has a suitable non-aneurysmal distal iliac artery length (seal zone) of >15
             mm. The resultant repair should preserve patency in at least one hypogastric artery.

          9. Patient has a suitable non-aneurysmal proximal aortic neck diameter between 20 and
             32mm, averaged across the diameters at the Celiac, SMA, at the lowest patent renal
             artery and at the midpoint of the renal arteries.

         10. Patient has suitable non-aneurysmal distal common iliac diameters between 8 and 20 mm.

         11. Patient has juxtarenal aortic neck angulation < 60º

         12. Patient must be willing to comply with all required follow-up exam-

        Exclusion Criteria:

        Patients that meet ANY of the following are not eligible for enrollment into the study:

          1. Patient has a mycotic aneurysm or has an active systemic infection

          2. Patient has unstable angina (defined as angina with a progressive increase in
             symptoms,new onset at rest or nocturnal angina, or onset of prolonged angina)

          3. Patient has a major surgical or interventional procedure planned within +/- 30 days of
             the AAA repair.

          4. Patient has history of connective tissue disease (e.g., Marfan's or Ehler's-Danlos
             syndrome).

          5. Patient has a known hypersensitivity or contraindication to anticoagulation or
             contrast media that is not amenable to pre-treatment.

          6. Patient has a known allergy or intolerance stainless steel or gold

          7. Patient has a body habitus that would inhibit X-ray visualization of the aorta

          8. Patient has a limited life expectancy of less than 1 year

          9. Patient is currently participating in another investigational device or drug clinical
             trial

         10. Patient has other medical, social or psychological conditions that, in the opinion of
             the investigator, preclude them from receiving the pre-treatment, required treatment,
             and post-treatment procedures and evaluations.
      

Gender

All

Ages

18 Years - N/A

Accepts Healthy Volunteers

No

Contacts

Benjamin W Starnes, MD, , 

Location Countries

United States

Location Countries

United States

Administrative Informations


NCT ID

NCT01538056

Organization ID

STUDY00002977


Responsible Party

Principal Investigator

Study Sponsor

University of Washington


Study Sponsor

Benjamin W Starnes, MD, Principal Investigator, University of Washington


Verification Date

August 2020