A Single Center, Pilot Study to Evaluate the Feasibility of the Percutaneous Ultrasound Jejunostomy (PUJ)
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Jejunostomy; Complications
- Sponsor
- CoapTech
- Enrollment
- 10
- Locations
- 1
- Primary Endpoint
- Procedural Success
- Status
- Not yet recruiting
- Last Updated
- 2 years ago
Overview
Brief Summary
The purpose of this study is to evaluate the feasibility and performance of the Percutaneous Ultrasound Jejunostomy (PUJ) procedure that utilizes a novel device (PUMA-J System) in conjunction with widely available ultrasound technology and endoscopic guidance.
The procedure will be performed in up to 10 eligible subjects. Patients will be followed for 2 days following performance of PUJ to assess for potential complications.
Detailed Description
Jejunostomy tubes (J-tubes) provide a path for nutrition delivery directly into the small intestinal lumen, bypassing the mouth, esophagus, and stomach for patients who have difficulty with proximal gut feeding. Many medical conditions may require J-tubes, including cancers, gastroparesis, and patients with high risk of aspiration. A recent innovation by CoapTech addresses technical and procedural limitations of current jejunostomy tube placement methods by leveraging ultrasound for visualization and magnets for control of the jejunal loop. The Percutaneous Ultrasound Magnet Aligned (PUMA) System enables clinicians to affix jejunal loops superficially via magnetic coaptation and visualize the planned stomal tract using ultrasound. The purpose of this pilot clinical study is to test the feasibility of the PUMA-Jejunostomy (PUMA-J) System in adults requiring a jejunostomy tube. This is a single-center, non-randomized, non-blinded feasibility study to evaluate the performance and safety of the PUJ procedure that utilizes a novel device (PUMA-J System).
Investigators
Eligibility Criteria
Inclusion Criteria
- •Informed consent must be obtained before any study-specific assessment is performed
- •Male or female \> 21 years of age
- •Estimated tract length (skin to anterior abdominal wall) \<= 4.5cm on prior imaging
- •Indication for percutaneous jejunostomy tube placement determined to be present by the primary clinical care team (examples below):
- •High aspiration risk
- •Malnourished- chronically ill and/or neurologically impaired requiring jejunal feeding for \>30 Days.
- •Neoplasia (stomach and esophagus)
- •Gastric and duodenal obstruction
- •Gastrointestinal dysmotility (gastroparesis)
- •Altered anatomy (gastric-esophageal surgeries)
Exclusion Criteria
- •Temperature ≥ 38 C
- •Systolic BP \< 90 or \> 180 mmHg
- •Heart Rate \< 50 or \> 120
- •Presence of a contraindication to being in proximity to a magnet (e.g. pacemaker)
- •History of prior major abdominal surgery
- •Patients with HgB \< 7g/dL, or fluid resuscitated within 48hrs prior, or history of life-threatening gastrointestinal bleeding within 1 month
- •Pregnant or nursing (lactating) women
- •Involvement in other investigational trials within 30 days prior to screening
- •Absolute contraindications:
- •Severe ascites
Outcomes
Primary Outcomes
Procedural Success
Time Frame: Procedure timeframe
Rate of procedural success in completing jejunostomy tube placement using the PUMA-J System
Secondary Outcomes
- Procedural Aborts(Procedure timeframe)
- Requirement for salvage surgery due to complication of the procedure(48 hours of procedure performance)
- Device Related Serious Adverse Events(48 hours of procedure performance)
- Adverse Events(48 hours of procedure performance)
- Rate of inadvertent puncture of vital organs(Procedure timeframe)