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Innoventric Trillium™ Stent Graft First-in-Human (FIH) Study

Not Applicable
Active, not recruiting
Conditions
Tricuspid Regurgitation
Interventions
Device: Trillium™
Registration Number
NCT04289870
Lead Sponsor
Innoventric LTD
Brief Summary

A prospective, single-arm, multi-center first-in-human (FIH) study to evaluate the safety and performance of the Innoventric Trillium™ Stent Graft System.

Twenty (20) patients in 8 investigational sites will be enrolled. All enrolled study patients will be assessed at baseline, during the procedure, at discharge, after 1 month, 3 months, 6 months, 1 year, 1.5 years, 2 years, and 3 years following the index procedure.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
20
Inclusion Criteria

Enrolled patients must meet ALL the following criteria:

  1. Age >40 (no upper limit)
  2. Patient has clinically significant TR graded as severe based on the presence of systolic hepatic vein flow reversal, and VCW≥7mm or EROA≥40mm^2
  3. Symptomatic despite medical therapy; patient must be on diuretic therapy.
  4. Peak central venous pressure of ≥ 15mmHg
  5. The local site Heart Team determines that the patient is appropriate for transcatheter tricuspid intervention
  6. Patient is willing and able to comply with all specified study evaluations.
  7. Patient has NYHA functional classification of III or IV
  8. Patient is not eligible for standard-of-care surgical or interventional therapy assessed by the central heart team or has refused standard-of-care surgical and interventional therapy or has received standard-of-care TR therapy and remains symptomatic
  9. Patient understands the nature of the study and study requirements and is willing to provide written Informed Consent prior to any study-specific procedures.
Exclusion Criteria

Patients will be excluded from participation if ANY of the following criteria apply:

  1. Echocardiographic parameters (Any of the following):

    I. LVEF < 20% II. Evidence of severe right ventricular dysfunction (e.g. right ventricular TAPSE < 13.0mm) III. IVC or SVC anatomy that precludes proper device deployment and function

  2. Systolic Pulmonary Artery Pressure > 70mmHg

  3. Severe aortic, mitral, and/or pulmonic valve stenosis and/or regurgitation

  4. Active endocarditis within 90 days of the scheduled implant

  5. Significant pericardial effusion

  6. Intra-cardiac masses, thrombi, or vegetation

  7. Thrombosis of the venous system

  8. Space-consuming lesion in the heart or on the valves, thrombus, or microbial colonization of the valves

  9. Untreated clinically significant coronary artery disease requiring immediate revascularization

  10. MI or known unstable angina within 30 days prior to the index procedure

  11. Any therapeutic invasive cardiac procedure within 30 days prior to the index procedure

  12. Any prior cardiac surgery, within 3 months of the index procedure

  13. Hemodynamic instability or treated with IV inotropes within 30 days of the index procedure

  14. Severe uncontrolled hypertension (SBP ≥ 180 mmHg and/or DBP ≥ 110 mm Hg)

  15. Severe uncontrolled hypotension (SBP≤80 mmHg and/or DBP≤40 mmHg)

  16. Cerebrovascular Accident (CVA) within the past 90 days

  17. Kidney dysfunction with estimated Glomerular Filtration Rate (eGFR) < 30 ml/min/1.73 m^2 or patient is on chronic dialysis

  18. Significant frailty (i.e. Clinical Frailty Scale© (CFS) ≥ 7) within 90 days of the scheduled implant procedure

  19. Chronic liver disease with a MELD score of 20 or greater

  20. Chronic anemia (Hb < 9 g/L) not corrected by transfusion

  21. Thrombocytopenia (Platelet count< 100,000/mm3) or thrombocytosis (Platelet count > 750,000/mm3)

  22. Bleeding disorders or hypercoagulable state

  23. Active peptic ulcer or active gastrointestinal (GI) bleeding within 90 days of the scheduled implant

  24. Contraindication to anticoagulants or antiplatelet agents

  25. Currently or history of IV drug use

  26. Pregnant or lactating; or female of childbearing potential with a positive pregnancy test 24 hours before any study-related radiation exposure.

  27. Inability to access the femoral vein with a 24 FR guide (e.g., DVT, occluded femoral veins).

  28. Known allergy to stainless steel, nickel, titanium, PET or contrast agents that cannot be adequately pre-medicated.

  29. Known hypersensitivity or contraindication to procedural medications which cannot be adequately managed medically

  30. Impaired judgment

  31. Undergoing emergent or urgent treatment for tricuspid insufficiency

  32. Currently participating in another investigational drug or device study that has not completed the primary endpoint or that clinically interferes with the endpoints of this study

  33. Co-morbid condition(s) that, in the opinion of the Investigator, limit life expectancy to < 12 months

  34. Cardiac cachexia

  35. In the judgment of the Investigator, co-morbid condition(s) that could limit the patient's ability to participate in the study, including compliance with follow-up requirements, or that could impact the scientific integrity of the study

  36. Patient is under guardianship

  37. Presence of any prosthetic device in the SVC or IVC (excluding pace-maker, ICD and CRT leads)

  38. Elevated inflammatory markers within 2 weeks of the scheduled procedure (e.g. CRP>1.5mg/dL).

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Innoventric Trillium™ Stent Graft Single ArmTrillium™Single-arm, open label, multi-center study
Primary Outcome Measures
NameTimeMethod
Safety EndpointEvaluated immediately after intervention, discharge and 30 days

Rate of device or procedure-related MAEs

and

Freedom from unplanned surgery or re-intervention, due to life-threatening device or procedure failure

Technical performanceEvaluated immediately after intervention

Successful access, delivery, and retrieval of the Trillium delivery system, the device is anchored both in SVC and IVC.

Efficacy EndpointEvaluated immediately after intervention

TR grade as measured on the device valves (Echocardiography), or by hepatic vein systolic backflow (Echocardiography), or reduction in peak central venous pressure (Invasive hemodynamic measurement).

Secondary Outcome Measures
NameTimeMethod
Efficacy EndpointAssessment at 30 days, 3-month, 6-month and 1-year

One or more of the following-

* TR grade measured on the device valves (Echocardiography), or by hepatic vein systolic backflow (Echocardiography), or measured by a regurgitant fraction (CMR) \[at 30 days, 3-month, 6-month, and 1-year\]

* Rate of hospitalizations for HF \[at 30 days, 3-month, 6-month, and 1-year\]

Or one or more of the following-

* Clinical Frailty Scale (CFS) \[at 30 days, 3-month, 6-month, and 1-year\]

* HF functional class (NYHA) \[at 30 days, 3-month, 6-month, and 1-year\]

* Six-minute walk test (6MWT) \[at 30 days, 3-month, 6-month, and 1-year\]

* The Kansas City Cardiomyopathy Questionnaire (KCCQ) \[at 30 days, 3-month, 6-month, and 1-year\]

Safety EndpointAssessment at 3-month, 6-month and 1-year

Composite of all device or procedure-related MAEs.

Trial Locations

Locations (9)

OLVZ Aalst

🇧🇪

Aalst, Belgium

Leipzig Heart Center

🇩🇪

Leipzig, Germany

ZNA

🇧🇪

Antwerp, Belgium

Herzzentrum der Charité (DHZC)

🇩🇪

Berlin, Germany

Heart & Diabetes Center NRW

🇩🇪

Bad Oeynhausen, Germany

Rabin Medical Center

🇮🇱

Petah tikva, Israel

Hospital Clinic de Barcelona

🇪🇸

Barcelona, Spain

Hospital Alvaro Cunqueiro, Hospital Universitario de Vigo

🇪🇸

Vigo, Spain

Hospital Universitario de Salamanca

🇪🇸

Salamanca, Spain

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