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Comparison Between Manta and Prostar Closure Devices

Completed
Conditions
Aortic Valve Stenosis
Interventions
Device: Transfemoral aortic valve replacement
Registration Number
NCT05662748
Lead Sponsor
RWTH Aachen University
Brief Summary

Use of the closure device in patient with percutaneous transfemoral aortic valve replacement

Detailed Description

The advent of endovascular, transcatheter aortic valve replacement (TAVR), and mechanical circulatory support has offered new, minimally invasive therapeutic options that are rapidly becoming standard of care. These percutaneous transfemoral interventions require large-bore catheters and have created challenges for femoral arterial access management. Current approaches include surgical cut-down with arterial puncture under direct vision, and suture-based "pre-closure." Surgical cut-down is associated with longer procedural time, increased patient discomfort, deeper anesthesia, risk of wound complications including infection, and slower ambulation. The pre-closure technique overcomes many of the disadvantages of surgical cut-down but can be technically demanding, time consuming, and associated with a significant failure rate. Recent randomized TAVR trials have reported major vascular complications in 6% to 8% . Furthermore, a study on the 2 suture-based closure techniques for management of TAVR access reported a 20% vascular complication rate despite being used by experienced operators . Currently, the majority of access site complications result from failed arteriotomy closure . The percutaneous MANTA Vascular Closure Device (VCD) (Essential Medical Inc., Malvern, Pennsylvania) is a novel collagen-based technology dedicated to closure of largebore arteriotomies . The MANTA VCD underwent prospective multicenter evaluation for Conformitä Europäenne (CE) mark approval in the first detailed report of outcomes achieved with a dedicated large-bore vascular closure device Contrary to the aforementioned TAVR procedures, mechanical circulatory support therapy can be extended up to several days on the intensive care ward. Data on such delayed closure with is lacking. This registry is therefore aimed to document the initial experiences of delayed closure of a femoral large bore access with vascular closure devices in patients with an TAVR device.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
250
Inclusion Criteria
  • Patient scheduled for treatment with the TAVR device 2. Decision to use the Manta or the Prostar closure device on a clinical base by the treating physician 3. Signed informed consent
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Exclusion Criteria
  • Male or female aged < 18 2. Pregnant and lactating females 3. Patient has been committed to an institution by legal or regulatory order
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Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
MANTATransfemoral aortic valve replacementPatient received MANTA Device
Pro StarTransfemoral aortic valve replacementpatient received Pro Star Device
Primary Outcome Measures
NameTimeMethod
Safety endpoints during index hospitalisation2018 - 2020

Major vascular complications,

Safety endpoints during index hospitalisation ( bleeding)2018-2020

life-threatining-, major bleeding

Safety endpoints during index hospitalisation ( death )2018-2020

death

Secondary Outcome Measures
NameTimeMethod
efficacy endpoints during index hospitalisation - (hemotasis)2018-2020

hemotasis in angiogram

efficacy endpoints during index hospitalisation ( device failure)2018-2020

device failure

efficacy endpoints during index hospitalisation ( bail-out )2018-2020

need for stent-graft

Trial Locations

Locations (1)

Universitätsklinikum Aachen

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Aachen, NRW, Germany

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