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Thoraflex Hybrid and Relay Extension Post-Approval Study

Recruiting
Conditions
Thoracic Diseases
Thoracic Aortic Dissection
Aortic Aneurysm
Aortic Dissection
Thoracic Aortic Aneurysm
Registration Number
NCT05639400
Lead Sponsor
Vascutek Ltd.
Brief Summary

The goal of this observational study is to evaluate the Thoraflex Hybrid device alone and in combination with the RelayPro NBS stent-graft in the treatment of aortic disease affecting the aortic arch and descending aorta with or without involvement of the ascending aorta.

Patients who undergo treatment with the Thoraflex Hybrid device with or without extension with a RelayPro NBS stent-graft will be eligible for enrolment and study activities and follow-up regime will follow standard care at each participating site.

Participant involvement in the study will last for a total of 10 years from the point at which the Thoraflex Hybrid device is placed.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
200
Inclusion Criteria

Patient is aged 18 years or older on date of consent. Patient is willing and able to comply with all study procedures and visits. Patient or their next of kin (NOK)/legally designated representative (LDR) has given written informed consent to participate in the study.

Patient will undergo treatment with a Thoraflex Hybrid device. If a patient requires an extension procedure due to the extent of aortic disease, a RelayPro NBS Stent-graft should be placed inside the distal end of the previously placed Thoraflex Hybrid device via a retrograde approach. This may be part of the same or a two-stage procedure.

Exclusion Criteria
  • Patient has any medical, social, or psychological problems that in the opinion of the investigator preclude them from receiving this treatment and the procedures and evaluations pre and post procedure.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Primary Safety Endpoint is a composite of the following:The primary safety endpoint will be measured again at least 8 months after the (first) extension procedure.

* Permanent disabling stroke (mRS \>2 and an increase in at least one mRS category from the individual's pre-stroke baseline, occurring within 30 days of either index procedure or extension and present at 1-year follow-up)\*

* Grade 3 spinal cord ischemia (SVS reporting standards) occurring within 30 days of either index procedure or extension

* All-cause mortality (within 1 year of either procedure) (\*Per VARC-3, disability assessment using the mRS should be performed between 30 and 90 days after a neurological event with 90 days being optimal. An increased mRS score by itself and in the absence of a neurological event does not constitute stroke.)

Primary Effectiveness Endpoint: Treatment SuccessThe primary effectiveness endpoint will be measured again at least 8 months after the (first) extension procedure.

Defined as device technical success (of either procedure) with absence of the following at 1-year:

* Lesion-related mortality (defined as all deaths occurring within 30 days of, or, prior to discharge, from either the index procedure or the extension procedure or any revision procedures to treat the original lesion(s) and any other deaths adjudicated by Clinical Events Committee as related or probably related to the lesion(s))

* Aortic rupture in the treated segment

* Lesion expansion (≥5mm increase from measurement at discharge/within 30 days)

* Secondary intervention to address the following:

* Stent graft-induced aortic wall injury (SAWI)

* Fistula

* Type I or III endoleak

* Migration

* Loss of Patency

* Thromboembolic events

* Failure of integrity

Secondary Outcome Measures
NameTimeMethod
Secondary effectiveness endpoints will be reportedThe secondary endpoints will be measured at each follow-up timepoint from discharge/30 days through to 10 years.

* Any aortic rupture (treated and untreated segments)

* Aortic remodeling in the treated segment(s)

* New dissections

* Proximal and distal extension of dissections

* Any false lumen perfusion (specifying location and if intentional or not)

* Fistula formation

* All endoleaks

* Device migration (measure both \>5mm from position at discharge/within 30 days, and \>10 mm from position at discharge/within 30 days, and requiring secondary intervention)

* Device integrity issues (e.g., stent fracture)

* All thromboembolic events

* Pseudoaneurysms (device-related)

* Secondary Interventions

* Graft patency (loss of patency will be defined as an opening of \<50% due to, for example, occlusion, stenosis, kinking)

Secondary Safety Endpoints, Absence of the followingThe secondary endpoints will be measured at each follow-up timepoint from discharge/30 days through to 10 years.

* All-cause mortality, and

* Lesion-related mortality (defined as all deaths occurring within 30 days of, or, prior to discharge, from either the index procedure or the extension procedure or any revision procedures to treat the original lesion(s) and any other deaths adjudicated by Clinical Events Committee as related or probably related to the lesion(s))

* All/any paraplegia/paraparesis defined as SCI (SVS grades 1 to 3)

* Any stroke (excluding TIA)

* Incidence of Myocardial Infarction

* Incidence of Respiratory Failure

* Incidence of Renal Failure

* Incidence of Bowel Ischemia

Trial Locations

Locations (25)

University of Alabama in Birmingham Medical Center

🇺🇸

Birmingham, Alabama, United States

Cedars-Sinai Medical Centre

🇺🇸

Los Angeles, California, United States

Keck Medical Centre of USC

🇺🇸

Los Angeles, California, United States

University of Colorado

🇺🇸

Aurora, Colorado, United States

Hartford Hospital

🇺🇸

Hartford, Connecticut, United States

Medstar Washington Hospital Centre

🇺🇸

Washington, District of Columbia, United States

Northwestern University

🇺🇸

Chicago, Illinois, United States

Ascension St. Vincent Heart Center

🇺🇸

Indianapolis, Indiana, United States

University of Maryland

🇺🇸

Baltimore, Maryland, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

UPMC Presbyterian

🇺🇸

Pittsburgh, Pennsylvania, United States

Washington University/Barnes Jewish Hospital

🇺🇸

St. Louis, Missouri, United States

Weill Cornell medicine

🇺🇸

New York, New York, United States

Duke University Medical Centre

🇺🇸

Durham, North Carolina, United States

University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

UT Dell Medical / Ascension Texas Cardiovascular

🇺🇸

Austin, Texas, United States

Baylor College of Medicine - St. Luke's

🇺🇸

Houston, Texas, United States

University of Utah

🇺🇸

Salt Lake City, Utah, United States

Paracelsus Medical University

🇦🇹

Salzburg, Austria

CHU Nantes

🇫🇷

Saint-Herblain, France

CHU de Toulouse - Hôpital de Rangueil

🇫🇷

Toulouse, France

University of Freiburg

🇩🇪

Freiburg, Germany

Policlinico Di S.Orsola, Universita' Di Bologna

🇮🇹

Bologna, Italy

Hospital Clinic of Barcelona

🇪🇸

Barcelona, Spain

Oxford University Hospitals NHS FT

🇬🇧

Oxford, United Kingdom

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