Nobles Medical Technology II has received FDA approval to restart its pivotal NobleStitch clinical trial, marking a significant milestone in the development of the first device-free, suture-mediated system for closing patent foramen ovale (PFO) to reduce recurrent cryptogenic stroke. The announcement on October 7, 2025, follows the company's proactive decision to pause the trial to ensure enhanced safety standards and scientific rigor.
Clinical Trial Resumption and Timeline
The clinical trial, originally designed to evaluate the safety and efficacy of the NobleStitch EL system for PFO closure, was voluntarily paused by Chairman and CEO Dr. Anthony Nobles. "We paused the trial to make a more robust protocol and data collection," Nobles explained. The company expects to resume patient enrollment in Q4 2025 and anticipates submitting a Pre-Market Approval (PMA) application upon completion of the pivotal study.
The trial has expanded its clinical network with the addition of Rush University Medical Center as a new clinical site, under the direction of Dr. Josh Murphy, described as a leading expert in PFO closure.
Technology and Clinical Rationale
The NobleStitch EL system leverages a proprietary percutaneous suturing technique to close intracardiac defects without leaving behind a permanent device. This approach may reduce complications associated with conventional metal mesh occluders, including nickel hypersensitivity and late device-related adverse events.
The FDA's approval to restart the trial follows the recent publication of a pivotal peer-reviewed study in the Journal of the American College of Cardiology: Advances in September 2025. According to the company, the findings demonstrate strong clinical rationale for suture-based closure strategies and reinforce the unique potential of the NobleStitch technology to establish new standards of care by eliminating permanent implants, reducing metal and nickel exposure, and expanding long-term patient safety.
Regulatory Status and Market Position
The NobleStitch EL system is currently FDA cleared in the USA for cardiovascular suturing and CE marked in the EU for cardiovascular suturing PFO closure. The technology is covered by several US and international patents and represents what the company positions as the first device-free alternative for structural heart defects.
"This decision reflects confidence in our technology, our trial design, and our commitment to advancing safer, more effective solutions for patients suffering from cryptogenic stroke and other PFO-related conditions," said Dr. Nobles. "The recently published data validates what we have long believed—that a suture-mediated, non-implant approach represents the future of PFO closure."
Company Background
NobleStitch is manufactured and distributed by HeartStitch, Inc., which serves as the exclusive global distributor for the patented suture-mediated cardiovascular closure system. Nobles Medical Technology II positions itself as a pioneering leader in innovative cardiovascular closure solutions, committed to advancing patient care through innovation.
