Clinical Trial: Endovascular Repair of Descending ThoracoAbdominal Aortic Pathologies Using Physician Modified Endovascular Prosthesis

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional

Official Title: Proposed Single Center Investigational Device Exemption: Endovascular Repair of Descending ThoracoAbdominal Aortic Pathologies Using Physician Modified Endovascular Prosthesis

Brief Summary: This is an early feasibility study that investigates the outcome of selected patients with complex thoracoabdominal aortic lesions who are suitable for endovascular (within the vessel) repair with a physician-modified Medtronic Thoracic Valiant stent graft. The Medtronic Valiant System includes a Valiant Thoracic Stent Graft, a self-expanding, tubular end prosthesis which is modified/customized by the Investigators to fit the patient's anatomy. The device is constructed by making a taper in the larger proximal thoracic device and attaching it to a smaller distal thoracic device. The Viabahn branches for the visceral vessels are sutured to holes made in the tapered section. The modified Valiant stent graft is advanced to the lesion site endoluminally via the iliac/femoral artery. Access for delivery of extensions to the device will be delivered through the left subclavian artery. Upon deployment, the stent graft self-expands at the target location, where it is designed to exclude the lesion by restoring blood flow through the stent graft lumen.

Detailed Summary: The study will be conducted with non-surgical or very high-risk patients who are considered suitable candidates for endoluminal repair and who are diagnosed with a Type IV complex thoracoabdominal aortic lesion. The total number of enrolled subjects is planned to be 15. It is a prospective evaluation of patients receiving the device to determine the proportion in whom successful implantation is achieved, as indicated by exclusion of the thoracic lesion and graft patency at implant, time of discharge, and 1, 6, and 12 months following implantation, and to determine the proportion of patients who die or experience adverse events during and after the implantation. Furthermore, the percentage of patients in whom technical and clinical success is achieved, will be determined. Patients will be followed for 5 years after the surgery in which the stent graft is implanted.
Sponsor: Rodney A. White, M.D.

Current Primary Outcome:

  • All cause mortality [ Time Frame: 30 days post intervention ]
    Early (at 30-days) death
  • Additional endovascular procedure [ Time Frame: At 30 days ]
    Re-intervention
  • Conversion to open repair [ Time Frame: At 30 days ]
    Surgical conversion
  • Stroke [ Time Frame: At 30 days ]
  • All cause mortality [ Time Frame: At 1 year post procedure ]
  • Additional endovascular procedure [ Time Frame: At 1 year ]
    Re-intervention
  • Conversion to open repair [ Time Frame: At 1 year ]
    Surgical conversion


Original Primary Outcome:

  • All cause mortality [ Time Frame: 30 days post intervention ]
    Early (at 30-days) death
  • Additional endovascular procedure [ Time Frame: At 30 days ]
    Re-intervention
  • Conversion to open repair [ Time Frame: At 30 days ]
    Surgical conversion
  • Stroke [ Time Frame: At 30 days ]
  • All cause mortality [ Time Frame: At 1 year post procedure ]
  • Additional endovascular procedure [ Time Frame: At 1 year ]
    Re-intervention
  • Conversion to open repair [ Time Frame: At 1 year ]
    Surigical conversion


Current Secondary Outcome:

  • Vessel complications [ Time Frame: Up to 5 years post intervention ]
    Includes dissection, thrombosis, embolization of vessels, malperfusion of branch vessels
  • Technical observations [ Time Frame: Up to 5 years post intervention ]
    Includes loss of patency, endoleaks, twisting, kinking, fracture of stent graft, migration and separation of components
  • Composite of myocardial infarction, organ failure, sepsis [ Time Frame: Up tp 5 years post intervention ]


Original Secondary Outcome: Same as current

Information By: Los Angeles Biomedical Research Institute

Dates:
Date Received: July 31, 2015
Date Started: July 2015
Date Completion: July 2025
Last Updated: February 6, 2017
Last Verified: September 2016