- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04396041
Microvascular Plug (MVP) for the Treatment of Pulmonary ArterioVenous Malformations (PAVMs)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Transcatheter embolization has become the standard of care in the treatment of Pulmonary Arteriovenous Malformations (PAVMs). PAVM embolization is performed to prevent right to left shunting which puts patients at risk of stroke, brain abscess, hypoxia and even sudden death. Despite long procedure times, numerous coils that are often required to occlude a single PAVM and recanalization rates ranging from 5% to 15%, the most widely used embolic device is still the detachable coil delivered through a microcatheter. An alternative to coil embolization is the Amplatzer Vascular plug (AVP). AVPs allow for quick delivery of a single occluding device. AVPs, however, cannot be delivered through a microcatheter, limiting the AVPs' utility to larger PAVM with larger feeding arteries. The new MVPTM Micro Vascular Plug System (MVP, Medtronic) was designed to combine the best of both devices and allows for the occlusion of small vessels in a quick and predictable manner with a single embolic device through a micro catheter. At the investigators' institution the investigators have a very large PAVM practice, as the investigators are a large Hereditary Hemorrhagic Telangiectasia (HHT) center of excellence. Currently there is a paucity of data comparing these devices for the treatment of PAVMs. Specifically, there is little data to inform interventional radiologists' decision making process about which device to choose based on the patient's clinical characteristics, the size of the PAVM feeding artery, and cost.
The investigators will create a registry/database of all patients who undergo embolization for Pulmonary AVM at the investigators' HHT center of excellence collecting data and adding in data from the investigators' existing PAVM database dating back at least the last 7 years. Patients with MVP embolizations will be assessed and compared to patients who are embolized with other solid embolic devices (coils/plugs). The investigators will assess reperfusion rates, immediate technical success, procedural attributes including procedure time, fluoroscopy time, contrast administration, and finally embolic and overall procedural costs.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Contact
- Name: Clifford R Weiss, M.D.
- Phone Number: 410-614-0601
- Email: cweiss@jhmi.edu
Study Contact Backup
- Name: Tom Hemmingson, B.S.
- Phone Number: 410-955-6081
- Email: themmin1@jhmi.edu
Study Locations
-
-
Maryland
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Baltimore, Maryland, United States, 21287
- Recruiting
- Johns Hopkins University
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Undergoing embolization of Pulmonary Arteriovenous Malformation (PAVM)
Exclusion Criteria:
- PAVM unable to be embolized
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Other
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Patients treated for Pulmonary Arteriovenous Malformation
All participants in the study will be patients who have been treated for Pulmonary Arteriovenous Malformation using Microvascular Plugs, Amplatzer Vascular Plugs or Detachable coils.
|
Patient's Pulmonary AVM(s) treated via transcatheter embolization with Microvascular Plugs.
Patient's Pulmonary AVM(s) treated via transcatheter embolization with Amplatzer Vascular Plugs.
Patient's Pulmonary AVM(s) treated via transcatheter embolization with detachable coils.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Reperfusion Rates
Time Frame: Up to 3 Years
|
Analyzed at 1 year and 3 years.
Based on the investigators' preliminary data, reperfusion has been seen at 1-2 years in the patients the investigators have treated with coils and AVP making the 3-year goal for the investigators' prospective analysis feasible to cover reperfusion.
|
Up to 3 Years
|
Immediate post-procedural success
Time Frame: Immediately after procedure up to 5 minutes
|
Immediate post-procedural technical success defined as complete occlusion of the feeding artery supplying the PAVM.
|
Immediately after procedure up to 5 minutes
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Procedure duration
Time Frame: Up to 4 hours
|
Duration of procedure in minutes.
|
Up to 4 hours
|
Fluoroscopy time
Time Frame: Up to 4 hours
|
Fluoroscopy time measured in minutes.
|
Up to 4 hours
|
Contrast dose
Time Frame: Up to 4 hours
|
Contrast dose in mL.
|
Up to 4 hours
|
Cost of embolic device per PAVM
Time Frame: Up to 4 hours
|
The number of embolic used per procedure will be used to determine the cost per PAVM.
|
Up to 4 hours
|
Overall procedure cost for PAVM
Time Frame: Up to 1 week
|
Overall procedure cost for PAVM will be determined at 1 week after the procedure.
|
Up to 1 week
|
Radiation Dose Area Product (DAP)
Time Frame: Up to 4 hours
|
Radiation DAP measured in milligray-centimeters squared (mGy-cm^2).
|
Up to 4 hours
|
Cumulative Air Kerma (AK) dose
Time Frame: Up to 4 hours
|
Cumulative Air Kerma dose measured in milligray (mGy).
|
Up to 4 hours
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Cardiovascular Diseases
- Vascular Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Pathological Conditions, Anatomical
- Cardiovascular Abnormalities
- Neoplasms, Vascular Tissue
- Vascular Malformations
- Vascular Fistula
- Fistula
- Congenital Abnormalities
- Hemangioma
- Arteriovenous Malformations
- Arteriovenous Fistula
Other Study ID Numbers
- IRB00173822
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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