- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04434729
Fetal Treatment of Galenic Malformations
December 27, 2023 updated by: Darren Orbach
This is a prospective, single-arm non-randomized interventional study of fetuses to assess the safety and efficacy of fetal embolization of Vein of Galen Malformation (VOGM).
Subjects will receive a one-time study intervention of fetal embolization.
Follow-up assessments will be collected every 4 weeks until delivery, as per standard of care.
After delivery, neurological assessments will be performed every 6 months for 2 years (adjusted for gestational age).
Data will be compared to historical cohorts.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Detailed Description
The study involves a single fetal intervention of maternal transuterine, fetal transcranial torcular puncture and median prosencephalic vein embolization.
Detachable platinum coils (Target XL and XXL Detachable Coil, Stryker Neurovascular) will be used to pack the prosencephalic varix.
This procedure will take place in an obstetric OR at Brigham and Women's Hospital.
Data will be collected every 4 weeks post-procedure until delivery, as per standard of care.
Data regarding delivery and post-delivery status will also be collected until the subject is discharged from the hospital.
After delivery, neurological assessments will be performed every 6 months for 2 years (adjusted for gestational age).
Data will be compared to historical cohorts.
Study Type
Interventional
Enrollment (Estimated)
20
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Darren Orbach, MD PhD
- Phone Number: 617-355-5012
- Email: Darren.Orbach@childrens.harvard.edu
Study Locations
-
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Massachusetts
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Boston, Massachusetts, United States, 02115
- Recruiting
- Boston Children's Hospital
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Contact:
- Darren Orbach, MD PhD
- Phone Number: 617-355-5012
- Email: Darren.Orbach@childrens.harvard.edu
-
Principal Investigator:
- Darren Orbach, MD PhD
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Pregnant woman carrying a fetus harboring a vein of Galen malformation in whom the straight sinus or falcine sinus draining the prosencephalic varix measures 7 mm or more on fetal MRI (medio-lateral diameter measured at the narrowest point of the sinus along the rostral-caudal axis, assessed on a T2-weighted coronal slice).
- Fetal gestational age between 23 weeks and term as determined by clinical information and evaluation of first ultrasound.
- Anatomic diagnosis of fetal vein of Galen malformation.
- Well preserved brain parenchyma.
- Maternal age of 18 years and older.
- Eligible for continuous lumbar epidural anesthesia.
- Able to travel to study site for study evaluation, procedures and visits.
Exclusion Criteria:
- Extensive fetal brain parenchymal injury/gliosis, >10% of supratentorial brain volume (i.e., SFP presentation). This is a degree of fetal brain injury beyond which the risk of significant neurological morbidity is high, based on studies of prenatal ischemic stroke.
- Irreversible fetal non-brain organ injury (e.g. hydrops fetalis as a manifestation of heart failure, a finding which portends fatal outcome in fetuses with vein of Galen malformation), i.e., SFP presentation.
- Fetus with VOGM in whom the straight sinus or falcine sinus draining the prosencephalic varix measures less than 8 mm on fetal MRI (T2-weighted coronal slice, medio-lateral diameter measured at the narrowest point of the sinus along the anterior-posterior axis), fitting fetal MRI criteria for likely evolution into the IT cohort.
- Severe maternal obesity pre-pregnancy as defined by body mass index (BMI) of 40 or greater.
- Fetuses with major congenital anomalies.
- Evidence of preterm labor, rupture of membranes or abruption.
- Maternal coagulopathy: INR > 1.2; PT/PTT above normal ranges for the lab; platelets <100.
- Medical disease requiring current anticoagulation including maternal deep vein thrombosis.
- Prior maternal medical history that would preclude epidural anesthesia.
- Multi-fetal pregnancy.
- Placenta previa or accreta.
- Participation in another fetal study that influences maternal and fetal morbidity and mortality.
- Known maternal hypersensitivity to 316LM stainless steel.
- Supine hypotensive syndrome.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Fetal embolization of vein of Galen malformation
This is a single-arm study.
Fetal subjects will undergo a one-time intervention of fetal embolization of vein of Galen malformation.
|
The study involves a single fetal intervention of maternal transuterine, fetal transcranial torcular puncture and median prosencephalic vein embolization.
Detachable platinum coils (Target XL and XXL Detachable Coil, Stryker Neurovascular) will be used to pack the prosencephalic varix.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Prenatal safety of fetal embolization for patients with vein of Galen malformations
Time Frame: From fetal embolization to delivery
|
The procedure is deemed safe if
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From fetal embolization to delivery
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Efficacy of fetal embolization for patients with vein of Galen malformations
Time Frame: Within 30 days of birth
|
The procedure is deemed efficacious if none of the following serious postnatal events occur within 30 days of birth:
|
Within 30 days of birth
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Darren Orbach, MD PhD, Boston Children's Hospital
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
September 30, 2022
Primary Completion (Estimated)
December 1, 2025
Study Completion (Estimated)
December 1, 2027
Study Registration Dates
First Submitted
June 13, 2020
First Submitted That Met QC Criteria
June 13, 2020
First Posted (Actual)
June 17, 2020
Study Record Updates
Last Update Posted (Estimated)
January 3, 2024
Last Update Submitted That Met QC Criteria
December 27, 2023
Last Verified
December 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Cardiovascular Diseases
- Vascular Diseases
- Cerebrovascular Disorders
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Cardiovascular Abnormalities
- Nervous System Malformations
- Vascular Malformations
- Intracranial Arterial Diseases
- Arteriovenous Malformations
- Central Nervous System Vascular Malformations
- Intracranial Arteriovenous Malformations
- Congenital Abnormalities
- Vein of Galen Malformations
Other Study ID Numbers
- IRB-P00034727
- 2020P000216 (Other Identifier: Partners Healthcare IRB)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
Yes
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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