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[Zkušební verze zařízení, které není schváleno nebo schváleno americkým FDA] (ARCH)

25. srpna 2026 aktualizováno: C. R. Bard
The objective of the study is to assess the safety and effectiveness of the BD Liverty™ TIPS Stent Graft for the treatment of the complications of portal hypertension from cirrhosis. This includes recurrent or refractory ascites, hepatic hydrothorax, and/or variceal bleeding (esophageal and/or gastric).

Přehled studie

Postavení

Aktivní, ne nábor

Detailní popis

This is a prospective, multi-center, single-arm study designed to assess the safety and effectiveness of the BD Liverty™ TIPS Stent Graft for the treatment of the complications of portal hypertension. Safety and effectiveness measures for subjects receiving the BD Liverty™ TIPS Stent Graft will be compared to a Performance Goal (PG) derived from published literature.

Typ studie

Intervenční

Zápis (Aktuální)

177

Fáze

  • Nelze použít

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní místa

      • Chambray-lès-Tours, Francie, 37170
        • Centre Hospitalier Régional Universitaire de Tours
      • Dijon, Francie, 21079
        • CHU Dijon Bourgogne
      • Lyon, Francie, 69002
        • Hospices Civils de Lyon
      • Berlin, Německo, 13353
        • Charité-Universitätsmedizin Berlin
      • Bonn, Německo, 53127
        • Universitatsklinikum Bonn
      • Dresden, Německo, 01307
        • Universitätsklinikum Carl Gustav Carus Dresden
      • Frankfurt, Německo, 60590
        • University Hospital Frankfurt
      • Hanover, Německo, 30625
        • Medizinische Hochschule Hannover
      • Münster, Německo, 48149
        • Westfälische Wilhelms-Universität
    • California
      • Palo Alto, California, Spojené státy, 94305
        • Stanford University
    • District of Columbia
      • Washington D.C., District of Columbia, Spojené státy, 20007
        • Georgetown University
    • Indiana
      • Indianapolis, Indiana, Spojené státy, 46202
        • Trustees of Indiana University ("IU")/ Indiana University Health, Inc.
    • Kansas
      • Kansas City, Kansas, Spojené státy, 66160
        • University of Kansas Medical Center Research Institute, Inc.
    • Massachusetts
      • Boston, Massachusetts, Spojené státy, 02215
        • Beth Israel Deaconess Medical Center, Inc.
      • Boston, Massachusetts, Spojené státy, 02114
        • The General Hospital Corporation d/b/a Massachusetts General Hospital
    • Missouri
      • St Louis, Missouri, Spojené státy, 63110
        • Washington University - Mallinckrodt Institute of Radiology
    • New Jersey
      • Newark, New Jersey, Spojené státy, 07103
        • Rutgers, The State University of New Jersey
    • New York
      • New York, New York, Spojené státy, 10029
        • Icahn School of Medicine at Mount Sinai
      • New York, New York, Spojené státy, 10032
        • The Trustees of Columbia University in the City of New York
    • North Carolina
      • Charlotte, North Carolina, Spojené státy, 28203
        • Charlotte Radiology
    • Ohio
      • Cleveland, Ohio, Spojené státy, 44195
        • Cleveland Clinic Foundation
    • Pennsylvania
      • Philadelphia, Pennsylvania, Spojené státy, 19125
        • University of Pennsylvania
    • Texas
      • San Antonio, Texas, Spojené státy, 78229
        • The University of Texas Health Science Center at San Antonio
    • Utah
      • Salt Lake City, Utah, Spojené státy, 84112
        • University of Utah
    • Virginia
      • Charlottesville, Virginia, Spojené státy, 22903
        • University of Virginia
    • Wisconsin
      • Milwaukee, Wisconsin, Spojené státy, 53226
        • Medical College of Wisconsin / Froedtert Hospital

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

  • Dospělý
  • Starší dospělý

Přijímá zdravé dobrovolníky

Ne

Popis

Inclusion Criteria:

In order to be eligible to participate in this study, an individual must meet all of the following criteria:

  1. The subject must voluntarily sign and date the approved Informed Consent Form (ICF) prior to the conduct of any study-specific procedures including any procedure required to determine subject eligibility (apart from those conducted as part of the subject's routine clinical management).
  2. The subject must be ≥18 years of age with a life expectancy of ≥12 months to allow for adequate completion of study procedures and collection of data.
  3. The subject must be willing and able to comply with protocol requirements, including all study visits and procedures.
  4. The subject must have a diagnosis of portal hypertension from cirrhosis with at least one of the following indications for de novo TIPS creation including:

    1. Recurrent, or Refractory Ascites (defined as ascites that cannot be mobilized or recurs after large volume paracentesis despite dietary sodium restriction and diuretic therapy)
    2. Hepatic Hydrothorax
    3. Esophageal Variceal Bleeding that is Endoscopically, Medically, or Balloon Tamponade-Controlled Esophageal Variceal Bleeding, or Recurrent Esophageal Variceal Bleeding
    4. Gastric Variceal Bleeding that is Endoscopically, Medically, or Balloon Tamponade-Controlled Gastric Variceal Bleeding, or Recurrent Gastric Variceal Bleeding
  5. The subject must have adequate functional hepatic reserve with a Model for End-Stage Liver Disease (MELD) Score of ≤18 or Child-Pugh Score of ≤12.
  6. The subject must have a platelet count of ≥50,000/microliter (with correction, if needed), as determined by the most recent pre-treatment laboratory tests performed within 7 days prior to treatment (Index Procedure).

Note: If multiple lab tests are performed within 7 days prior to the date of Index Procedure, the most recent results must demonstrate eligibility.

Exclusion Criteria:

Subjects are excluded from the study if any of the following criteria apply:

  1. The subject is pregnant. Subjects of child-bearing potential must have a negative pregnancy test (urine or serum).
  2. The subject has undergone prior transcatheter procedures for the treatment of complications from portal hypertension (e.g., TIPS, surgical shunt creation, peritoneovenous shunt, retrograde transvenous obliteration (-RTO)). Note: Subjects with variceal bleeding that have undergone -RTO at least 8 weeks prior to the planned Index Procedure may be enrolled.
  3. The subject has undergone prior stent or stent graft placement in the hepatic vein, portal vein and/or inferior vena cava (IVC).
  4. The subject is hemodynamically unstable with uncontrolled bleeding.
  5. The subject has hepatic and/or portal vein thrombosis (PVT). Note: Subjects with partial non-flow-limiting, non-malignant PVT may be enrolled.
  6. The subject has undergone prior liver transplant or is a current transplant candidate that is likely to undergo liver transplant within 6 months of enrollment.
  7. The subject has extrahepatic or hepatic malignancy or a history of previous hepatic malignancy, unless treated curatively ≥5 years prior to enrollment.
  8. The subject has overt (West Haven Criteria Grade ≥2), controlled or uncontrolled hepatic encephalopathy.
  9. The subject has any of the following medical conditions contraindicated to placement of TIPS:

    1. Congestive Heart Failure or Pulmonary Edema
    2. Severe Tricuspid Regurgitation
    3. Elevated Right or Left Heart Pressures
    4. Polycystic Liver Disease
    5. Moderate or Severe Pulmonary Hypertension or Severe Hepatopulmonary Syndrome
    6. Uncontrolled Systemic Infection or Sepsis
    7. Unrelieved Biliary Obstruction
    8. Acute Kidney Injury, Renal Failure, or Dialysis
    9. Uncontrolled Blood Coagulation/Bleeding Disorder
  10. The subject has a known allergy, intolerance, or condition (e.g., allergy to contrast media/narcotics/sedatives, bleeding diathesis, or severe peripheral arterial disease) that cannot be adequately pre-treated and would preclude angiography or selective catheterization.
  11. The subject has a known allergy or hypersensitivity to any of the device materials including nickel-titanium (nitinol) or tantalum.
  12. The subject is taking a medication or has another medical condition, which, in the opinion of the Investigator, would preclude safe treatment with the BD Liverty™ TIPS Stent Graft, may cause the subject to be non-compliant with the protocol, or may confound the data interpretation.
  13. The subject is currently participating in an investigational drug or another device study that has not completed the study treatment or that clinically interferes with the study endpoints. Note: Studies requiring extended follow-up visits for products that were investigational, but have since become commercially available, are not considered investigational studies.

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Léčba
  • Přidělení: N/A
  • Intervenční model: Přiřazení jedné skupiny
  • Maskování: Žádné (otevřený štítek)

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Experimentální: Subjects
Subjects that are treated with the BD Liverty™ TIPS Stent Graft
Treatment of portal hypertension complications with placement of the BD Liverty™ TIPS Stent Graft after creation of a Transjugular Intrahepatic Portosystemic Shunt.
Ostatní jména:
  • TIPY

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Freedom from Major Complications through 30 days post-Index Procedure
Časové okno: 30 days

The primary safety endpoint is Freedom from Major Complications through 30 days post-Index Procedure.

Major complications are defined as:

The following Adverse Events (if determined to be related to the device and/or procedure and to meet the definition of a Serious Adverse Event (SAE)):

  • Accelerated Liver Failure
  • Biliary Peritonitis
  • Caval Occlusion
  • Death
  • Hemobilia
  • Hemoperitoneum
  • Hepatic Artery Injury
  • Hepatic Infarction
  • Radiation Skin Burn
  • Renal Failure
  • Severe Hepatic Encephalopathy
  • Vascular Perforation (resulting from stent graft malposition due to excessive extension of the stent graft into the inferior vena cava or the right atrium)

The following Device Deficiencies, if having the potential to or if confirmed to have led to a Serious Adverse Event (SAE):

o Stent Migration (within the portal or systemic venous circulations resulting from stent graft malposition)

30 days
Freedom from Shunt Dysfunction through 6 months post-Treatment Completion
Časové okno: 6 months
The primary effectiveness endpoint is Freedom from Shunt Dysfunction through 6-months post-Treatment Completion. Shunt Dysfunction is defined as the proportion of subjects free from both a >50% reduction of the lumen of the stent (confirmed by direct shunt venography for subjects with suspected shunt dysfunction) and a PSG greater than the PSG achieved post-TIPS Index Procedure. Treatment Completion is defined as the latter to occur of (i) completion of the Index Procedure and (ii) if performed, the Tailored Expansion Procedure (TEP).
6 months

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Technical Success
Časové okno: Index Procedure
Technical Success, defined as the successful creation of a BD Liverty™ TIPS Stent Graft lined shunt between the hepatic vein and a branch of the portal vein, as assessed by the Investigator during the Index Procedure.
Index Procedure
Hemodynamic Success
Časové okno: Index Procedure
Hemodynamic Success, defined as the successful post-TIPS reduction of the portosystemic gradient (PSG) to an Investigator-determined target of ≤12 mmHg or by ≥50% from the baseline PSG, as assessed by the Investigator during the Index Procedure.
Index Procedure
Clinical Success for subjects with Recurrent or Refractory Ascites
Časové okno: 3, 6, 12, 18, and 24 months post-Treatment Completion
Clinical Success for subjects with recurrent or refractory ascites through 3, 6, 12, 18, and 24 months post-Treatment Completion, defined as freedom from large volume paracentesis (LVP) of >5L occurring >6 weeks post-Treatment Completion.
3, 6, 12, 18, and 24 months post-Treatment Completion
Clinical Success for subjects with Hepatic Hydrothorax
Časové okno: 3, 6, 12, 18, and 24 months post-Treatment Completion
Clinical Success for subjects with hepatic hydrothorax through 3, 6, 12, 18, and 24 months post-Treatment Completion, defined as freedom from thoracentesis of >1L occurring >6 weeks post-Treatment Completion.
3, 6, 12, 18, and 24 months post-Treatment Completion
Clinical Success for subjects with Esophagogastric Variceal Re-Bleeding
Časové okno: 3, 6, 12, 18, and 24 months post-Treatment Completion
Clinical Success for subjects with esophagogastric variceal bleeding through 1, 3, 6, 12, 18, and 24 months post-Treatment Completion, defined as freedom from endoscopically-confirmed esophagogastric variceal re-bleeding.
3, 6, 12, 18, and 24 months post-Treatment Completion
Freedom from Shunt Re-Intervention
Časové okno: 1, 3, 6, 12, 18, and 24 months post-Treatment Completion
Freedom from Shunt Re-Intervention through 1, 3, 6, 12, 18, and 24 months post-Treatment Completion.
1, 3, 6, 12, 18, and 24 months post-Treatment Completion
Freedom from Hepatic Encephalopathy of Grade ≥3 per West Haven Criteria
Časové okno: 1, 3, 6, 12, 18, and 24 months post-Treatment Completion
Freedom from Hepatic Encephalopathy of Grade ≥3 per West Haven Criteria through 1, 3, 6, 12, 18, and 24 months post-Treatment Completion.
1, 3, 6, 12, 18, and 24 months post-Treatment Completion
Liver Transplant-Free Survival
Časové okno: Through 24 months
Liver Transplant-Free Survival post-Index Procedure, defined as the proportion of subjects with freedom from death from any cause and from liver transplantation.
Through 24 months
Overall Survival
Časové okno: Through 24 months
Overall Survival post-Index Procedure, defined as the proportion of subjects with freedom from death from any cause.
Through 24 months
Health-Related Quality of Life (HRQoL) Questionnaire
Časové okno: 1, 3, 6, 12, 18, and 24 months post-Treatment Completion
Health-Related Quality of Life (HRQoL) at Screening and at 1, 3, 6, 12, 18, and 24 months post-Treatment Completion, as measured by PROMIS-29 Profile v2.1.
1, 3, 6, 12, 18, and 24 months post-Treatment Completion
Freedom from Shunt Dysfunction
Časové okno: 1, 3, 12, 18, and 24 months post-Treatment Completion
Freedom from Shunt Dysfunction through 1, 3, 12, 18, and 24 months post-Treatment Completion. Shunt Dysfunction is defined as the proportion of subjects free from both a >50% reduction of the lumen of the stent (confirmed by direct shunt venography for subjects with suspected shunt dysfunction) and a PSG greater than the PSG achieved post-TIPS Index Procedure.
1, 3, 12, 18, and 24 months post-Treatment Completion

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Sponzor

Vyšetřovatelé

  • Vrchní vyšetřovatel: Ziv Haskal, M.D., University of Virginia

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Aktuální)

8. srpna 2023

Primární dokončení (Aktuální)

23. června 2025

Dokončení studie (Odhadovaný)

11. ledna 2027

Termíny zápisu do studia

První předloženo

19. ledna 2023

První předloženo, které splnilo kritéria kontroly kvality

31. ledna 2023

První zveřejněno (Aktuální)

3. února 2023

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

27. srpna 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

25. srpna 2026

Naposledy ověřeno

1. června 2026

Více informací

Termíny související s touto studií

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ne

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ano

Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .

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