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Management of Complex Airway Stenoses With Dedicated Tailored Stents Wrought by 3D Computer-assisted Conception (DASCAS)

4. november 2020 opdateret af: University Hospital, Toulouse

Management of complex airway stenoses with dedicated tailored stents wrought by 3D computer-assisted conception

Dedicated Airway Stents for Central Airway Stenoses

DASCAS

Toulouse University Hospital is the sponsor of this research.

This research will be conducted with the support of AnatomikModeling and ADERSPOT

  • Background: Tracheobronchial stent are devices designed to manage central airway stenoses of various origins. Their shape and sizes are however not suitable for stenosis of complex anatomy.
  • Purpose: The investigators propose to test the feasibility and safety of treating complex airway stenoses with dedicated tailored stents wrought by 3D computer-assisted conception

Abstract: Central airway obstruction is currently managed with non-personalized stents, which are usually efficient but lead to severe and potentially lethal complications in 10% of cases (stent migration, obstructive granuloma, perforation, hemoptysis). These stents seem particularly unsuited for anatomically complex stenosis.

Dedicated airway stents (wrought and tailored by 3D computer-assisted conception based on 3D chest CT-scan), by fitting perfectly tracheal or bronchial anatomy, should dramatically improve the tolerance and safety of such prostheses.

This first feasibility study, dedicated to patients suffering from anatomically complex stenosis will test the safety of treating patients with these new approach. It should lead to larger studies evaluating these new types of stents in larger indications.

After 3D computer-assisted modelization of airways, a virtual prosthesis and its shape are designed and the shape of the stent is wrought by 3D-machining by AnatomikModeling®. The stent is then build and sterilized by Sebbin® and inserted during rigid bronchoscopy on the same terms as pre-existing models.

Close follow up is then conducted, including clinical evaluation after one week, three and six months; spirometry at one week and 6 months and chest CT-scan at one week.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Study design: Prospective monocentric feasibility study

Arm number or label and arm type: Only one experimental arm

Interventions:

After signature of a informed consent

Collection of clinical data (age, sex, etiology, site and mechanism of the stenosis, previous treatments dyspnea, quality of life (VQ11 questionnaire))

Chest CT-scan without contrast under continuous positive pressure

Spirometry (peak flow, FEV1)

Computer-assisted modelization of the shape of the prosthesis using 3D reconstruction of CT-scan

Machining of the shape in Ertacetal® (AnatomikModeling®)

Fabrication and sterilization of the stent in silicon (Sebbin®)

Insertion of the stent under rigid bronchoscopy and general anesthesia

Clinical follow-up at one week, 3 months and 6 months

Chest CT-scan without contrast at 1 week, spirometry at 1 week and 6 months

Number of subjects : 10 patients

Statistical analysis:

For the primary outcome, percentages of procedures conducted without complication at 1 week, 3 months, and 6 months and their confidence interval at 95% and incidences at 1 week, 3 months and 6 months for each complication will be calculated.

For secondary outcomes:

  • Percentages of procedures conducted with improvement of dyspnea (improvement of at least one point of NYHA score) at 1 week, 3 months, and 6 months and their confidence interval at 95% will be calculated.
  • Percentages of procedures conducted with improvement of quality of life (improvement of at least 10% of VQ11 score) at 1 week, 3 months, and 6 months and their confidence interval at 95% will be calculated.
  • Percentages of procedures conducted with improvement of functional parameters (improvement of at least 20% of DEP or FEV1) at 1 week and 6 months and their confidence interval at 95% will be calculated.
  • Percentage of procedures conducted with radiologic congruence of the stent at 1 week and its confidence interval at 95% will be calculated.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

10

Fase

  • Ikke anvendelig

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Age > 18 years
  • Signature of the informed consent form
  • Patient with a complex upper airway stenosis .
  • Symptomatic stenosis ( Dyspnea > NYHA II , cough, PEF < 50%)
  • Stenosis whose complex anatomy does not allow the establishment of a currently available stent on the market: the assessment of the experts ( consensus decision between 3 bronchoscopistes of interventional endoscopy service) or after failure of one or several models.
  • Affiliated with a social security scheme

Exclusion Criteria:

  • Indication of implementation of emergency aid : signs of acute respiratory distress , PEF < 20 % predicted , SpO2 oxygen saturation <90 % on room air
  • Contraindication to rigid bronchoscopy (severe coagulation disorders not correct )
  • Patient under legal protection system
  • Pregnancy
  • Breastfeeding

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: new 3D device
dedicated tailored stents wrought by 3D computer-assisted conception
Enhed: new 3D device
dedicated tailored stents wrought by 3D computer-assisted conception

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change of percentage of procedures conducted without complications at 1 week , 3 months and 6 months
Tidsramme: Change of percentage of procedures conducted without complications at 1 week, 3 months and 6 months
percentages of procedures conducted without complication at 1 week, 3 months and 6 month and their confidence interval at 95% and incidences at 1 week, 3 months and 6 months for each complication will be calculated.
Change of percentage of procedures conducted without complications at 1 week, 3 months and 6 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

University Hospital, Toulouse

Efterforskere

  • Ledende efterforsker: Nicolas Guibert, Dr, University Hospital, Toulouse

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. september 2016

Primær færdiggørelse (Faktiske)

1. december 2019

Studieafslutning (Faktiske)

1. november 2020

Datoer for studieregistrering

Først indsendt

19. juli 2016

Først indsendt, der opfyldte QC-kriterier

30. august 2016

Først opslået (Skøn)

5. september 2016

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

6. november 2020

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

4. november 2020

Sidst verificeret

1. november 2020

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • RC31/15/7860

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Obstruktiv luftvejssygdom

Kliniske forsøg med new 3D device

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Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

CROs by country

CROs in Poland

Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

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