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【米国FDAの承認・認可を受けていない機器のトライアル】 (ARCH)

2026年8月25日 更新者：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).

調査の概要

状態

積極的、募集していない

条件

介入・治療

詳細な説明

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.

研究の種類

介入

入学 (実際)

177

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

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

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 大人
  • 高齢者

健康ボランティアの受け入れ

いいえ

説明

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.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか？

デザインの詳細

  • 主な目的：処理
  • 割り当て：なし
  • 介入モデル：単一グループの割り当て
  • マスキング：なし（オープンラベル）

武器と介入

参加者グループ / アーム
介入・治療
実験的：Subjects
Subjects that are treated with the BD Liverty™ TIPS Stent Graft
デバイス：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.
他の名前：
  • チップ

この研究は何を測定していますか？

主要な結果の測定

結果測定
メジャーの説明
時間枠
Freedom from Major Complications through 30 days post-Index Procedure
時間枠：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
時間枠：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

二次結果の測定

結果測定
メジャーの説明
時間枠
Technical Success
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

C. R. Bard

捜査官

  • 主任研究者：Ziv Haskal, M.D.、University of Virginia

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2023年8月8日

一次修了 (実際)

2025年6月23日

研究の完了 (推定)

2027年1月11日

試験登録日

最初に提出

2023年1月19日

QC基準を満たした最初の提出物

2023年1月31日

最初の投稿 (実際)

2023年2月3日

学習記録の更新

投稿された最後の更新 (実際)

2026年8月27日

QC基準を満たした最後の更新が送信されました

2026年8月25日

最終確認日

2026年6月1日

詳しくは

本研究に関する用語

キーワード

追加の関連 MeSH 用語

その他の研究ID番号

  • BDPI-20-004

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

はい

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。

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