TAVR 中の塞栓予防のための F2 フィルターと送達システムの試験 (SHIELD)
A Prospective, Randomized, Multicenter, Single-blind Trial to Assess the Safety and Effectiveness of the Encompass F2 Cerebral Protection Catheter Vs. Unprotected Transfemoral Transcatheter Aortic Valve Replacement
The objective of this pivotal study is to compare the safety and effectiveness of the F2 CPC (Treatment group) to a Control group (no embolic protection) in participants undergoing transfemoral (TF) TAVR with commercially available devices.
調査の概要
状態
詳細な説明
The study is designed to demonstrate that the F2 CPC performs in a consistent manner as the control group in terms of safety, and the F2 Cerebral Protection Catheter (CPC) will be superior in performance when compared to the control group in terms of effectiveness in patients undergoing Transcatheter Aortic Valve Replacement (TF TAVR).
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前:Sandra Show
- 電話番号:7142928652
- メール:sshow@encompassf2.com
研究場所
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Florida
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Naples、Florida、アメリカ、34102
- まだ募集していません
- NCH Baker Hospital-Naples Heart Institute
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コンタクト:
- Kathy Byrd
- 電話番号:(239)624-8113
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主任研究者:
- Robert Cubeddu
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Indiana
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Indianappolis、Indiana、アメリカ、46260
- 募集
- St. Vincent Hospital
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主任研究者:
- James Hermiller, MD
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コンタクト:
- Kelly Verel
- 電話番号:317-338-8042
- メール:kelly.verel@ascension.org
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Michigan
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Detroit、Michigan、アメリカ、48202
- 募集
- Henry Ford Hospital
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主任研究者:
- Brian O'Neill, MD
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コンタクト:
- Stephen Krafchak
- 電話番号:313-972-4018
- メール:skrafch1@hfhs.org
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コンタクト:
- Sara Poggio, RN
- 電話番号:313-916-0119
- メール:spoggio1@hfhs.org
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Missouri
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Kansas City、Missouri、アメリカ、64111
- 募集
- St. Lukes Hospital Of Kansas City
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コンタクト:
- Caroline Kempter
- メール:ckempter@saint-lukes.org
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コンタクト:
- Anne Hoffman
- 電話番号:816-932-5707
- メール:ahoffman@saint-lukes.org
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New York
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New York、New York、アメリカ、10032
- 募集
- Cumc/Nyph
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コンタクト:
- Kate Dalton
- 電話番号:212-342-1820
- メール:keb2114@columbia.edu
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コンタクト:
- Treena Williams
- メール:taw2112@columbia.edu
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主任研究者:
- Torsten Vahl, MD
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Ohio
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Cleveland、Ohio、アメリカ、44195
- 募集
- Cleveland Clinic Foundation
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主任研究者:
- Amar Krishnaswamy, MD
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コンタクト:
- Emily Tylicki
- 電話番号:216-287-8237
- メール:TYLICKE@ccf.org
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Columbus、Ohio、アメリカ、43214
- まだ募集していません
- Ohio Health Research Institute (aka Riverside Methodist Hospital)
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主任研究者:
- Steven Yakubov, MD
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コンタクト:
- Christina Belcher
- 電話番号:614-813-4555
- メール:christina.belcher@ohiohealth.com
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コンタクト:
- Maureen McCormack
- 電話番号:(614) 788-3885
- メール:Maureen.McCormack@ohiohealth.com
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Virginia
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Charlottesville、Virginia、アメリカ、22903
- まだ募集していません
- University of Virginia Medical Center
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コンタクト:
- Linda Bailes Bryceland
- 電話番号:434-982-1058
- メール:LGS2M@uvahealth.org
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主任研究者:
- John Saxon
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Queensland
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Spring Hill、Queensland、オーストラリア、4000
- まだ募集していません
- St Andrews War Memorial Hospital
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コンタクト:
- Linda Pearce
- メール:linda.pearce@wesleyresearch.org.au
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主任研究者:
- Karl Poon, MD
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Victoria
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Clayton、Victoria、オーストラリア、3168
- 募集
- Monash Health Public
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主任研究者:
- Robert Gooley, MD
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コンタクト:
- Monique Farmer
- メール:monique.farmer@monashhealth.org
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Key Inclusion Criteria:
- Age ≥ 21 and ≤ 90 years
- Patient meets the established criteria and indications for commercially available TAVR (e.g., balloon expandable SAPIEN valve platform, self-expanding CoreValve platform, or Navitor TAVI System) via transfemoral access and is scheduled to undergo TAVR per their treating physician.
- Patient is willing and able to comply with protocol-specified follow-up evaluations.
- Patient is able and willing to provide written informed consent
Key Exclusion Criteria:
General Exclusion Criteria:
Participants are not eligible for the study if any of the following criteria are present:
General Exclusion Criteria:
- Requires an urgent or emergent TAVR procedure.
- Any interventional cardiovascular procedure performed within 30 days prior to TAVR procedure (e.g., pacemaker placement, BAV, PCI) or planned within 30 days post-TAVR procedure.
- Current or planned participation in any investigational device/biopharma study during the duration of this study protocol.
- Diagnostic cardiac catheterization within 10 days prior to TAVR procedure (Note: unplanned diagnostic catheterization is allowed during TAVR procedure, but must be performed prior to insertion of the investigational device into the vasculature).
- Concomitant non-valvular intervention, vascular intervention, or leaflet modification is planned at time of TAVR procedure. (Note: balloon aortic valvuloplasty during TAVR procedure is permitted).
- Evidence of an acute myocardial infarction within 3 months prior to TAVR procedure.
- Prior prosthetic heart valve in any position.
- Known intracardiac thrombus.
- Active infection or endocarditis.
- Severe allergy or known hypersensitivity or contraindication to aspirin, heparin/bivalirudin, clopidogrel, nitinol, stainless steel alloy, nickel-titanium and/or contrast sensitivity that cannot be adequately pre-medicated.
- Presence or history of bleeding diathesis or coagulopathy.
- Contraindicated for anti-platelet and/or anticoagulant therapy.
- Refuses blood transfusion.
- Active peptic ulcer or history of upper gastrointestinal (GI) bleeding within the 3 months prior to TAVR procedure.
- Renal insufficiency (creatinine > 2.5 mg/dL or GFR < 30) and/or renal replacement therapy at the time of screening.
- Hepatic failure (Child-Pugh class C).
- Presenting with cardiogenic shock or requiring vasopressor or inotropic support, or with severe hypotension (systolic blood pressure < 90 mm Hg) at the time of randomization.
- Severe ventricular dysfunction with left ventricular ejection fraction (LVEF) < 30%.
- Females who are pregnant or nursing or plan to become pregnant during their participation in the study. Female participants of child-bearing potential must have a negative pregnancy test at screening.
- Any other condition that in the opinion of the investigator precludes study participation or poses a significant hazard to the patient.
Neurological Exclusion Criteria:
- Modified Rankin Scale (mRS) ≥ 2 at screening.
- Cerebrovascular event including TIA within 6 months of the procedure.
- Active major psychiatric disease, known mental or physical illness or known history of substance abuse that may cause non-compliance with the protocol or confound the data interpretation.
- Severe visual, auditory, or learning impairment.
- Neurodegenerative or other progressive neurological disease or history of significant head trauma followed by persistent neurologic defaults or known structural brain abnormalities.
Note: use of general anesthesia during TAVR may affect neurocognitive function shortly after the procedure. While not an exclusion criterion, it is recommended that general anesthesia not be used, if possible.
Magnetic Resonance Imaging Exclusion Criteria:
- Body Mass Index (BMI) precluding imaging in scanner.
- Contraindications to MRI (participants with MR unsafe implants including implantable temporary or permanent pacemaker or defibrillator, metal implants in field of view, metallic fragments, clips, or devices in the brain or eye before TAVR procedure).
- High risk of complete AV block after TAVR, with the need of permanent pacemaker (e.g., patients with pre-existing bifascicular block or complete right bundle branch block plus any degree of AV block).
- Claustrophobia precluding MRI scanning.
Anatomical and CT Exclusion Criteria:
- Severe peripheral arterial, abdominal aortic, or thoracic aortic disease that precludes delivery sheath, vascular access or filter deployment.
- Presence of cardiovascular implant in aorta and/or peripheral access vessels (e.g., thoracic endovascular aortic repair [TEVAR]/endovascular abdominal aortic aneurysm repair [EVAR], iliac/superficial femoral artery [SFA] stent).
- Access vessels with excessive tortuosity or complex anatomy that would likely necessitate a surgical cutdown approach (e.g., distance from skin to vessel is extensive).
- Aortic arch, which is heavily calcified, severely atheromatous, or severely tortuous.
- Ascending aortic diameter less than 18 mm or greater than 38 mm measured 6 to 8 cm from the annulus.
- Transverse aortic arch diameter less than 18 mm or greater than 27 mm when measured immediately proximal to the ostium of the left subclavian artery.
研究計画
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:ランダム化
- 介入モデル:並列代入
- マスキング:独身
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:F2 Filter and Delivery System
The F2 Cerebral Embolic Protection System will be used during your Transcatheter Aortic Valve Replacement procedure. |
Use of the F2 Filter and Delivery System in conjunction with a Transcatheter Aortic Valve Replacement (TAVR) procedure Transcatheter Aortic Valve Replacement (TAVR) with commercially available Transcatheter Aortic Valve Replacement (TAVR) device |
|
アクティブコンパレータ:No embolic protection device
No embolic protection device will be used during your Transcatheter Aortic Valve Replacement procedure. |
Transcatheter Aortic Valve Replacement (TAVR) with commercially available Transcatheter Aortic Valve Replacement (TAVR) device |
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 |
|---|---|---|
|
Ability of the F2 CPC to provide neuroprotection during a TF TAVR procedure
時間枠:8 to 72 hours post procedure
|
Determined by pair-wise comparisons among participants in the eITT population (Finkelstein-Schoenfeld [FS] method) according to the following prespecified hierarchy of adverse outcomes:
|
8 to 72 hours post procedure
|
|
Major Adverse Events (MAE)
時間枠:30 days post procedure
|
Defined as the composite of the following components at 30 days:
|
30 days post procedure
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Combined Safety and Efficacy - VARC-2
時間枠:Discharge or Day 5-10, whichever comes first
|
All-cause mortality; all stroke (disabling and non-disabling) and transient ischemic attack (TIA); acute kidney injury (stage 2 or 3, including renal replacement therapy) |
Discharge or Day 5-10, whichever comes first
|
|
Neurological events (VARC-2 and NeuroARC)
時間枠:Discharge or Day 5-10, whichever comes first; Day 30
|
Stroke (subclassified as ischemic, hemorrhagic, or undetermined, and as disabling or non-disabling); TIA |
Discharge or Day 5-10, whichever comes first; Day 30
|
|
Incidence of acute kidney injury (AKIN)
時間枠:Discharge or Day 5-10, whichever comes first; Day 30
|
Subclassified as stage 1, 2, or 3 Acute Kidney Injury (VARC-2) |
Discharge or Day 5-10, whichever comes first; Day 30
|
|
Incidence of major vascular complications (VARC-3)
時間枠:Discharge or Day 5-10, whichever comes first; Day 30
|
Discharge or Day 5-10, whichever comes first; Day 30
|
|
|
Bleeding
時間枠:Discharge or Day 5-10, whichever comes first; Day 30
|
Incidence of life-threatening or disabling bleeding and major bleeding (VARC-2) - life-threatening or disabling bleeding; major bleeding |
Discharge or Day 5-10, whichever comes first; Day 30
|
|
Major adverse embolic events (MAEE)
時間枠:Discharge or Day 5-10
|
Incidence of the composite of all stroke (disabling or non-disabling) and transient ischemic attack (TIA), and Acute Kidney Injury Stage 2 or 3 (including renal replacement therapy), and systemic embolization |
Discharge or Day 5-10
|
|
Total volume of new lesions by DW-MRI
時間枠:8-72 hours post-procedure
|
Assessed by an independent MRI Core Laboratory |
8-72 hours post-procedure
|
その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
NIHSS
時間枠:Discharge or Day 5-10, whichever comes first; Day 30
|
NIHSS worsening (increase of 2 or more from baseline) |
Discharge or Day 5-10, whichever comes first; Day 30
|
|
MoCA
時間枠:Discharge or Day 5-10, whichever comes first; Day 30
|
MoCA worsening (decrease of 2 or more from baseline) |
Discharge or Day 5-10, whichever comes first; Day 30
|
|
Number of new lesions by DW-MRI
時間枠:8-72 hours post-procedure
|
Assessed by an independent MRI Core Laboratory |
8-72 hours post-procedure
|
|
Average size of new lesions by DW-MRI
時間枠:8-72 hours post-procedure
|
Assessed by an independent MRI Core Laboratory |
8-72 hours post-procedure
|
|
Largest per-subject single new lesion by DW-MRI
時間枠:8-72 hours post-procedure
|
Assessed by an independent MRI Core Laboratory |
8-72 hours post-procedure
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
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
- ET03
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
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