Stent Graft for Aortic Dissection

(PS-IDE Trial)

Overseen By Megan C White, BA

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Baylor Research Institute

Disqualifiers: Pregnancy, Pediatric, Infection risk, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 2 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 2

Duration: 1 day

20 Participants Needed

Trial Summary

What is the purpose of this trial?

The purpose of this early feasibility study is to investigate the outcome of selected patients with ascending thoracic aortic pathologies including type A aortic dissection, who are suitable for endovascular repair with the Medtronic Valiant PS-IDE Stent Graft System with the Captivia Delivery System (or the Valiant PS-IDE Stent Graft).

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the Valiant PS-IDE Stent Graft treatment for aortic dissection?

The Valiant Thoracic Stent Graft, used in similar procedures for thoracic aortic aneurysms, has shown positive outcomes in both short-term (30-day) and longer-term (12-month) evaluations, suggesting its potential effectiveness in treating aortic dissection as well. ^{1 2 3 4 5}

Is the Valiant Stent Graft generally safe for humans?

The Valiant Stent Graft has been evaluated in several studies, showing safety data for up to 30 days and 12 months after use in treating thoracic aortic aneurysms. However, there have been reports of complications like misaligned deployment, which are rare but important to consider. ^{1 2 3 4 5}

How is the Valiant PS-IDE Stent Graft treatment different from other treatments for aortic dissection?

The Valiant PS-IDE Stent Graft is unique because it is an advanced version of previous stent grafts, designed specifically for endovascular repair (a minimally invasive procedure) of the thoracic aorta. It offers a new delivery system that may improve precision and reduce complications compared to older models. ^{1 2 3 4 5}

Research Team

William Brinkman, MD

Principal Investigator

Cardiac Surgery Specialists

Eligibility Criteria

This trial is for adults with a type A thoracic aortic dissection who need an alternative to traditional surgery. They must have specific measurements of their aorta, be high-risk surgical candidates (ASA score IV), and not pregnant or expected to live less than one year due to another condition.

Inclusion Criteria

My aorta's width is between 28 mm and 44 mm at specific points.

The areas for my graft placement are at least 1 cm apart.

I have a type A thoracic aortic dissection suitable for endovascular repair.

Exclusion Criteria

I am expected to live more than a year, not counting my aortic condition.

I am not pregnant and I am 21 years old or older.

Patients or their legally authorized representative (LAR) who do not sign the informed consent

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Endovascular repair of ascending aortic pathologies using the Valiant PS-IDE Stent Graft System

1 day

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

1 visit (in-person)

Treatment Details

Interventions

• Valiant PS-IDE Stent Graft

Trial Overview The study tests the Valiant PS-IDE Stent Graft System in patients with ascending thoracic aortic pathologies. It aims to see if this endovascular repair method is feasible and safe for those who are unsuitable for conventional surgery.

Participant Groups

Group I: Type A Dissection Experimental Treatment 1 Intervention

High risk subjects with ascending thoracic aortic pathologies including type A aortic dissection who are suitable for endovascular repair

Valiant PS-IDE Stent Graft is already approved in European Union, United States for the following indications:

Approved in European Union as Valiant Captivia Stent Graft for:

• Thoracic aortic aneurysms (TAA)
• Type B aortic dissection (TBAD)
• Intramural hematoma (IMH)
• Penetrating atherosclerotic (PAU)
• Blunt thoracic aortic injury (BTAI)

Approved in United States as Valiant Captivia Stent Graft for:

• Thoracic aortic aneurysms (TAA)
• Type B aortic dissection (TBAD)
• Intramural hematoma (IMH)
• Penetrating atherosclerotic (PAU)
• Blunt thoracic aortic injury (BTAI)

Who Is Running the Clinical Trial?

Baylor Research Institute

Lead Sponsor

Trials

210

Recruited

205,000+

Medtronic

Industry Sponsor

Trials

627

Recruited

767,000+

Geoff Martha

Medtronic

Chief Executive Officer since 2020

Finance degree from Penn State University

Dr. Richard Kuntz

Medtronic

Chief Medical Officer since 2023

MD, MSc

Findings from Research

The Valiant Thoracic Stent Graft with the Captivia Delivery System achieved a 100% technical success rate in 100 patients, indicating its reliability for treating thoracic aortic conditions.

The 30-day outcomes showed a 4% all-cause mortality rate, with most complications being procedure-related, suggesting that while the device is effective, careful monitoring is necessary for potential risks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Valiant thoracic stent-graft deployed with the new captivia delivery system: procedural and 30-day results of the Valiant Captivia registry. Heijmen, RH., Thompson, MM., Fattori, R., et al.[2022]

The Valiant Thoracic Stent Graft System demonstrated a high success rate in deployment (96.3%) and low rates of serious complications, with a 30-day perioperative mortality of only 3.1% and no cases of paraplegia or major strokes reported.

At 12 months, the Valiant stent graft showed noninferior all-cause mortality compared to the previous Talent stent graft and achieved a high effectiveness rate of 97.4% in preventing aneurysm growth and the need for secondary procedures, indicating it is a safe and effective option for treating descending thoracic aortic aneurysms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pivotal results for the Medtronic Valiant Thoracic Stent Graft System in the VALOR II trial. Fairman, RM., Tuchek, JM., Lee, WA., et al.[2013]

The Valiant NavionTM stent graft system demonstrated a high technical success rate of 94.7% in a study of 21 Asian patients undergoing thoracic endovascular aortic repair, with no major vascular complications reported.

The procedure showed versatility and safety, with a 30-day survival rate of 100% and a mean hospital stay of just 5.3 days, indicating it is an effective option for treating various aortic pathologies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Valiant NAVION stent graft system application: First Asian case-series analysis. Chow, SCY., Ho, JYK., Fujikawa, T., et al.[2021]

In a study involving 87 patients treated with the Valiant Navion stent graft system for descending thoracic aortic aneurysms, there were no access or deployment failures, and only 2.3% experienced a major device effect within 30 days, indicating high safety and efficacy.

The occurrence of endoleaks was low at 2.5%, and the overall freedom from all-cause mortality was 97.7%, suggesting that the Valiant Navion stent graft system is a promising option for patients with complex aortic conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pivotal results for the Valiant Navion stent graft system in the Valiant EVO global clinical trial. Azizzadeh, A., Desai, N., Arko, FR., et al.[2020]

Two cases of misaligned deployment of the Valiant Captivia stent graft were reported after treating thoracic aneurysms, a complication not previously documented in the literature.

The paper discusses potential factors contributing to this misalignment and describes a bailout technique used to address the issue during the procedure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Two cases of misaligned deployment of Valiant Captivia thoracic stent graft. Mlynski, A., Marzelle, J., Desgranges, P., et al.[2012]

References

1. United States pubmed.ncbi.nlm.nih.gov

Valiant thoracic stent-graft deployed with the new captivia delivery system: procedural and 30-day results of the Valiant Captivia registry. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Pivotal results for the Medtronic Valiant Thoracic Stent Graft System in the VALOR II trial. [2013]

3. United States pubmed.ncbi.nlm.nih.gov

Valiant NAVION stent graft system application: First Asian case-series analysis. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

Pivotal results for the Valiant Navion stent graft system in the Valiant EVO global clinical trial. [2020]

5. United States pubmed.ncbi.nlm.nih.gov

Two cases of misaligned deployment of Valiant Captivia thoracic stent graft. [2012]