10 Participants Needed

Fetal Endoscopic Tracheal Occlusion for Congenital Diaphragmatic Hernia

RR
Overseen ByRodrigo Ruano, MD, Ph.D
Age: 18 - 65
Sex: Female
Trial Phase: Academic
Sponsor: Rodrigo Ruano
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

The purpose of this research is to gather information on the safety and effectiveness of a new procedure called Fetoscopic Endoluminal Tracheal Occlusion (FETO).

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.

Is the use of balloon catheters generally safe in humans?

Balloon catheters, like the Foley catheter, are generally safe for use in humans, with minimal complications reported. However, there are some risks, such as urethral trauma, which can be mitigated with safety measures like a safety-valve to prevent balloon inflation injuries.12345

How is the BALT GoldbBAL2 Detachable Balloon treatment different for congenital diaphragmatic hernia?

The BALT GoldbBAL2 Detachable Balloon treatment is unique because it involves a minimally invasive procedure called fetal endoscopic tracheal occlusion (FETO), which places a balloon in the fetus's trachea to promote lung growth and improve survival in severe congenital diaphragmatic hernia cases. This approach is different from traditional open fetal surgery and is designed to be reversible, offering a potentially safer alternative.678910

Who Is on the Research Team?

RR

Rodrigo Ruano, MD, Ph.D

Principal Investigator

University of Miami

Are You a Good Fit for This Trial?

This trial is for pregnant individuals with a single fetus diagnosed with severe left-sided Congenital Diaphragmatic Hernia (CDH) and liver up, without other fetal anomalies or chromosomal abnormalities. The fetus must have a specific lung-to-head ratio indicating pulmonary hypoplasia, and the gestational age should be between 27 to just under 32 weeks at the time of surgery.

Inclusion Criteria

My condition involves the left side of my diaphragm being affected with my liver positioned higher.
My baby's genetic test results are normal.
You are pregnant with only one baby.
See 3 more

Exclusion Criteria

I do not have HIV, Hepatitis-B, or Hepatitis-C.
My unborn baby has been diagnosed with additional anomalies or chromosomal abnormalities.
My baby has a right-sided or bilateral diaphragmatic hernia, or an isolated left-sided one with specific ultrasound measurements.
See 10 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

FETO Procedure

Participants undergo fetal endoscopic tracheal occlusion (FETO) surgery by insertion of the BALT GoldbBAL2 Detachable Balloon with the BALT catheter system

Up to 34 weeks gestation

Delivery and Immediate Postpartum

Monitoring of gestational age at delivery and maternal complications

Up to 41 weeks gestation

Follow-up

Participants are monitored for safety and effectiveness after treatment, including infant diaphragmatic repair, ECMO support, and other neonatal outcomes

Up to 24 months post partum

What Are the Treatments Tested in This Trial?

Interventions

  • BALT GoldbBAL2 Detachable Balloon
  • Catheter System
Trial Overview The study tests Fetoscopic Endoluminal Tracheal Occlusion (FETO), using BALT GoldbBAL2 Detachable Balloon and Catheter System. This procedure aims to improve lung development in fetuses with CDH by temporarily blocking their trachea.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: FETO GroupExperimental Treatment2 Interventions

BALT GoldbBAL2 Detachable Balloon is already approved in European Union for the following indications:

🇪🇺
Approved in European Union as BALT GoldbBAL2 Detachable Balloon for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Rodrigo Ruano

Lead Sponsor

Trials
5
Recruited
40+

Published Research Related to This Trial

The Trans-Urethral Catheterisation Safety Valve effectively prevents urethral trauma during catheterization in male spinal cord injury patients by stopping balloon inflation if the catheter is incorrectly positioned, as demonstrated in 44 catheterizations.
While the safety-valve is generally effective, it is important for health professionals to follow proper procedures, such as pre-valve inflation, to avoid issues like leakage and ensure the catheter is correctly placed.
Possible Use of a Safety-Valve with a Foley Catheter During Catheterisation of Male Spinal Cord Injury Patients for Prevention of Urethral Trauma Caused by Inflation of the Catheter Balloon in the Urethra.Subramanian, V., Soni, BM.[2023]
The exchangeable atrial balloon device is designed to be implanted in the atrial appendage, providing a novel approach for potential cardiac interventions.
This device utilizes a combination of an outer guide and a latex Foley catheter, which may offer advantages in terms of accessibility and functionality during procedures involving the heart.
An exchangable intra-atrial balloon device.Chapman, LW., Mittmann, UM.[2017]
In a study involving 24 medical students, those trained through in-person lectures were significantly faster at setting up instruments for balloon removal in fetal endoluminal tracheal occlusion (FETO) compared to those trained via online video (62 seconds vs 81 seconds).
However, both training methods showed no significant difference in the time taken to locate and intubate the balloon in the trachea, indicating that while in-person training may enhance setup speed, both methods are equally effective for the critical task of balloon removal.
Simulation training for urgent postnatal fetal tracheal balloon removal: Two learning methods.Lehoczky, L., Corroenne, R., Espinoza, J., et al.[2023]

Citations

Possible Use of a Safety-Valve with a Foley Catheter During Catheterisation of Male Spinal Cord Injury Patients for Prevention of Urethral Trauma Caused by Inflation of the Catheter Balloon in the Urethra. [2023]
An exchangable intra-atrial balloon device. [2017]
A Prospective Multi-institutional Study Using a Novel Safety Valve for the Prevention of Catheter Balloon Inflation Injury of the Urethra. [2023]
[Long-term usefulness and safety of the contemporary balloon catheter]. [2019]
The use of mineral oil to manage the nondeflating Foley catheter. [2019]
Simulation training for urgent postnatal fetal tracheal balloon removal: Two learning methods. [2023]
Tracheal obstruction in experimental diaphragmatic hernia: an endoscopic approach in the fetal lamb. [2014]
Severe diaphragmatic hernia treated by fetal endoscopic tracheal occlusion. [2022]
Comparison between fetal endoscopic tracheal occlusion using a 1.0-mm fetoscope and prenatal expectant management in severe congenital diaphragmatic hernia. [2016]
Feasibility and outcomes of fetoscopic endoluminal tracheal occlusion for severe congenital diaphragmatic hernia: A Japanese experience. [2020]
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