Early Feasibility of the Branched TAG® Device in the Treatment of Aortic Arch Aneurysms

• ClinicalTrials.gov Identifier: NCT02264977
• Recruitment Status: Active, not recruiting
• First Posted: October 15, 2014
• Results First Posted: August 2, 2017
• Last Update Posted: February 11, 2022
• Sponsor: W.L.Gore & Associates
• Information provided by (Responsible Party): W.L.Gore & Associates

Study Description

Brief Summary:

The purpose of this study is to assess the feasibility of the use of the GORE® TAG® Thoracic Branch Endoprosthesis to treat aneurysms involving the aortic arch

Condition or disease	Intervention/treatment	Phase
Aneurysm of Aortic Arch	Device: Branched TAG® Device	Not Applicable

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 9 participants
• Allocation: N/A
• Intervention Model: Single Group Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: Evaluation of the GORE® TAG® Thoracic Branch Endoprosthesis (Branched TAG® Device) in the Treatment of Aortic Arch Aneurysms
• Actual Study Start Date: April 2015
• Actual Primary Completion Date: July 2016
• Estimated Study Completion Date: April 2022

Arms and Interventions

Arm	Intervention/treatment
Experimental: Branched TAG® Device; Treatment with the GORE® TAG® Thoracic Branch Endoprosthesis	Device: Branched TAG® Device

Outcome Measures

Primary Outcome Measures :

1. Number of Participants With Successful Study Device Access [ Time Frame: During treatment procedure (day 0) ]
   Access to the aneurysm and target landing zone location is obtained via conventional vascular access and endovascular techniques.
2. Number of Participants With Successful Study Device Deployment [ Time Frame: During treatment procedure (day 0) ]
   Absence of deployment failure will be considered a successful deployment. Deployment failure will be considered the failure of any Branched TAG® Device component (Aortic Component, Aortic Extender, or SB Component) to be released from the delivery catheter resulting in a serious adverse event (SAE) due to mechanical failure or use error.
3. Number of Participants With Primary Procedural Side Branch Patency [ Time Frame: At conclusion of the treatment procedure (day 0) ]
   The presence of forward flow through the implanted Side Branch Component into the target branch vessel.

Secondary Outcome Measures :

1. Number of Participants With 1 Month Side Branch Primary Patency Assessed by an Independent Core Lab [ Time Frame: 1 month post procedure ]
2. Number of Participants With 1 Month Device Related Endoleaks Assessed by an Independent Core Lab [ Time Frame: 1 month post procedure ]
   Device-related endoleaks are defined as the presence of contrast within the aneurysm sac originating from the junction between any Branched TAG® Device component and the landing zone (endoleak type IA or IB) OR the junction between the Aortic Component and either the Side Branch Component or the Aortic Extender (type III endoleak).

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

1. Presence of aortic aneurysm involving the aortic arch deemed to warrant surgical repair which requires proximal graft placement in Zone 0 or Zone 1:

   1. Fusiform (≥ 55 mm), or
   2. Fusiform (>2 times native aortic diameter), or
   3. Saccular (no diameter criteria)
2. Subject is considered a high risk candidate for conventional open surgical repair at the discretion of the Investigator
3. Age ≥18 years at time of informed consent signature
4. Subject is capable of complying with protocol requirements, including follow-up
5. Informed Consent Form (ICF) is signed by Subject or legal representative

6. Must have appropriate proximal aortic landing zone, defined as:

   1. Must require placement of the proximal extent of the Aortic Component in Zone 0 or Zone 1 for exclusion of the lesion
   2. Acceptable proximal landing zone outer curvature length for the required device
   3. Landing zone inner diameters between 16-48 mm in Zone 1 Subjects and 24-48mm in Zone 0 Subjects
   4. Landing zone, which must include either the brachiocephalic or left common carotid native ostium, cannot be aneurysmal, heavily calcified, or heavily thrombosed

7. Must have appropriate distal aortic landing zone, defined as:

   1. Outer curvature length must be ≥2cm proximal to the celiac artery
   2. Aortic inner diameters between 16-48 mm (diameter must be between 16-42mm if using distal TAG® Device extension)
   3. Landing zone cannot be aneurysmal, heavily calcified, or heavily thrombosed
   4. Landing zone in native aorta or previously implanted GORE® TAG® Device

8. Must have appropriate target branch vessel landing zone, defined as:

   1. Length of ≥3 cm proximal to first major branch vessel if using Aortic Component with 8 mm portal diameter, or length of ≥2.5 cm proximal to first major branch vessel if using Aortic Component with 12 mm portal diameter (required for Zone 0 Subjects)
   2. Target branch vessel inner diameters of 6-15 mm if using Aortic Component with 8mm portal diameter, or inner diameters of 11-18 mm if using Aortic Component with 12mm portal diameter (required for Zone 0 Subjects)
   3. Target branch vessel landing zone must be in native aorta that cannot be aneurysmal, heavily calcified, or heavily thrombosed

Exclusion Criteria:

1. Concomitant aneurysm/disease of the ascending aorta, or abdominal aorta requiring repair
2. Previous endovascular repair of the ascending aorta
3. Previous endovascular repair of the DTA with a non-Gore device
4. Surgery within 30 days of treatment
5. Infected aorta
6. Dissection of the aorta
7. Intramural hematoma of the aortic arch or DTA without aneurysm
8. Life expectancy <2 years
9. Myocardial infarction or stroke within 6 weeks prior to treatment
10. Patient has a systemic infection and may be at increased risk of endovascular graft infection
11. Pregnant female at time of informed consent signature
12. Degenerative connective tissue disease, e.g. Marfan's or Ehler-Danlos Syndrome
13. Participation in another drug or medical device study within one year of study enrollment
14. Known history of drug abuse within one year of treatment
15. Significant thrombus or atheroma in the aortic arch
16. Tortuous or stenotic iliac and/or femoral arteries preventing introducer sheath insertion and the inability to use a conduit for vascular access
17. Planned coverage of celiac artery
18. Patient has known sensitivities or allergies to the device materials
19. Patient has known hypersensitivity or contraindication to anticoagulants or contrast media, which is not amenable to pre-treatment
20. Previous instance of Heparin Induced Thrombocytopenia type 2 (HIT-2) or known hypersensitivity to heparin
21. Diameter taper outside of the device sizing range between proximal and distal landing zones of aorta and the inability to use additional devices of different diameters to compensate for the taper
22. Mycotic aneurysm
23. Persistent refractory shock (systolic blood pressure <90 mm Hg)
24. Patient has body habitus or other medical condition which prevents adequate visualization of the aorta

Contacts and Locations

Locations

United States, California

Leland Stanford Junior University

Stanford, California, United States, 94305-5407

United States, Michigan

University of Michigan

Ann Arbor, Michigan, United States, 48109

United States, Minnesota

Mayo Clinic Rochester

Rochester, Minnesota, United States, 55905

United States, New Hampshire

The Hitchcock Foundation (Dartmouth Hitchcock Medical Center)

Lebanon, New Hampshire, United States, 03756

United States, Pennsylvania

Hospital at University of Pennsylvania

Philadelphia, Pennsylvania, United States, 19104

Univerisity of Pittsburgh Medical Center

Pittsburgh, Pennsylvania, United States, 15232

Sponsors and Collaborators

W.L.Gore & Associates

Investigators

• Principal Investigator: Michael D Dake, MD; Stanford University

More Information

• Responsible Party: W.L.Gore & Associates
• ClinicalTrials.gov Identifier: NCT02264977
• Other Study ID Numbers: SSB 11-03
• First Posted: October 15, 2014
• Results First Posted: August 2, 2017
• Last Update Posted: February 11, 2022
• Last Verified: February 2022

Additional relevant MeSH terms:

Aneurysm; Vascular Diseases; Cardiovascular Diseases