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Trial record 1 of 4 for:    htn-off
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The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT02439749
Recruitment Status : Active, not recruiting
First Posted : May 12, 2015
Last Update Posted : October 19, 2020
Information provided by (Responsible Party):
Medtronic Vascular

Brief Summary:
The purpose of this study is to test the hypothesis that renal denervation decreases blood pressure and is safe when studied in the absence of antihypertensive medications.

Condition or disease Intervention/treatment Phase
Hypertension Vascular Diseases Cardiovascular Diseases Device: Symplicity Spyral™ multi-electrode renal denervation system Procedure: Sham Procedure Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 366 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Participant)
Primary Purpose: Treatment
Official Title: Global Clinical Study of Renal Denervation With the Symplicity Spyral™ Multi-electrode Renal Denervation System in Patients With Uncontrolled Hypertension in the Absence of Antihypertensive Medications (SPYRAL PIVOTAL - SPYRAL HTN-OFF MED)
Actual Study Start Date : June 2015
Actual Primary Completion Date : January 8, 2020
Estimated Study Completion Date : March 2023

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: Renal Denervation
Renal angiography and Renal Denervation (Symplicity Spyral™ multi-electrode renal denervation system)
Device: Symplicity Spyral™ multi-electrode renal denervation system
After a renal angiography according to standard procedures, subjects remain blinded and are immediately treated with the renal denervation procedure after randomization.
Other Names:
  • Renal angiography
  • Renal Denervation

Sham Comparator: Sham Procedure
Renal angiography
Procedure: Sham Procedure
After a renal angiography according to standard procedures, subjects remain blinded and remain on the catheterization lab table for at least 20 minutes prior to introducer sheath removal.
Other Name: Renal angiography

Primary Outcome Measures :
  1. Acute and chronic safety by evaluating incidence of Major Adverse Events [ Time Frame: From baseline to 1 month post-procedure (6 months for new renal artery stenosis) ]
  2. Change in systolic blood pressure as measured by 24-hour Ambulatory Blood Pressure Monitoring (ABPM) [ Time Frame: From baseline to 3 months post-procedure ]

Secondary Outcome Measures :
  1. Change in office systolic blood pressure [ Time Frame: From baseline to 36 months post-procedure ]
  2. Significant embolic event resulting in end-organ damage [ Time Frame: From baseline to 1 month post-procedure ]
  3. Renal artery perforation requiring intervention [ Time Frame: From baseline to 1 month post-procedure ]
  4. Renal artery dissection requiring intervention [ Time Frame: From baseline to 1 month post-procedure ]
  5. Vascular complications [ Time Frame: From baseline to 1 month post-procedure ]
  6. End-stage renal disease [ Time Frame: From baseline to 36 months post-procedure ]
  7. ≥40% decline in eGFR [ Time Frame: From baseline to 36 months post-procedure ]
  8. New myocardial infarction [ Time Frame: From baseline to 36 months post-procedure ]
  9. New stroke [ Time Frame: From baseline to 36 months post-procedure ]
  10. Renal artery re-intervention [ Time Frame: From baseline to 36 months post-procedure ]
  11. Major bleeding according to TIMI definition [ Time Frame: From baseline to 36 months post-procedure ]
  12. Increase in serum creatinine > 50% [ Time Frame: From baseline to 36 months post-procedure ]
  13. New renal artery stenosis > 70% [ Time Frame: From baseline to 36 months post-procedure ]
  14. Hospitalization for hypertensive crisis not related to confirmed nonadherence with medications or the protocol [ Time Frame: From baseline to 36 months post-procedure ]
  15. All-cause mortality [ Time Frame: From baseline to 36 month post-procedure ]
  16. Change in systolic blood pressure as measured by 24-hour ABPM [ Time Frame: From baseline to 36 month post-procedure ]
  17. Incidence of achieving target office systolic blood pressure (SBP <140 mmHg) [ Time Frame: From 1 month to 36 months post-procedure ]
  18. Change in office diastolic blood pressure [ Time Frame: From baseline to 36 months post-procedure ]
  19. Change in diastolic blood pressure as measured by 24-hour ABPM [ Time Frame: From baseline to 36 months post-procedure ]

Information from the National Library of Medicine

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Ages Eligible for Study:   20 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Individual has office systolic blood pressure (SBP) ≥ 150 mmHg and <180 mmHg and a diastolic blood pressure (DBP) ≥ 90 mmHg after being off medications.
  • Individual has 24-hour Ambulatory Blood Pressure Monitoring (ABPM) average SBP ≥ 140 mmHg and < 170 mmHg.
  • Individual is willing to discontinue current antihypertensive medications.

Exclusion Criteria:

  • Individual lacks appropriate renal artery anatomy.
  • Individual has estimated glomerular filtration rate (eGFR) of <45.
  • Individual has type 1 diabetes mellitus or poorly-controlled type 2 diabetes mellitus.
  • Individual has one or more episodes of orthostatic hypotension.
  • Individual requires chronic oxygen support or mechanical ventilation other than nocturnal respiratory support for sleep apnea.
  • Individual has primary pulmonary hypertension.
  • Individual is pregnant, nursing or planning to become pregnant.
  • Individual has frequent intermittent or chronic pain that results in treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) for two or more days per week over the month prior to enrollment.
  • Individual has stable or unstable angina within 3 months of enrollment, myocardial infarction within 3 months of enrollment; heart failure, cerebrovascular accident or transient ischemic attack, or atrial fibrillation at any time.
  • Individual works night shifts.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT02439749

Hide Hide 47 study locations
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United States, Alabama
Heart Center Research, LLC
Huntsville, Alabama, United States, 35801
United States, Arizona
Honor Health Research Institute
Scottsdale, Arizona, United States, 85258
United States, California
Kaiser Permanente LA Medical Center
Los Angeles, California, United States, 90027
Stanford Hospital and Clinics
Stanford, California, United States, 94305
United States, Connecticut
Yale New Haven Hospital
New Haven, Connecticut, United States, 06520
United States, Florida
Baptist Medical Center Jacksonville
Jacksonville, Florida, United States, 32207
Tallahassee Research Institute
Tallahassee, Florida, United States, 32308
United States, Georgia
Emory University Hospital Midtown
Atlanta, Georgia, United States, 30308
Piedmont Heart Institute
Atlanta, Georgia, United States, 30309
United States, Iowa
Iowa Heart Center
West Des Moines, Iowa, United States, 50266
United States, Kentucky
University of Kentucky
Lexington, Kentucky, United States, 40536
United States, Michigan
St Joseph Mercy Oakland
Pontiac, Michigan, United States, 48341
Providence Hospital
Southfield, Michigan, United States, 48075
United States, Minnesota
Minneapolis Heart Institute Foundation
Minneapolis, Minnesota, United States, 55407
United States, Mississippi
Hattiesburg Clinic
Hattiesburg, Mississippi, United States, 39401
Cardiology Associates Research LLC
Tupelo, Mississippi, United States, 38801
United States, Missouri
Barnes-Jewish Hospital
Saint Louis, Missouri, United States, 63110
United States, New Jersey
Saint Barnabas Medical Center
Livingston, New Jersey, United States, 07039
United States, New York
North Shore University Hospital
Manhasset, New York, United States, 11030
Mount Sinai Medical Center
New York, New York, United States, 10029
United States, North Carolina
Duke University Medical Center
Durham, North Carolina, United States, 27710
United States, Ohio
University Hospitals Cleveland Medical Center
Cleveland, Ohio, United States, 44106
United States, Pennsylvania
PinnacleHealth Cardiovascular Institute
Harrisburg, Pennsylvania, United States, 17011
Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, United States, 19104
United States, Rhode Island
The Miriam Hospital
Providence, Rhode Island, United States, 02906
United States, South Carolina
AnMed Health
Anderson, South Carolina, United States, 29621
United States, Tennessee
Centennial Medical Center
Nashville, Tennessee, United States, 37203
United States, Texas
Baylor Heart & Vascular Hospital
Dallas, Texas, United States, 75226
United States, West Virginia
Charleston Area Medical Center
Charleston, West Virginia, United States, 25304
United States, Wisconsin
Aurora St. Luke's Medical Center
Milwaukee, Wisconsin, United States, 53215
Australia, Victoria
Alfred Hospital
Melbourne, Victoria, Australia, 3004
Klinikum Wels-Grieskirchen
Wels, Austria, 4600
Canada, Ontario
St. Michael's Hospital
Toronto, Ontario, Canada, M5B 1W8
Canada, Quebec
Institut de cardiologie de Montréal / Montreal Heart Institute
Montréal, Quebec, Canada, H1T 1C8
Universitäts-Herzzentrum Freiburg - Bad Krozingen GmbH
Bad Krozingen, Germany, 79189
Universitätsklinikum Erlangen
Erlangen, Germany, 91054
Universitätsklinikum des Saarlandes
Homburg, Germany, 66421
Herzzentrum Leipzig, Universitätsklinik
Leipzig, Germany, 04289
Sana Kliniken Lübeck
Lübeck, Germany, 23560
Hippokration General Hospital of Athens
Athens, Greece, 11527
University General Hospital of Thessaloniki (AHEPA)
Thessaloniki, Greece, 54621
Galway University Hospital
Galway, Ireland
Jichi Medical University Hospital
Shimotsuke, Tochigi, Japan, 329-0498
Mitsui Memorial Hospital
Chiyoda, Tokyo, Japan, 101-8643
United Kingdom
Cardiff and Vale University Health Board - University Hospital of Wales
Cardiff, United Kingdom
Royal Devon & Exeter NHS Foundation Trust
Exeter, United Kingdom, EX2 5DW
Imperial College Healthcare NHS Trust
London, United Kingdom, W12 0HS
Sponsors and Collaborators
Medtronic Vascular
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Principal Investigator: Raymond Townsend, MD University of Pennsylvania
Principal Investigator: David Kandzari, MD Piedmont Hospital
Principal Investigator: Michael Böhm, MD Universitätskliniken des Saarlandes
Principal Investigator: Kazuomi Kario, MD Jichi Medical University
Publications automatically indexed to this study by Identifier (NCT Number):

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Responsible Party: Medtronic Vascular Identifier: NCT02439749    
Other Study ID Numbers: SPYRAL HTN-OFF MED
First Posted: May 12, 2015    Key Record Dates
Last Update Posted: October 19, 2020
Last Verified: October 2020

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Studies a U.S. FDA-regulated Device Product: Yes
Device Product Not Approved or Cleared by U.S. FDA: Yes
Keywords provided by Medtronic Vascular:
Uncontrolled hypertension
Renal denervation
Additional relevant MeSH terms:
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Cardiovascular Diseases
Vascular Diseases