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Preprocedural Assessment of Anatomy and Device Sizing With CT and 3D Simulation in Left Atrial Appendage Occlusion. (PRECISE LAAO)

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ClinicalTrials.gov Identifier: NCT04640051
Recruitment Status : Recruiting
First Posted : November 23, 2020
Last Update Posted : July 14, 2021
Sponsor:
Information provided by (Responsible Party):
Ian Buysschaert, AZ Sint-Jan AV

Brief Summary:

The objectives of the current proposal are to analyse to what extend:

  1. The use of 3D in silico simulation by FEops HEARTguide improves of influences the pre-procedural assessment and device size selection and to what extend it correlates with final implanted device size and depth compared to TEE, CT and angiography.
  2. The use of 3D in silico simulation by FEops HEARTguide increases the operator's confidence in the device size selection.

A total of 100 consecutive patients for the total registry, or 15 to 20 consecutive patients per center, with standard of care follow-up at ±6 weeks and 1 year post procedure.


Condition or disease Intervention/treatment
LAAO With Amplatzer Amulet Procedure: LAAO

Detailed Description:

Left atrial appendage (LAA) occlusion (LAAO) is a well-accepted alternative to oral anticoagulant in the prevention of stroke or systemic thromboembolism in patients with atrial fibrillation (AF).1 While the occlusion is effective, the procedure can sometime be challenging. Part of the challenge is based on the high degree of variability, both at the patient level (anatomy, size, access, filling status etc); and at the device level (different architecture, size, depth, degree of conformity or compression of the device etc.). This is reflected in the percentage change in device sizes of 6.1% to 6.4%; inability to close the LAA 1% to 2.7%; complications such as embolization, tamponade etc.; residual leaks and chances for thrombus formation and subsequent stroke or systemic embolization; lengthy procedures etc.2,3 A well-prepared preprocedural planning addressing the exact anatomy of the left atrial appendage in conjunction with the optimal device size and conformability, results in optimal device selection, reduced instrumentation in the left atrium, faster and safer procedure and optimal final occlusion of the LAA. Different and complimentary techniques are being used by implanting teams, such as transoesophageal echocardiography (TEE), computed tomography (CT) scan, angiography, 3D reconstruction and 3D printing etc.

Some centres are using FEops HEARTguideTM as part of their preprocedural assessment. This is a computational tomography (CT)-based 3D in silico simulation technology suite relying on proprietary computational modelling and simulation techniques, offering physicians detailed preoperative insights into the interaction between transcatheter structural heart devices and the patient's anatomy. It is CE-marked and commercially available on the European and Canadian market. It is currently being used in 81 hospitals in 22 countries.

Belgian Hospitals who are using 3D simulations by FEops HEARTguide as part of their preprocedural assessment are asked to participate to this prospective multicentric registry. The present registry aims to compare all preprocedural imaging tools and to investigate to what extend 3D in silico simulations influences device size selection in LAAO.

The objectives of the current proposal are to analyse to what extend:

  1. The use of 3D in silico simulation by FEops HEARTguide improves of influences the pre-procedural assessment and device size selection and to what extend it correlates with final implanted device size and depth compared to TEE, CT and angiography.
  2. The use of 3D in silico simulation by FEops HEARTguide increases the operator's confidence in the device size selection.

A total of 100 consecutive patients for the total registry, or 15 to 20 consecutive patients per center, with standard of care follow-up at ±6 weeks and 1 year post procedure.

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Study Type : Observational [Patient Registry]
Estimated Enrollment : 100 participants
Observational Model: Cohort
Time Perspective: Prospective
Target Follow-Up Duration: 12 Months
Official Title: Preprocedural Assessment of Anatomy and Device Sizing With CT and 3D Simulation in Left Atrial Appendage Occlusion: the PRECISE LAAO Registry
Actual Study Start Date : July 2, 2021
Estimated Primary Completion Date : December 31, 2021
Estimated Study Completion Date : December 31, 2022

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Anatomy

Group/Cohort Intervention/treatment
LAAO group
Patients scheduled for LAAO with Amplatzer Amulet (Abbott) and for whom a 3D in silico simulation by FEops HEARTguide is available and reviewed before implantation
Procedure: LAAO
LAAO by use of 3D in silico simulation by FEops HEARTguide as part of the pre-procedural assessment and device size selection




Primary Outcome Measures :
  1. Improvement in pre-procedural device size selection by use of FEops HEARTguide [ Time Frame: At time of procedure ]
    Correlation between device size selection by use of FEops HEARTguide and implanted device size



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
A total of 100 consecutive patients, schedule for LAAO with Amplatzer Amulet (Abbott) will be enrolled in this prospective registry after receiving signed informed consent.
Criteria

Inclusion Criteria:

  • Patient signed informed consent
  • Patient scheduled for LAAO with Amplatzer Amulet (Abbott)
  • 3D in silico simulation by FEops HEARTguide available and reviewed before implantation

Exclusion Criteria:

- 3D in silico simulation by FEops HEARTguide not available or not reviewed before implantation


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 ClinicalTrials.gov identifier (NCT number): NCT04640051


Contacts
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Contact: Ian Buysschaert, MD, PhD 003250452670 ian.buysschaert@me.com
Contact: Michelle Lycke, MSc, PhD 003250453293 michelle.lycke@azsintjan.be

Locations
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Belgium
ZNA Middelheim Not yet recruiting
Antwerp, Belgium
Contact       mi.stusec-cardiologie@zna.be   
Principal Investigator: Paul Vermeersch, MD, PhD         
AZ Sint-Jan Brugge-Oostende AV Recruiting
Brugge, Belgium
Contact: Ian Buysschaert, MD, PhD         
UZ Brussel Recruiting
Brussels, Belgium
Contact: Karen Vandenbussche       karen.vandenbussche@uzbrussel.be   
Principal Investigator: Stijn Lochy, MD         
Ziekenhuis Oost-Limburg Not yet recruiting
Genk, Belgium
Contact: Caroline Swijsen       Caroline.Swijsen@zol.be   
Principal Investigator: Maximo A Rivero, MD, PhD         
AZ Maria Middelares Not yet recruiting
Ghent, Belgium
Contact       kristoff.cornelis@azmmsj.be   
Principal Investigator: Kristoff Cornelis, MD, PhD         
Sart Tilman - CHU de Liège Not yet recruiting
Liège, Belgium
Contact       mathieu.lempereur@chu.ulg.ac.be   
Principal Investigator: Mathieu Lempereur, MD, PhD         
Sponsors and Collaborators
AZ Sint-Jan AV
Investigators
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Principal Investigator: Ian Buysschaert, MD, PhD AZ Sint-Jan AV
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Ian Buysschaert, Principal Investigator, AZ Sint-Jan AV
ClinicalTrials.gov Identifier: NCT04640051    
Other Study ID Numbers: version 1.0 26/10/2020
First Posted: November 23, 2020    Key Record Dates
Last Update Posted: July 14, 2021
Last Verified: July 2021

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No