PROTECT TAVI - Prospective Randomized Outcome Study in TAVI Patients Undergoing Periprocedural Embolic Cerebral Protection With the Sentinel™ Device

NCT ID: NCT02895737

Last Updated: 2021-03-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

328 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-12-28

Study Completion Date

2022-06-30

Brief Summary

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This prospective, randomized study was designed to analyse the difference of cerebral embolization in patients undergoing transcatheter aortic valve implantation with balloon-expandable vs. self-expandable valves by using a cerebral protection system (Sentinel™ Device).

Detailed Description

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Conditions

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Cerebral Embolization During TAVI Using Balloon-expandable vs. Self-expandable Valves

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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balloon-expandable TAVI without cerebral protection

Patient receives a balloon-expandable transcatheter aortic valve replacement without cerebral protection

Group Type OTHER

TAVI: Edwards SAPIEN 3, Edwards Lifesciences, Edwards Sapien Ultra

Intervention Type DEVICE

balloon-expandable TAVI with cerebral protection

Patient receives a balloon-expandable transcatheter aortic valve replacement with cerebral protection

Group Type OTHER

TAVI: Edwards SAPIEN 3, Edwards Lifesciences, Edwards Sapien Ultra; Sentinel™ Cerebral Protection Systems

Intervention Type DEVICE

self-expandable TAVI without cerebral protection

Patient receives a self-expandable transcatheter aortic valve replacement without cerebral protection

Group Type OTHER

TAVI: CoreValve® Evolut R™, CoreValve Medtronic

Intervention Type DEVICE

self-expandable TAVI with cerebral protection

Patient receives a self-expandable transcatheter aortic valve replacement with cerebral protection

Group Type OTHER

TAVI: CoreValve® Evolut R™, CoreValve Medtronic; Sentinel™ Cerebral Protection Systems

Intervention Type DEVICE

Interventions

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TAVI: Edwards SAPIEN 3, Edwards Lifesciences, Edwards Sapien Ultra

Intervention Type DEVICE

TAVI: Edwards SAPIEN 3, Edwards Lifesciences, Edwards Sapien Ultra; Sentinel™ Cerebral Protection Systems

Intervention Type DEVICE

TAVI: CoreValve® Evolut R™, CoreValve Medtronic

Intervention Type DEVICE

TAVI: CoreValve® Evolut R™, CoreValve Medtronic; Sentinel™ Cerebral Protection Systems

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patients with aortic stenosis and indication for transfemoral aortic valve replacement
* Freedom of significant stenosis in the area of Truncus brachiocephalicus and left A. carotis (CT)
* Necessary vessel diameter of 6.5-10 mm in the area of A. carotis communis sinistra and 9-15 mm in the area of Truncus brachiocephalicus (for delivery of protection system)
* Anomalies of aortic arch ("bovine arch" variants):

1. Direct outflow of left A. carotis communis out of Truncus brachiocephalicus
2. Conjoint origin of Truncus brachiocephalicus and left A. carotis communis out of aortic arch
* The patient has provided written informed consent

Exclusion Criteria

* Apoplexy/ TIA during the last ½ year
* Severe carotid stenosis (\>70%)
* Symptomatic or asymptomatic carotid stenosis with necessity of TEA or stenting
* Relevant psychiatric diseases
* Severe/ relevant visual, auditory or cognitive deficits which impede targeted anamnesis, neurologic evaluation or consenting.
* Severe neurodegenerative or progressive neuromuscular disease and state after severe craniocerebral injury with permanent neurologic sequelae and structural cerebral diseases
* Pronounced kinking/ stenosis or calcification in the area of the right A. radialis/ brachialis/ subclavia, which impede implantation of the cerebral protection system
* Significant stenosis, relevant calcifications, dissections or aneurysmatic alterations in the area of Truncus brachiocephalicus and/or A. carotis communis sinistra.
* Contraindications for MRI: among others the presence of a non-MRI-compatible pacemaker or defibrillator, metal implants in the area to be evaluated, metal fragments in the craniocerebral area, allergies, claustrophobia.
* Vessel alterations which impede among others the introduction of a 6 French sheath:

1. Inadequate perfusion in the area of the right upper extremity (pathologic Allen´s test, vessel obstructions, peripheral vascular disease)
2. Hemodialysis shunt, grafts, or arteriovenous fistulas in the area of right upper extremity
* Acute myocardial infarction ≤ 1 month prior to the planned procedure
* Every contraindication for the execution of a transfemoral TAVI
* Aortic annulus \<19 or \>29 mm
* Combined aortic vitium with predominant insufficiency.
* Severly reduced leftventricular function ≤ 20%
* Patients who are planned for a hybrid procedure (e.g. conventional operation and TAVI or simultaneous coronary intervention at coronary artery disease needing intervention) 14 days prior to the planned study procedure
* Intracardiac thrombus, hematoma, tumor or vegetations confirmed by echocardiography
* Endocarditis
* Planned concomitant procedure for atrial fibrillation (operative or via catheter ablation) during the follow up phase
* Need for emergency procedure
* Chronic drug-, medication or alcohol abuse
* Consuming disease
* Life expectancy \< 1 year
* Dialysis dependency
* Patient with legal incapacity, who is not able to understand the essence, meaning and consequences of the study
* Participation in other interventional clinical trials in the month of study start or planned participation during the participation of this study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Deutsches Herzzentrum Muenchen

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Deutsches Herzzentrum Muenchen, Klinik für Herz- und Gefäßchirurgie

Munich, Bavaria, Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Stephanie Voss, Dr.

Role: CONTACT

0049 89 1218 0

Facility Contacts

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Stephanie Voss, Dr.

Role: primary

00498912180

Other Identifiers

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290/16s

Identifier Type: -

Identifier Source: org_study_id

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