Comparison of EVAR and ESAR for Infrarenal Aortic Aneurysms With a Wide Proximal Neck

NCT ID: NCT05484115

Last Updated: 2025-12-22

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

RECRUITING

Clinical Phase

NA

Total Enrollment

300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-05-26

Study Completion Date

2033-04-30

Brief Summary

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The HERCULES trial is a Randomized controlled clinical trial designed to prospectively compare endosuture aneurysm repair (ESAR) to standard endovascular aneurysm repair (EVAR) clinical outcomes in treatment of infrarenal abdominal aortic aneurysm (AAA) in subjects having wide proximal aortic neck diameters (≥ 28mm and ≤ 32mm).

Detailed Description

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HERCULES is an investigator driven trial and a collaborative research project with Medtronic.

Design; Prospective, post-market, global, multicenter, randomized (1:1), two-arm, superiority trial

Up to 300 subjects will be recruited in up to 40 sites in Europe and the US. All subjects shall be followed per local societal guidelines and per the Endurant II/IIs and Heli-FX EndoAnchor instruction for use (IFU) recommendations for post-implant follow-up and CT-imaging, with expected assessments at baseline, index procedure(s), 1-month, and annually at 1, 2, 3, 4, and 5 years post-index procedure.

Devices used in HERCULES include the Endurant II/IIs stent graft system (EVAR arm) and the Endurant II/IIs stent graft system plus the Heli-FX EndoAnchor System (ESAR arm)

This study is being conducted to collect clinical evidence from treatment of patients with infrarenal AAA having wide proximal aortic neck diameters (≥ 28mm and ≤ 32mm), comparing clinical outcomes with treatment of the AAA with the Endurant II/IIs stent graft in conjunction with Heli-FX EndoAnchors to treatment of the AAA with the Endurant II/IIs stent graft alone. Though both the Endurant II/IIs stent graft and Heli-FX EndoAnchors are commercially approved in this indication, clinical evidence comparing these two treatments in patients with wide proximal aortic neck diameters is not currently available. Collecting clinical data specific to this patient population, including procedure and imaging data as well as long term outcomes, will provide a foundation to further characterize the clinical outcomes of treatment for patients with infrarenal AAA with wide proximal aortic neck diameters.

Conditions

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Aortic Aneurysm, Abdominal

Keywords

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AAA Endovascular treatment Wide proximal neck EndoAnchors Infrarenal EVAR (Endovascular aneurysm repair) ESAR (Endosuture aneurysm repair) Endurant II/IIs stent graft system Heli-FX EndoAnchor system

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

HERCULES is a post-market, prospective, global, multicenter, randomized (1:1), two-arm, superiority trial designed to compare ESAR to standard EVAR clinical outcomes in treatment of infrarenal AAA in patients having wide proximal aortic neck diameters (≥ 28mm and ≤ 32mm).
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Standard endovascular aneurysm repair (EVAR) using the Endurant II/IIs stent graft system

Group Type ACTIVE_COMPARATOR

endovascular aneurysm repair (EVAR) using the Endurant II/IIs stent graft system

Intervention Type DEVICE

treatment of AAA's with wide proximal neck diameters with Endurant II/IIs endograft system

Endosuture aneurysm repair (ESAR) with the Endurant II/IIs in conjunction with Endoanchors

Group Type ACTIVE_COMPARATOR

endosuture aneurysm repair (ESAR) using Heli-FX EndoAnchor system

Intervention Type DEVICE

treatment of AAA's with wide proximal neck diameters with the Endurant II/IIs in conjunction with the Heli-FX EndoAnchor system

Interventions

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endovascular aneurysm repair (EVAR) using the Endurant II/IIs stent graft system

treatment of AAA's with wide proximal neck diameters with Endurant II/IIs endograft system

Intervention Type DEVICE

endosuture aneurysm repair (ESAR) using Heli-FX EndoAnchor system

treatment of AAA's with wide proximal neck diameters with the Endurant II/IIs in conjunction with the Heli-FX EndoAnchor system

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Age 18 years or older
* Provided written informed consent
* Clinical necessity for treatment of the AAA, according to the current guidelines in the geographies participating
* Elective repair
* Eligible anatomy for treatment with the Endurant II/IIs stent graft system and Heli-FX EndoAnchor system according to the IFU of both devices
* Infrarenal neck diameter ≥ 28 mm and ≤32 mm
* Proximal neck length ≥10mm

Exclusion Criteria

* Anatomy outside the IFU of the ndurant II/IIs stent graft system and Heli-FX EndoAnchor system
* Planned use of AUI main body device
* Patient is participating in another clinical study, potentially conflicting with the outcomes of the current study.
* Patient with eGFR \< 30 ml/min/1.73m2 before the intervention
* Patient's life expectancy \<2 years as judged by the investigator
* Patient has a psychiatric or other condition that may interfere with the study
* Patient has a known allergy to any device component
* Patients with a systemic infection who may be at increased risk of endovascular graft infection.
* Patient has a coagulopathy or uncontrolled bleeding disorder
* Patient has a ruptured, leaking, or mycotic aneurysm
* Patient is not eligible for standard EVAR
* Patient had a Cerebro Vascular Accident (CVA) or a myocardial infarction (MI) within the prior three months
* Patient is pregnant (Female patients of childbearing potential only)
* Patient has active COVID-19 infection or has been diagnosed with long COVID-19 requiring hospitalization within the 6 months prior to procedure.
* Patient has previously been treated with stent grafts in the aorto-iliac arteries
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medtronic

INDUSTRY

Sponsor Role collaborator

Rijnstate Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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MMPJ Reijnen, Prof. Dr.

Role: PRINCIPAL_INVESTIGATOR

Rijnstate, Arnhem, the Netherlands

K. Donas, Prof. Dr.

Role: PRINCIPAL_INVESTIGATOR

Asklepios Clinic Langen, Langen, Germany

Locations

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Washington Regional Medical Center

Washington, Arkansas, United States

Site Status RECRUITING

Mt Sinai Med Ctr

Miami Beach, Florida, United States

Site Status RECRUITING

Loyola

Maywood, Illinois, United States

Site Status RECRUITING

Henry Ford Hospital

Detroit, Michigan, United States

Site Status NOT_YET_RECRUITING

Beaumont University Hospital

Royal Oak, Michigan, United States

Site Status RECRUITING

Alina Health

Minneapolis, Minnesota, United States

Site Status RECRUITING

University of Missouri

Columbia, Missouri, United States

Site Status RECRUITING

Barnes-Jewish Hospital

St Louis, Missouri, United States

Site Status RECRUITING

Robert Wood Johnson University Medical Center

New Brunswick, New Jersey, United States

Site Status RECRUITING

Sisters of Charity hospital

Buffalo, New York, United States

Site Status RECRUITING

Stony Brook University Medical Center

Stony Brook, New York, United States

Site Status RECRUITING

NC Heart& Vascular

Raleigh, North Carolina, United States

Site Status RECRUITING

Promedica Toledo Hospital

Toledo, Ohio, United States

Site Status RECRUITING

Ballad Health/Holston Valley

Kingsport, Tennessee, United States

Site Status RECRUITING

Virginia Commonwealth University (VCU)

Richmond, Virginia, United States

Site Status RECRUITING

HCL Lyon

Lyon, , France

Site Status RECRUITING

Saint Joseph Marseille

Marseille, , France

Site Status RECRUITING

Les Franciscaines

Nîmes, , France

Site Status RECRUITING

Asklepios Klinik Langen

Langen, Hesse, Germany

Site Status RECRUITING

Universitatsklinikum Frankfurt

Frankfurt, , Germany

Site Status NOT_YET_RECRUITING

University Hospital Leipzig

Leipzig, , Germany

Site Status NOT_YET_RECRUITING

IRCCS Ospedale Policlinico San Martino

Genova, Metropolitan City of Genoa, Italy

Site Status RECRUITING

Osp. S.Orsola Malpighi - Bologna

Bologna, , Italy

Site Status RECRUITING

Noordwest ziekenhuis

Alkmaar, North Holland, Netherlands

Site Status NOT_YET_RECRUITING

Spaarne Gasthuis

Haarlem, North Holland, Netherlands

Site Status NOT_YET_RECRUITING

Rijnstate hospital

Arnhem, , Netherlands

Site Status RECRUITING

Catharina Ziekenhuis

Eindhoven, , Netherlands

Site Status RECRUITING

Hospital Clinic de Barcelona

Barcelona, , Spain

Site Status RECRUITING

Hospital Ramon Y Cajal

Madrid, , Spain

Site Status RECRUITING

Hospital Clinico Universitario Lozano Blesa

Zaragoza, , Spain

Site Status RECRUITING

Hospital Universitario Miguel Servet

Zaragoza, , Spain

Site Status NOT_YET_RECRUITING

EHC-Hôpital de Morges

Morges, , Switzerland

Site Status RECRUITING

Queen Elizabeth University Hospital, Glasgow

Glasgow, , United Kingdom

Site Status RECRUITING

Leeds General Infirmary

Leeds, , United Kingdom

Site Status RECRUITING

St. George's Hospital

London, , United Kingdom

Site Status RECRUITING

St. Mary's Hospital

London, , United Kingdom

Site Status RECRUITING

Countries

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United States France Germany Italy Netherlands Spain Switzerland United Kingdom

Central Contacts

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Suzanne Holewijn, PhD

Role: CONTACT

Phone: 0031880057282

Email: [email protected]

Daphne van der Veen, MSc

Role: CONTACT

Phone: 0031880057282

Email: [email protected]

Facility Contacts

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P. Dr. Halandras, MD

Role: primary

Dr. Mitchel Weaver

Role: primary

Prof. Dr. med. Konstantinos Donas, MD PhD

Role: primary

Anja Bukvarevic

Role: backup

Prof. Dr. med. Kyriakos Oikonomou, Prof. MD

Role: primary

Tanja Dietrich

Role: backup

Dr. Schmidt, MD PhD

Role: primary

Steffi Anding

Role: backup

Prof. G. Pratesi

Role: primary

M Prof. Gargiulo, PhD

Role: primary

Dr. Cagdas Unlu

Role: primary

Dr. Maarten Truijers

Role: primary

Suzanne Holewijn, PhD

Role: primary

Daphne van der Veen, MSc

Role: backup

Ph.W.M. Cuypers

Role: primary

A. Dr. Reyes Valdivia, MD

Role: primary

Dr Gabriel C. Inaraja Perez

Role: primary

Dr Marzo Alvarez

Role: primary

P. Dr. Walker, MD

Role: primary

I Prof. Loftus, MD PhD

Role: primary

Other Identifiers

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2021-1968

Identifier Type: -

Identifier Source: org_study_id