An Evaluation of the AeriSeal System for CONVERTing Collateral Ventilation Status in Patients With Severe Emphysema

NCT ID: NCT06035120

Last Updated: 2025-12-02

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

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-02-22

Study Completion Date

2028-03-31

Brief Summary

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This is a prospective, open-label, multi-center, single-arm study planned to enroll 200 subjects with heterogeneous emphysema and collateral ventilation (CV) in the target lobe. Subjects will undergo instillation of AeriSeal Foam in the target lobe and subsequent assessment of CV status using Chartis Pulmonary Assessment System. Subjects with CV- status will then undergo placement of Zephyr Valve in the target lobe for bronchoscopic lung volume reduction (BLVR) and be followed for 24 months.

Detailed Description

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This is a multicenter, prospective, single-arm, pivotal trial with a 24-month follow-up to evaluate the safety and effectiveness of the AeriSeal System to block CV. The study plans to enroll up to 200 subjects at up to 35 clinical centers in US and OUS. Study subjects will be patients with severe, heterogeneous emphysema and collateral ventilation in the lobe targeted who are candidates for BLVR. Subjects meeting initial eligibility will undergo a bronchoscopy procedure under general anesthesia during which the presence of CV will be confirmed using Chartis. All enrolled subjects meeting final eligibility will undergo the AeriSeal procedure. Conversion of collateral ventilation status from CV+ to CV- in the target lobe will be evaluated by Chartis at Day 45 post-AeriSeal treatment (primary effectiveness endpoint). All subjects not converted from CV+ to CV- status will undergo a repeat of the AeriSeal procedure, provided that the total volume from both the initial and the repeat treatments does not exceed 40 mL in up to 3 segments. All subjects converted from CV+ to CV- status after either the index or repeat AeriSeal procedure will undergo BLVR with Zephyr Valve per standard of care in accordance with the approved instructions for use and will be followed through Month 24 (end of study). All CV+ subjects who remain CV+ after the repeat procedure or do not undergo the repeat AeriSeal procedure will be followed through Month 24 (end of study).

Conditions

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Emphysema, Pulmonary Emphysema or COPD

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

The study is designed as a single-arm clinical trial in which eligible subjects with an identified fissure gap in the target lobe will be treated with the AeriSeal System to determine the rate of conversion from having collateral ventilation (CV+) to having little to no collateral ventilation (CV-). Subjects who convert to CV- status with AeriSeal will then undergo BLVR using Zephyr Valve per standard of care.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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AeriSeal

All enrolled subjects meeting final eligibility will undergo the AeriSeal procedure to block collateral ventilation by closing the lobar fissure gaps or collateral air channels.

Group Type EXPERIMENTAL

AeriSeal System

Intervention Type DEVICE

The AeriSeal System comprises AeriSeal Foam and the AeriSeal Balloon Catheter Preparation Kit that is used for bronchoscopic delivery of AeriSeal Foam to the targeted regions of the lung.

Interventions

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AeriSeal System

The AeriSeal System comprises AeriSeal Foam and the AeriSeal Balloon Catheter Preparation Kit that is used for bronchoscopic delivery of AeriSeal Foam to the targeted regions of the lung.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Subject is willing and able to provide informed consent and to participate in the study.
2. Subject is aged ≥ 40 and ≤ 80 years at the time of the ICF signature date.
3. Subject has completed a documented pulmonary rehabilitation (in clinic or home-based) program within 12 months prior to Baseline.
4. Subject has stopped smoking for at least 8 weeks prior to the ICF signature date as confirmed by carboxyhemoglobin or cotinine levels.
5. Subject has a recent HRCT meeting the scan parameter requirements and performed within 3 months of the ICF signature date with the following findings at -910 Hounsfield Units:

1. At least one (1) lobe with segmental emphysema destruction score ≥ 50%.
2. Subject has heterogenous emphysema, defined as difference in emphysema destruction score of ≥ 15 between the density scores of the target lobe and the ipsilateral non-target lobe(s) per QCT report with % voxel density of \< -910 HU. For non-target lobes that include the RML, calculate the combination of non-target lobes as a single density score using volume-weighted percent.
3. LUL, LLL, RUL, RLL, or RUL+RML are targets for valve intervention.
4. Subject has a gap in the interlobar fissure that corresponds to one or more segments and the fissure(s) contacting the target lobe is ≥ 80% complete per QCT report.
5. Subject has 98% of the fissure gap confined to a maximum of 3 segments within the target lobe per Fissure Targeting Report (FTR).
6. Subject has 6MWD ≥ 150 m and ≤ 450 m.
7. Subject has clinically significant dyspnea with an mMRC score of ≥ 2.
8. Subject has post-bronchodilation FEV1 ≥ 15% predicted and ≤ 45% predicted.
9. Subject has an FEV1/FVC ratio of \< 0.7.
10. Subject has post-bronchodilation TLC, measured by body plethysmography, ≥ 100% predicted.
11. Subject has post-bronchodilation RV ≥ 175% predicted, measured by body plethysmography.
12. Subject has post-bronchodilation DLCO ≥ 20% predicted.
13. Subject has received preventative vaccinations against potential respiratory infections, including COVID-19, consistent with local recommendation or policy.
14. Subject is on optimal medical management for more than one month prior to the ICF signature date.
15. Subject has collateral ventilation (CV+) as confirmed per the Chartis assessment prior to the AeriSeal Index Procedure.

Exclusion Criteria

1. Subject has prior lung volume reduction surgery, lobectomy or pneumonectomy, lung transplantation, airway stent placement, pleurodesis, or BLVR of any type, except BLVR using Zephyr Valve with \< 50% TLVR at 6 months, followed by valve removal \> 6 months prior to ICF signature date.
2. Subject has visible radiological abnormality on HRCT scan such as pulmonary nodule greater than 0.8 cm in diameter (does not apply, if present for 2 years or more without increase in size or if deemed benign by biopsy) or active pulmonary infection (e.g., unexplained parenchymal infiltrate, significant interstitial lung disease or significant pleural disease).
3. Post-COVID-19 pathology on CT, including ground glass opacities with or without consolidation, adjacent pleura thickening, interlobular septal thickening, or air bronchograms.
4. Large bullae encompassing greater than 1/3 of the total lung.
5. Subject had 3 or more COPD exacerbations requiring hospitalization within 12 months preceding the ICF signature date or a COPD exacerbation requiring hospitalization within 8 weeks of the ICF signature date. Subjects may be re-considered for future enrollment.
6. Subject has asthma as their primary diagnosis.
7. Subject has chronic bronchitis (defined as greater than 4 tablespoons of sputum production per day) as their primary diagnosis.
8. Subject has clinically significant bronchiectasis.
9. Subjects with evidence of active respiratory infection should be considered for enrollment only after satisfactory resolution.
10. Subject requires invasive ventilatory support. Note: The use of Continuous Positive Airway Pressure (CPAP) or BiPAP devices for sleep apnea is permitted.
11. Subject has severe gas exchange abnormalities as defined by any one of the following tests, conducted at rest, on room air, as tolerated.

* PaCO2 ≥ 50 mm Hg (6.7 kPa)
* PaO2 \< 45 mm Hg (6.0 kPa)
12. Subject has pulmonary hypertension, defined as mean pulmonary systolic pressure \> 45 mm Hg.
13. Subject has known documented alpha-1 antitrypsin deficiency.
14. Subject has clinically significant hematological disorder.
15. Subject has recent significant unplanned or unexplained weight loss or other relevant comorbidities considered by the investigator to be potentially confounding or limiting to the subject's participation in the study.
16. Subject has non-atrial arrhythmias or conduction abnormalities on EKG.
17. Subject has high cardiac risk after undergoing cardiac risk assessment in accordance with published guidelines (Fleisher 2007) or has ischemic heart disease, congestive heart failure, cerebrovascular disease (stroke or TIA within 6 months of the ICF signature date), serum creatinine \> 2.0 mg/dL (177 μmol/L), or left ventricular ejection fraction (LVEF) \< 45% on echocardiogram.
18. Subject has uncontrolled exercise induced syncope.
19. Subject has evidence of severe disease which in the judgment of the investigator may compromise the anticipated treatment effect or the subject's survival for the duration of at least 12 months.
20. Subject has any other condition that the investigator believes would interfere with the intent of the study or would make participation not in the best interest of the subject including but not limited to alcoholism, high risk for drug abuse, or noncompliance in returning for follow-up visits.
21. Subject cannot tolerate corticosteroids or relevant antibiotics.
22. Subject use of systemic corticosteroids \> 20 mg/day prednisolone or equivalent within four (4) weeks of the ICF signature date. Subjects may be re-considered for future enrollment.
23. Subject use of immunosuppressive agents within four (4) weeks of the ICF signature date. Subjects may be re-considered for future enrollment.
24. Subject is unable to temporarily discontinue heparins and oral anticoagulants (e.g., warfarin, dicumarol) according to local pre-procedural protocols. Note: Antiplatelet drugs including aspirin, thienopyridines and ticagrelor are permitted.
25. Subject has allergy or sensitivity to medications required to safely perform bronchoscopy under conscious sedation or general anesthesia.
26. Subject has known allergy to the following device components: Polyether block amide (PEBAX), Polyvinyl Alcohol or Glutaraldehyde, Nitinol (nickel-titanium) or its constituent metals (nickel or titanium) or Silicone.
27. Subject is a female who is pregnant (positive βHCG Pregnancy test), breast-feeding, or planning to be pregnant in the next 12 months.
28. Subject has Body Mass Index \< 18 kg/m2 or \> 35 kg/m2.
29. Subject participated in an investigational study of a drug, biologic, or device not currently approved for marketing within 30 days prior to the ICF signature date. Note: Subjects being followed as part of a long-term surveillance of a non-pulmonary study that has reached its primary endpoint are eligible for participation in this study.
Minimum Eligible Age

40 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Pulmonx Corporation

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Narinder Shargill, PhD

Role: STUDY_DIRECTOR

Pulmonx Corporation

Locations

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Banner University Medical Center

Phoenix, Arizona, United States

Site Status RECRUITING

Saint Francis Hospital and Medical Center (Trinity Health of New England)

Hartford, Connecticut, United States

Site Status RECRUITING

Orlando Health

Orlando, Florida, United States

Site Status RECRUITING

Northwestern University

Chicago, Illinois, United States

Site Status RECRUITING

University of Chicago Medical Center

Chicago, Illinois, United States

Site Status RECRUITING

OSF Saint Francis Medical Center

Peoria, Illinois, United States

Site Status RECRUITING

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Site Status RECRUITING

Brigham Lung Center

Boston, Massachusetts, United States

Site Status RECRUITING

Henry Ford Hospital

Detroit, Michigan, United States

Site Status RECRUITING

Cleveland VA Northeast

Cleveland, Ohio, United States

Site Status COMPLETED

Penn Medicine

Philadelphia, Pennsylvania, United States

Site Status RECRUITING

Temple University

Philadelphia, Pennsylvania, United States

Site Status RECRUITING

Allegheny General Hospital

Pittsburgh, Pennsylvania, United States

Site Status RECRUITING

University of Pittsburgh Medical Center (UPMC)

Pittsburgh, Pennsylvania, United States

Site Status RECRUITING

Fort Sanders Regional Medical Center (StatCare)

Knoxville, Tennessee, United States

Site Status RECRUITING

University of Texas Southwestern

Dallas, Texas, United States

Site Status RECRUITING

Inova Fairfax Hospital

Falls Church, Virginia, United States

Site Status RECRUITING

Medical College of Wisconsin (MCW)

Milwaukee, Wisconsin, United States

Site Status RECRUITING

Royal Adelaide Hospital

Adelaide, , Australia

Site Status RECRUITING

Wesley Hospital

Brisbane, , Australia

Site Status RECRUITING

Macquarie University

Macquarie Park, , Australia

Site Status RECRUITING

Klinik Floridsdorf

Vienna, , Austria

Site Status RECRUITING

Rigshospitalet

Copenhagen, , Denmark

Site Status COMPLETED

CHU Limoges

Limoges, , France

Site Status RECRUITING

Hopital Bichat-APHP

Paris, , France

Site Status RECRUITING

CHRU Strasbourg

Strasbourg, , France

Site Status RECRUITING

CHU Toulouse

Toulouse, , France

Site Status RECRUITING

Ruhrlandklink, Uni Essen

Essen, , Germany

Site Status RECRUITING

Universitätsklinikum Halle

Halle, , Germany

Site Status RECRUITING

Asklepios Klinik Barmbek

Hamburg, , Germany

Site Status RECRUITING

Thoraxklinik am Universitats klinikum Heidelberg

Heidelberg, , Germany

Site Status RECRUITING

Lungenklinik Hemer

Hemer, , Germany

Site Status RECRUITING

ASST Spedali Civili, University Hospital

Brescia, , Italy

Site Status RECRUITING

University Medical Center Groningen

Groningen, , Netherlands

Site Status RECRUITING

Hospital Universitario y Politecnico La Fe

Valencia, , Spain

Site Status RECRUITING

Royal Brompton Hospital

London, England, United Kingdom

Site Status RECRUITING

Countries

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United States Australia Austria Denmark France Germany Italy Netherlands Spain United Kingdom

Central Contacts

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Christina Kutzavitch, PhD

Role: CONTACT

+1 650-216-0134

Joshua Percy

Role: CONTACT

+1 650-810-1420

Facility Contacts

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Surya Olguin

Role: primary

602-521-3400

Raed Alalawi, MD

Role: backup

602-521-3400

Kendra Williams

Role: primary

860-714-7161

Karla Ferrer

Role: primary

321-841-6764

Adriana Martinez

Role: primary

312-926-6680

Vanita Patel

Role: primary

773-702-9660

Kimberly Hartwig

Role: primary

309-655-4229

Adnan Majid, MD

Role: primary

617-667-7000

Majid Shafiq, MD

Role: primary

617-525-6645

Avi Cohen, MD

Role: primary

Kevin Ma, MD

Role: primary

Gerard Criner, MD

Role: primary

Paige Rutter

Role: primary

412-295-7659

Paula Consolaro

Role: primary

412-605-1904

Frank Sciurba, MD

Role: backup

412-648-6494

Jennifer Thornton

Role: primary

865-588-8831

Khyati Vadera

Role: primary

214-645-8464

Muhanned Abu-Hijleh, MD

Role: backup

214-645-8464

Priya Patel, MD

Role: primary

571-472-1380

Sam Servi

Role: primary

414-955-7030

Jonathan Kurman, MD

Role: backup

414-955-7040

Phan Nguyen, MD

Role: primary

Jenny McGrath

Role: backup

Farzad Bashirzadeh, MD

Role: primary

Chris Henderson

Role: backup

+61 07 3721 1724

Alvin Ing, MD

Role: primary

Jessica Lewis

Role: backup

+61 9812 2974

Arschang Valipour, MD

Role: primary

Thomas Egenod, MD

Role: primary

Hakima Rabia

Role: primary

+33 (0)1 40 25 69 16

Armelle Marceau, MD

Role: backup

+33 1 40 25 69 12

Michele Porzio, MD

Role: primary

Nicolas Guibert, MD

Role: primary

Jennifer Thaelker

Role: primary

+49 201 43301

Ruediger Karpf-Wissel, MD

Role: backup

+49 201 43301

Stephan Eisenmann, MD

Role: primary

Ralf Eberhardt, MD

Role: primary

Felix Herth, MD

Role: primary

Kaid Darwiche, MD

Role: primary

+49 2372 908-0

Birte Schwarz

Role: backup

+49 (0)2 372-908-2179

Michela Bezzi, MD

Role: primary

Dirk-Jan Slebos, MD

Role: primary

Enrique Cases Viedma, MD

Role: primary

Pallav Shah, MD

Role: primary

+44 0207 351 8021

Ashish Karir, MD

Role: backup

+44 0207 351 8030

Other Identifiers

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630-2000-01

Identifier Type: -

Identifier Source: org_study_id

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