Thoraflex Hybrid: Thoraflex Hybrid is designed for the open surgical repair of aneurysms and/or dissections in the aortic arch and descending aorta with or without involvement of the ascending aorta. There are two types of Thoraflex Hybrid implants, namely the Plexus 4 and the Ante-Flo versions. Each patient receives one Thoraflex Hybrid device (either the Plexus 4 or Ante-Flo).
RelayPro NBS: The RelayPro NBS Thoracic Stent-Graft System is an endovascular device intended for treatment of thoracic aortic pathologies such as aneurysms, pseudoaneurysms, dissections, penetrating ulcers and intramural hematoma.
Study summary
The goal of this observational study is to evaluate the Thoraflex Hybrid device alone and in combination with the RelayPro NBS stent-graft in the treatment of aortic disease affecting the aortic arch and descending aorta with or without involvement of the ascending aorta.
Patients who undergo treatment with the Thoraflex Hybrid device with or without extension with a RelayPro NBS stent-graft will be eligible for enrolment and study activities and follow-up regime will follow standard care at each participating site.
Participant involvement in the study will last for a total of 10 years from the point at which the Thoraflex Hybrid device is placed.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
Patient is aged 18 years or older on date of consent. Patient is willing and able to comply with all study procedures and visits. Patient or their next of kin (NOK)/legally designated representative (LDR) has given written informed consent to participate in the study.
Patient will undergo treatment with a Thoraflex Hybrid device. If a patient requires an extension procedure due to the extent of aortic disease, a RelayPro NBS Stent-graft should be placed inside the distal end of the previously placed Thoraflex Hybrid device via a retrograde approach. This may be part of the same or a two-stage procedure.
Exclusion Criteria:
* Patient has any medical, social, or psychological problems that in the opinion of the investigator preclude them from receiving this treatment and the procedures and evaluations pre and post procedure.
Primary outcome measure(s)
Primary Safety Endpoint is a composite of the following: — The primary safety endpoint will be measured at one-year after the index procedure and again at least 8 months after the (first) extension procedure. * Permanent disabling stroke (mRS \>2 and an increase in at least one mRS category from the individual's pre-stroke baseline, occurring within 30 days of either index procedure or extension and present at 1-year follow-up)\* Note: If a subject dies prior to 1-year follow-up, their last recorded mRS will be considered their final score
* Grade 3 spinal cord ischemia (SVS reporting standards) occurring within 30 days of either index procedure or extension
* All-cause mortality (within 1 year of either procedure)
(\*Per VARC-3, disability assessment using the mRS should be performed between 30 and 90 days after a neurological event with 90 days being optimal. An increased mRS score by itself and in the absence of a neurological event does not constitute stroke.)
Primary Effectiveness Endpoint: Treatment Success — The primary effectiveness endpoint will be measured at one-year after the index procedure and again at least 8 months after the (first) extension procedure. Defined as device technical success (of either procedure) with absence of the following at 1-year:
* Lesion-related mortality (defined as all deaths occurring within 30 days of, or, prior to discharge, from either the index procedure or the extension procedure or any revision procedures to treat the original lesion(s) and any other deaths adjudicated by Clinical Events Committee as related or probably related to the lesion(s))
* Aortic rupture in the treated segment
* Lesion expansion (≥5mm increase from measurement at discharge/within 30 days)
* Secondary intervention to address the following:
* Stent graft-induced aortic wall injury (SAWI)
* Fistula
* Type I or III endoleak (see definitions)
* Migration
* Loss of Patency
* Thromboembolic events
* Failure of integrity
Trial sites (27)
Facility
City
Region
Status
University of Alabama in Birmingham Medical Center
Birmingham
Alabama
Cedars-Sinai Medical Centre
Los Angeles
California
Keck Medical Centre of USC
Los Angeles
California
University of Colorado
Aurora
Colorado
Hartford Hospital
Hartford
Connecticut
Medstar Washington Hospital Centre
Washington D.C.
District of Columbia
Northwestern University
Chicago
Illinois
Ascension St. Vincent Heart Center
Indianapolis
Indiana
University of Maryland
Baltimore
Maryland
Massachusetts General Hospital
Boston
Massachusetts
Washington University/Barnes Jewish Hospital
St Louis
Missouri
Weill Cornell medicine
New York
New York
Duke University Medical Centre
Durham
North Carolina
University of Pennsylvania
Philadelphia
Pennsylvania
UPMC Presbyterian
Pittsburgh
Pennsylvania
UT Dell Medical / Ascension Texas Cardiovascular
Austin
Texas
Baylor College of Medicine - St. Luke's
Houston
Texas
University of Utah
Salt Lake City
Utah
Paracelsus Medical University
Salzburg
Austria
CHU Nantes
Saint-Herblain
France
CHU de Toulouse - Hôpital de Rangueil
Toulouse
France
University of Freiburg
Freiburg im Breisgau
Germany
Policlinico Di S.Orsola, Universita' Di Bologna
Bologna
Italy
Hospital Clinic of Barcelona
Barcelona
Spain
University Hospitals Bristol and Weston NHS Foundation Trust
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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