Safety and Effectiveness of Percutaneous Axillary Artery Access for Complex Aortic Interventions.
Christopher J Agrusa, Peter H Connolly, Sharif H Ellozy...
https://pubmed.ncbi.nlm.nih.gov/31394224/Actively Recruiting
Led by Darren Schneider, M.D. · Updated on 2025-12-15
520
Participants Needed
2
Research Sites
260 weeks
Total Duration
Researchers are evaluating the feasibility, safety, and clinical outcomes of endovascular repair for complex aortic aneurysms, including thoracoabdominal aortic aneurysms TAAA and aortic arch aneurysms. This study focuses on patients considered high risk for open surgery and compares two approaches within two study arms one for TAAA and one for aortic arch aneurysms. The goal is to assess how well these minimally invasive techniques work in managing these serious aneurysms. The study involves implanting specialized stent graft devices tailored to each aneurysm type. In the TAAA arm, either a standard Off-the-Shelf multibranched stent graft or a custom-made physician-specified branched and fenestrated stent graft is used. These devices are designed to maintain blood flow to vital arteries supplying the liver, stomach, intestines, and kidneys. In the aortic arch arm, customized stent grafts with up to three branches or a retrograde left subclavian branch stent-graft with wide scallops are implanted to treat aneurysms involving the aortic arch and its branches. Participants will undergo pre-treatment assessments and receive the endovascular repair procedure. They will be followed closely with evaluations including technical and procedural success during and after the operation, and monitoring for aneurysm-related mortality and treatment success up to one year. Further yearly assessments for up to five years will check artery patency, survival, complications, and stent graft performance. The entire involvement ensures ongoing safety monitoring and evaluation of long-term outcomes after the procedure.
CONDITIONS
Endovascular Treatment of TAAA and Aortic Arch Aneurysms Using Fenestrated and Branched Stent Grafts
D
Darren Schneider, MD
K
Kiera Zehner
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Darren Schneider, M.D.
Lead Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Custom endovascular stent-graft repair for thoracoabdominal aortic aneurysm | Custom endovascular stent-graft repair for aortic arch aneurysm |
|---|---|---|
| What it is | A custom-made endovascular stent-graft system designed to treat thoracoabdominal aortic aneurysms by relining the diseased segment of the aorta and preserving blood flow to major abdominal arteries via branches or fenestrations. | A custom-made endovascular stent-graft system designed to treat aortic arch aneurysms by relining the affected segment of the arch and preserving blood flow to the head, neck, and arms through multiple branch cuffs. |
| Role in trial | Primary arm for patients with thoracoabdominal aortic aneurysm, evaluating technical and procedural success of the custom stent-graft. | Primary arm for patients with aortic arch aneurysm, evaluating technical and procedural success of the custom arch stent-graft. |
| Primary use | Endovascular repair of thoracoabdominal aortic aneurysm in patients considered high-risk for open surgery. The aim is to prevent aneurysm rupture while preserving blood flow to vital organs. | Endovascular repair of aortic arch aneurysm in patients considered high-risk for open surgical repair. The procedure aims to prevent rupture while maintaining arterial supply to the head and arms. |
| How it is given or performed | The custom stent-graft is delivered via endovascular access—typically through the femoral or iliac arteries—using imaging guidance. Branches or fenestrations are aligned with target arteries. The procedure is suitable for patients with specific anatomical and high-risk criteria. | The custom arch stent-graft is delivered endovascularly, with placement guided by imaging to align branch cuffs with supra-aortic vessels. The approach requires prior anatomical assessment to ensure suitable landing zones and artery sizes. |
| Evidence status | Published multicenter studies show technical success for custom branched/fenestrated endovascular repair in high-risk TAAA patients, with procedural success and survival dependent on aneurysm extent and patient factors. | Current published evidence for custom endovascular arch repair is limited. The trial aims to provide procedural and outcome data in high-risk patients where traditional surgery is not feasible. |
| Important limitations | Success depends on anatomical suitability and high-risk inclusion. Complex procedures may involve prolonged imaging, risk of organ or vessel injury, and device migration. Limited long-term outcome data for this investigational custom device. | Custom arch repair may be limited by the complexity of supra-aortic vessel anatomy. Risks include possible stroke, device migration, and procedural complications. Published outcome evidence is less mature, and long-term results are still pending. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
You may qualify if you...
You will not qualify if you...
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
Duration - Single procedure
Participants receive an endovascular stent graft implantation procedure to treat thoracoabdominal or aortic arch aneurysms using customized or off-the-shelf fenestrated and branched stent grafts designed for their aneurysm anatomy.
1 procedure visit (in-person)
Duration - Up to 5 years
Participants are followed for clinical outcomes, safety, and device performance, including monitoring for aneurysm-related mortality, complications, and stent graft function over time.
Yearly visits for up to 5 years
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NON_RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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https://pubmed.ncbi.nlm.nih.gov/33262091/Darren Schneider, M.D.
Lead Sponsor