Actively Recruiting

Phase Not Applicable
Age: 18Years +
All Genders
ID05339061

A Single-Arm, Single-Center, Non-Randomized, Prospective Clinical Study to Evaluate the Safety and Effectiveness of Physician Modified Endograft for Complex Abdominal and Thoracoabdominal Aortic Aneurysm Repair

Led by University of California, Davis · Updated on 2026-05-06

40

Participants Needed

1

Research Sites

52 weeks

Total Duration

On this page

Sponsors

U

University of California, Davis

Lead Sponsor

U

University of California, San Diego

Collaborating Sponsor

AI-Summary

What this Trial Is About

Researchers are evaluating a physician modified endograft for treating complex aortic aneurysms, including pararenal, juxtarenal, and thoracoabdominal types, in high-risk patients who lack options for FDA-approved endovascular repair. This study focuses on patients with aneurysms involving visceral vessels such as the renal arteries, superior mesenteric artery, or celiac trunk. The purpose is to assess the safety and effectiveness of this device in a minimally invasive manner for those who cannot undergo traditional open repair. The treatment involves modifying Cook Medical devices, including Zenith TX2 Dissection Endovascular Grafts, Zenith Alpha Thoracic Endovascular Grafts, and Zenith Fenestrated Abdominal Aortic Aneurysm Endovascular Grafts. These devices are customized by creating fenestrations or branches to preserve blood flow to vital arteries. A staged approach may be used before device implantation to reduce risk. The modified graft is implanted using imaging guidance, and flow through the branches is ensured with selective angiograms. Participants will be followed for five years after enrollment, with visits at one month, six months, one year, and annually thereafter. Follow-up includes clinical exams, which may be conducted by phone or video, along with CT scans and ultrasounds as needed. Researchers will monitor safety by tracking major adverse events within 30 days or hospitalization and measure treatment success at one year and annually up to five years. Lifelong clinical follow-up will also be conducted to evaluate long-term outcomes.

CONDITIONS

Brief Title

Physician Modified Endograft For Complex Aortic Aneurysm Repair

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Patient is over 18 years of age
  • Male or non-pregnant female (females of childbearing potential must have a negative pregnancy test before enrollment)
  • Able and willing to sign an IRB-approved informed consent form
  • Has a complex, juxtarenal, pararenal, or thoracoabdominal abdominal aortic aneurysm (Extent I-V) with at least one of: diameter 5.5 cm or larger, growth of 0.5 cm or more in last 6 months, or symptomatic aneurysm
  • Not treatable with currently approved non-modified devices
  • High risk for open surgical repair due to anatomical or physiological factors
  • Patent iliac or femoral arteries suitable for endovascular access or iliac conduit
  • Suitable non-aneurysmal proximal aortic neck length of 20 mm or more
  • Suitable non-aneurysmal distal iliac artery length of 15 mm or more
  • Repair should preserve at least one hypogastric artery
  • Suitable non-aneurysmal proximal aortic neck diameter between 15 and 42 mm
  • Suitable non-aneurysmal distal common iliac diameters between 7 and 20 mm
Not Eligible

You will not qualify if you...

  • Has a mycotic aneurysm
  • Has a ruptured aneurysm requiring urgent or emergency repair
  • Has systemic or local infection increasing graft infection risk
  • Body habitus prevents X-ray visualization of the aorta
  • Participating or eligible for another manufacturer-sponsored clinical study at another institution
  • Has major surgery or intervention planned within 30 days before or after the repair
  • Currently participating in another investigational device or drug trial
  • Known hypersensitivity or contraindication to anticoagulation or contrast media not amenable to pretreatment
  • Allergy or intolerance to stainless steel, polyester, polypropylene, nickel, titanium, or gold
  • Uncorrectable coagulopathy
  • Unstable angina with increasing or new symptoms
  • History of connective tissue disease like Marfan's or Ehler's-Danlos syndrome
  • Active malignancy with life expectancy under 2 years
  • Limited life expectancy under 2 years
  • Medical, social, or psychological conditions precluding treatment and evaluations
  • Significant occlusive disease, tortuosity, or calcification preventing endovascular access
  • Proximal seal site with circumferential thrombus or atheroma
  • Inability to maintain at least one patent hypogastric artery
  • Shaggy aorta
  • Not suitable for temporary or permanent open surgical or endovascular conduit

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

1 visit (in-person)

Treatment

Duration - Single procedure with possible staged approach 2 to 4 weeks prior to main implantation

Participants undergo a physician-modified endograft procedure to repair complex abdominal or thoracoabdominal aortic aneurysms. This involves modification of the endograft device on a sterile table and implantation through a minimally invasive endovascular approach.

1 to 2 procedures (in-person)

Follow-up

Duration - Up to 5 years

Participants are monitored after treatment to assess safety and effectiveness, including evaluations at one month, six months, one year, and yearly thereafter for up to five years.

Visits at 1 month, 6 months, 1 year, and annually thereafter

Trial Site Locations

Total: 1 location

1

University of California San Diego

San Diego, California, United States, 92037

Actively Recruiting

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Research Team

S

Sina Zarrintan, MD

K

Kathleen Groh

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

NA

Model

SINGLE_GROUP

Primary Purpose

TREATMENT

Number of Arms

1

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Published Research Related To This Trial

Midterm results from a physician-sponsored investigational device exemption clinical trial evaluating physician-modified endovascular grafts for the treatment of juxtarenal aortic aneurysms.

Benjamin W Starnes, Rachel E Heneghan, Billi Tatum

https://pubmed.ncbi.nlm.nih.gov/27687323

Evolution from physician-modified to company-manufactured fenestrated-branched endografts to treat pararenal and thoracoabdominal aortic aneurysms.

Gustavo S Oderich, Mauricio S Ribeiro, Giuliano A Sandri...

https://pubmed.ncbi.nlm.nih.gov/30583902

Low-profile Zenith Alpha™ Thoracic Stent Graft Modification Using Preloaded Wires for Urgent Repair of Thoracoabdominal and Pararenal Abdominal Aortic Aneurysms.

Sukgu M Han, Emanuel R Tenorio, Aleem K Mirza...

https://pubmed.ncbi.nlm.nih.gov/32205248

Intraoperative adverse events and early outcomes of custom-made fenestrated stent grafts and physician-modified stent grafts for complex aortic aneurysms.

Jean Nicolas Sénémaud, Iannis Ben Abdallah, Paul de Boissieu...

https://pubmed.ncbi.nlm.nih.gov/31708298