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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT05409976
Registration number
NCT05409976
Ethics application status
Date submitted
17/05/2022
Date registered
8/06/2022
Titles & IDs
Public title
The GORE® VIAFORT Vascular Stent IVC Study
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Scientific title
Evaluation of the GORE® VIAFORT Vascular Stent for Treatment of Symptomatic Inferior Vena Cava Obstruction With or Without Combined Iliofemoral Obstruction
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Secondary ID [1]
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VNS 21-05
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Venous Thromboses
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Venous Disease
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Venous Leg Ulcer
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Venous Stasis
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0
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Venous Ulcer
0
0
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Venous Stenosis
0
0
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Venous Occlusion
0
0
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Vein Thrombosis
0
0
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Vein Occlusion
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0
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Vein Disease
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0
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Condition category
Condition code
Cardiovascular
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0
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0
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Diseases of the vasculature and circulation including the lymphatic system
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Cardiovascular
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0
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Other cardiovascular diseases
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Blood
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0
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Clotting disorders
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Skin
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Other skin conditions
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Oral and Gastrointestinal
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Devices - GORE® VIAFORT Vascular Stent
Experimental: GORE® VIAFORT Vascular Stent - GORE® VIAFORT Vascular Stent
Treatment: Devices: GORE® VIAFORT Vascular Stent
Treatment of symptomatic IVC obstruction with or without combined iliofemoral obstruction with the GORE® VIAFORT Vascular Stent.
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Intervention code [1]
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Treatment: Devices
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Composite of efficacy and safety events
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Assessment method [1]
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Composite primary endpoint consisting of freedom from the following:
* Loss of primary patency through 12-month follow-up
* Stent embolization through 12-month follow-up
* Device- or procedure-related death through 30 days
* Clinically significant pulmonary embolism confirmed via Computed Tomography Angiography through 30 days
* Device- or procedure-related vascular injury through 30 days requiring surgical or endovascular intervention
* Device- or procedure-related major bleeding events through 30 days
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Timepoint [1]
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12 months
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Secondary outcome [1]
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Number of subjects with primary patency as confirmed by imaging and adverse events
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Assessment method [1]
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Number of subjects with freedom from both:
* stent occlusion due to restenosis or thrombosis as confirmed with imaging, and
* clinically driven target lesion revascularization as confirmed with imaging and adverse events
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Timepoint [1]
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60 months
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Secondary outcome [2]
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Number of subjects with secondary patency as confirmed by imaging and adverse events
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Assessment method [2]
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Number of subjects with freedom from permanent loss of blood flow through the device, regardless of reintervention.
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Timepoint [2]
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60 months
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Secondary outcome [3]
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Number of subjects with clinically driven target lesion revascularization as confirmed by imaging and adverse events
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Assessment method [3]
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Number of subjects with repeat endovascular procedures (e.g., PTA, stenting, thrombectomy/thrombolysis) to restore flow, performed within the margins of the investigational devices due to =50% restenosis of the target lesion as measured via imaging AND the failure to improve or recurrence of venous origin leg pain or venous edema related to the target lesion present at baseline, or the onset of new symptoms including venous origin pain and venous edema related to the target lesion.
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Timepoint [3]
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60 months
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Secondary outcome [4]
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Number of subjects with device fracture as confirmed with imaging
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Assessment method [4]
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Number of subjects with device fracture as confirmed with imaging.
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Timepoint [4]
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60 months
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Secondary outcome [5]
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Number of subjects with stent embolization as confirmed with imaging
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Assessment method [5]
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Number of subjects with stent embolization as confirmed with imaging.
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Timepoint [5]
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12 months
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Secondary outcome [6]
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Number of subjects with device- or procedure-related death
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Assessment method [6]
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Number of subjects with device- or procedure-related death.
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Timepoint [6]
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30 days
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Secondary outcome [7]
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Number of subjects with clinically significant pulmonary embolism as confirmed with imaging and adverse events
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Assessment method [7]
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Number of subjects with clinically significant pulmonary embolism confirmed via Computed Tomography Angiography through 30 days.
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Timepoint [7]
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30 days
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Secondary outcome [8]
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Number of subjects with device- or procedure-related vascular injury as confirmed with adverse events
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Assessment method [8]
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Number of subjects with device- or procedure-related vascular injury through 30 days requiring surgical or endovascular intervention.
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Timepoint [8]
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30 days
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Secondary outcome [9]
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Number of subjects with device- or procedure-related major bleeding events as confirmed with adverse events
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Assessment method [9]
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Number of subjects with device- or procedure-related major bleeding events through 30 days.
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Timepoint [9]
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30 days
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Secondary outcome [10]
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Revised Venous Clinical Severity Scale (rVCSS)
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Assessment method [10]
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Change in Revised Venous Clinical Severity Scale (rVCSS) Measurement through 60-month follow-up compared to baseline prior to treatment.
Note: The rVCSS scale ranges from 0 to 30, with higher scores reflecting worse symptoms.
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Timepoint [10]
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60 months
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Secondary outcome [11]
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Revised Venous Clinical Severity Scale (rVCSS) Pain
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Assessment method [11]
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Change in Revised Venous Clinical Severity Scale (rVCSS) Pain Measurement through 60-month follow-up compared to baseline prior to treatment.
Note: The rVCSS Pain scale ranges from 0 to 3, with higher scores reflecting worse pain.
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Timepoint [11]
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60 months
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Secondary outcome [12]
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Venous Insufficiency Epidemiological and Economic Study - Quality of Life/Symptoms (VEINES-QOL/Sym) VEINES-QOL/Sym
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Assessment method [12]
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Change in Venous Insufficiency Epidemiological and Economic Study - Quality of Life/Symptoms (VEINES-QOL/Sym) Measurement through 60-month follow-up compared to baseline prior to treatment.
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Timepoint [12]
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60 months
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Secondary outcome [13]
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Villalta
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Assessment method [13]
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Change in Villalta Measurement through 60-month follow-up compared to baseline prior to treatment.
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Timepoint [13]
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60 months
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Secondary outcome [14]
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5 Level EuroQol-5 Dimension (EQ-5D-5L)
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Assessment method [14]
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Change in 5 Level EuroQol-5 Dimension (EQ-5D-5L) Measurement through 60-month follow-up compared to baseline prior to treatment.
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Timepoint [14]
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60 months
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Secondary outcome [15]
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Technical success
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Assessment method [15]
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Number of subjects with successful delivery and deployment of the stent to the intended location, and removal of delivery system.
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Timepoint [15]
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Index procedure (post-op day 0)
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Secondary outcome [16]
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Lesion success
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Assessment method [16]
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Number of subjects with evidence of =50% residual stenosis at the conclusion of the index procedure as measured by IVUS or venogram.
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Timepoint [16]
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Index procedure (post-op day 0)
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Secondary outcome [17]
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Procedural success
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Assessment method [17]
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Number of subjects with lesion success and the absence of major adverse events (i.e., stent embolization, device- or procedure-related death, clinically significant pulmonary embolism, device- or procedure-related vascular injury requiring surgical or endovascular intervention, and device- or procedure-related major bleeding) prior to discharge.
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Timepoint [17]
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Index procedure through hospital discharge (discharge estimated as up to 30 days post-treatment)
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Eligibility
Key inclusion criteria
Preoperative
* Patient is at least 18 years of age.
* Patient is willing and able to comply with all follow-up evaluations as well as any required medication or compression regimen.
* Patient is able to provide informed consent.
* One of the following: Clinical severity class of CEAP 'C' classification =3 or rVCSS pain score =2.
* Intention to treat the target areas with only the GORE® VIAFORT Vascular Stent.
* Estimated life expectancy =1 year.
* Patient is ambulatory (use of assistive walking device such as a cane or walker is acceptable).
* Patient has adequate inflow to the target lesion(s), per investigator/sub-investigator discretion, involving at least a patent femoral or deep femoral vein.
Preoperative
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Patient is a pregnant or breastfeeding woman, a woman planning to become pregnant through the 12-month visit, or a woman who is unwilling to practice an acceptable method of preventing pregnancy through the 12-month visit.
* Patient has clinically significant (e.g., symptoms of chest pain, hemoptysis, dyspnea, hypoxia, etc.) pulmonary embolism (confirmed via Computed Tomography Angiography) at the time of enrollment.
* Patient has a known uncorrectable bleeding diathesis or active coagulopathy meeting the following definitions: uncorrected INR>2 (not as a result of warfarin or DOAC therapy), OR platelet count <50,000 or >1,000,000 cells/mm3, OR white blood cell count <3,000 or >12,500 cells/mm3.
* Patient has impaired renal function (eGFR <30 mL/min/1.73m2) or is currently on dialysis.
* Patient has uncorrected hemoglobin of <9 g/dL.
* Patient has known history of antiphospholipid syndrome (APS) or patients with hypercoagulable states that are unwilling to take anticoagulant medications on a long-term basis.
* Patient has known homozygous inherited coagulation defect or Protein C/S deficiency.
* Patient has a planned surgical intervention (other than pre-stenting procedures such as thrombolysis or thrombectomy) within 30 days prior to or within 30 days after the planned study procedure.
* Patient is currently participating in another investigational drug or device study that has not completed the primary endpoint or that clinically interferes with the endpoints of this treatment, in the opinion of the investigator/sub-investigator. Observational studies are permitted.
* Patient has had a previous major (i.e., above the ankle) amputation of the target lower limb.
* Patient has known sensitivity to device materials or contraindication to antiplatelets, thrombolytics, anticoagulants (including patients with known prior instances of Heparin Induced Thrombocytopenia type 2 (HIT-2)), or iodinated contrast.
* Patient has had prior stenting or grafts in the target vessels.
* Patient has a known or suspected active systemic infection at the time of the index procedure. Patients with a chronic infection (e.g., HIV, hepatitis C) that is well controlled under their current treatment regimen may be eligible.
* Patient has known history of intravenous drug abuse within one year of treatment.
* Patient has significant peripheral arterial disease (chronic Rutherford Type 2 or greater, acute Rutherford Type IIa or greater).
* Patient has a BMI >40.
* Patient is actively undergoing or plans to begin cancer treatment.
Intraoperative Inclusion Criteria:
* Presence of non-malignant obstruction of the inferior vena cava defined as occlusion or at least 50% reduction in target vessel lumen as measured by procedural IVUS and venogram, with or without non-malignant obstruction of the common femoral vein, external iliac vein, and/or common iliac vein.
* Patient can accommodate an appropriately sized GORE® VIAFORT Vascular Stent as per reference vessel diameter (see IFU), as determined by intraoperative IVUS post pre-dilation.
* Patient must have appropriate access vessels to accommodate the delivery sheath for the selected device size.
* Patient has adequate landing zones free from significant disease requiring treatment within the native vessels beyond the proximal and distal margins of the lesion.
* Patient has adequate inflow to the target lesion(s), per investigator/sub-investigator discretion, involving at least a patent femoral or deep femoral vein.
* Lesion can be traversed with a guidewire.
* Disease involves the inferior vena cava and may include iliofemoral segments with intent to stent all affected iliofemoral and caval segments.
* Patient does not have significant (i.e., >20% residual thrombosis) acute thrombus within the target stent area at the time of investigational device placement. Patients with acute thrombus within the target stent area must have thrombus successfully treated prior to investigational device placement. Successful thrombus treatment is defined as reestablishment of antegrade flow with =20% residual thrombosis as confirmed by IVUS and venogram, AND freedom from bleeding, vascular injury, or hemodynamically significant pulmonary embolism. After successful thrombus treatment, investigational device placement can occur within the same procedure.
* Patient does not have an inferior vena cava filter present within the target stent area at the time of investigational device placement. Patients with an inferior vena cava filter present within the target stent area must have the filter successfully removed prior to investigational device placement. Successful removal is defined as removal of the main body of the filter and intra-luminal fragments such that there is minimal risk to luminal integrity per investigator/sub-investigator discretion AND freedom from bleeding, vascular injury, or hemodynamically significant pulmonary embolism. After successful filter removal, investigational device placement can occur within the same procedure.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
NA
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
NA
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
25/10/2022
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/01/2029
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Actual
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Sample size
Target
111
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
SA,WA
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Recruitment hospital [1]
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Flinders Medical Centre - Adelaide
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Recruitment hospital [2]
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Sir Charles Gairdner Hospital - Nedlands
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Recruitment hospital [3]
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Royal Perth Hospital - Perth
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Recruitment postcode(s) [1]
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5042 - Adelaide
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Recruitment postcode(s) [2]
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6009 - Nedlands
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Recruitment postcode(s) [3]
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6000 - Perth
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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California
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Country [2]
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United States of America
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State/province [2]
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Connecticut
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Country [3]
0
0
United States of America
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State/province [3]
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District of Columbia
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Country [4]
0
0
United States of America
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State/province [4]
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Illinois
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Country [5]
0
0
United States of America
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State/province [5]
0
0
Michigan
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Country [6]
0
0
United States of America
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State/province [6]
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New York
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Country [7]
0
0
United States of America
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State/province [7]
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North Carolina
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Country [8]
0
0
United States of America
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State/province [8]
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Ohio
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Country [9]
0
0
United States of America
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State/province [9]
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Virginia
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Country [10]
0
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Germany
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State/province [10]
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Aachen
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Country [11]
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Germany
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State/province [11]
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Arnsberg
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Country [12]
0
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Ireland
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State/province [12]
0
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Connaught
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Country [13]
0
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Italy
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State/province [13]
0
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Milan
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Country [14]
0
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Italy
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State/province [14]
0
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Modena
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Country [15]
0
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New Zealand
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State/province [15]
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Auckland
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Country [16]
0
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United Kingdom
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State/province [16]
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Cambridge
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Country [17]
0
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United Kingdom
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State/province [17]
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London
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Country [18]
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United Kingdom
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State/province [18]
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Oxford
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
W.L.Gore & Associates
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
This study is a prospective, multicenter, non-randomized, single-arm study to evaluate the performance, safety, and efficacy of the GORE® VIAFORT Vascular Stent for treatment of symptomatic inferior vena cava obstruction with or without combined iliofemoral obstruction in adult patients.
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Trial website
https://clinicaltrials.gov/study/NCT05409976
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Kush Desai, MD
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Address
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Northwestern University
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Carl Conway
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Address
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Country
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Phone
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6175952277
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Fax
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0
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Email
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT05409976