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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT06284837
Registration number
NCT06284837
Ethics application status
Date submitted
8/12/2023
Date registered
29/02/2024
Titles & IDs
Public title
Secondary Access - FEmoral or Radial in Transcatheter Aortic Valve Implantation?
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Scientific title
Secondary Access - FEmoral or Radial in Transcatheter Aortic Valve Implantation?
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Secondary ID [1]
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HREC/99382/Alfred-2023
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Universal Trial Number (UTN)
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Trial acronym
SAFER-TAVI
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Valve Stenoses, Aortic
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Condition category
Condition code
Cardiovascular
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Diseases of the vasculature and circulation including the lymphatic system
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Other interventions - Access site
Active comparator: Radial secondary access -
Active comparator: Femoral secondary access -
Other interventions: Access site
The SAFER-TAVI trial is randomized study comparing secondary access via a transradial versus transfemoral approach among patients undergoing transfemoral TAVI for aortic valve disease. Secondary access is gained along with primary access at the commencement of the TAVI procedure and is used for aortography before and after valve deployment and for assessment of the primary femoral access site after closure to confirm haemostasis. For patients assigned to radial access, the radial sheath will be removed using a radial band at the end of the procedure. For patients assigned to femoral access, the puncture site will be obtained under ultrasound guidance and fluoroscopic landmark identification. Unless contraindicated, the use of vascular closure devices will be recommended for all femoral cases. The choice of closure device is at the discretion of the operator. Catheters used in the access groups will be 5 or 6 French size at the discretion of the operator.
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Intervention code [1]
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Other interventions
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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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All bleeding and vascular complications
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Assessment method [1]
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The composite of all bleeding (according to BARC criteria) and vascular complications (according to VARC-3 criteria)
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Timepoint [1]
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30 days
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Secondary outcome [1]
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All bleeding
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Assessment method [1]
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According to BARC criteria
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Timepoint [1]
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30 days
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Secondary outcome [2]
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All vascular complications
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Assessment method [2]
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According to VARC-3 criteria
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Timepoint [2]
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30 days
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Secondary outcome [3]
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All-cause death
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Assessment method [3]
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According to VARC-3 criteria
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Timepoint [3]
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30 days
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Secondary outcome [4]
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Stroke
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Assessment method [4]
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According to VARC-3 criteria
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Timepoint [4]
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30 days
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Secondary outcome [5]
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Myocardial infarction
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Assessment method [5]
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According to VARC-3 criteria
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Timepoint [5]
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30 days
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Secondary outcome [6]
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Major adverse cardiovascular events
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Assessment method [6]
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The composite of cardiovascular death, non-fatal myocardial infarction and non-fatal stroke
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Timepoint [6]
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30 days
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Secondary outcome [7]
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Length of stay post-procedure
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Assessment method [7]
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Length of stay post-procedure measured in time (days) from procedure to discharge
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Timepoint [7]
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30 days
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Secondary outcome [8]
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Overall procedure duration
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Assessment method [8]
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TAVI procedure duration measured in time (minutes)
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Timepoint [8]
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1 day
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Secondary outcome [9]
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Radiation dose
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Assessment method [9]
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Radiation dose measured as air kerma in milligrays
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Timepoint [9]
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1 day
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Secondary outcome [10]
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Conversion rate to alternative vascular access site
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Assessment method [10]
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Conversion rate to alternative vascular access site
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Timepoint [10]
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30 days
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Secondary outcome [11]
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Tertiary site utilised to treat vascular complication
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Assessment method [11]
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Tertiary site utilised to treat vascular complication
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Timepoint [11]
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30 days
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Secondary outcome [12]
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Failure to perform angiogram of primary access site at completion of TAVI
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Assessment method [12]
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Failure to perform angiogram of primary access site at completion of TAVI
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Timepoint [12]
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1 day
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Eligibility
Key inclusion criteria
* Age >18 years
* Undergoing transfemoral TAVI with any commercially available transcatheter heart valve
* Suitable radial and secondary femoral access
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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
* Primary arterial access via surgical cut-down
* Inadequate contralateral femoral artery access and/or bilateral radial artery access as determined by the interventional cardiologist
* Previously failed attempt to access bilateral radial arteries.
* Patient on hemodialysis
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Study design
Purpose of the study
Other
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Allocation to intervention
Randomised controlled trial
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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
Parallel
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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
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
4/12/2023
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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
1/08/2025
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Actual
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Sample size
Target
560
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Alfred Health - Melbourne
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Recruitment hospital [2]
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Epworth Healthcare - Melbourne
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Recruitment hospital [3]
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Cabrini Health - Melbourne
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Recruitment postcode(s) [1]
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3004 - Melbourne
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Recruitment postcode(s) [2]
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3121 - Melbourne
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Recruitment postcode(s) [3]
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3144 - Melbourne
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Funding & Sponsors
Primary sponsor type
Other
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Name
The Alfred
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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Epworth Healthcare
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Address [1]
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Country [1]
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Other collaborator category [2]
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Other
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Name [2]
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Cabrini Health
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Address [2]
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Country [2]
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Ethics approval
Ethics application status
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Summary
Brief summary
Transcatheter aortic valve implantation (TAVI) is a well known safe treatment for severe aortic stenosis. To perform TAVI safely, there is a need for two vascular entry (access) sites: the primary and secondary access sites. While the femoral approach remains the most common site for primary access, secondary access (which is needed for guidance during the procedure) has drawn little attention in trials of TAVI. The two secondary access sites most commonly used are the radial (through an artery in the wrist) and femoral (through an artery in the groin) access sites. Observational studies comparing the two have shown a lower risk of complications with radial access compared to femoral access, but there are no randomized controlled data to confirm these findings. Accordingly, investigators aim to undertake a multicenter, randomized controlled trial among patients who are undergoing transfemoral TAVI, to assess if radial access is superior to femoral access as a secondary access site.
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Trial website
https://clinicaltrials.gov/study/NCT06284837
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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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Antony Walton, MBBS
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Address
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The Alfred and Epworth Healthcare
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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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Jennifer Zhou, MBBS, BMedSc
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Address
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Country
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Phone
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+61390763263
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Fax
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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)?
Undecided
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No/undecided IPD sharing reason/comment
Yes if ethics is approved
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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/NCT06284837