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NCT05489588NARecruiting

The GORE® VIABAHN® FORTEGRA Venous Stent Iliofemoral Study

W.L.Gore & Associates

Start Date

3/2/2023

Completion Date

3/1/2031

Summary

This study is a prospective, non-randomized, multicenter, single-arm, clinical study to evaluate the performance, safety and efficacy of the GORE® VIABAHN® FORTEGRA Venous Stent (formerly known as GORE® VIAFORT Vascular Stent) for treatment of symptomatic iliofemoral venous obstruction.

Detailed Description

A maximum of 30 clinical sites across the U.S. will participate in the study. One hundred and sixty-five subjects are intended to be implanted with the GORE® VIABAHN® FORTEGRA Venous Stent (formerly known as GORE® VIAFORT Vascular Stent) in this study, with a limit of 33 treated subjects per site. Subjects will be evaluated through hospital discharge and return for follow-up visits at 1, 6, 12, 24, 36, 48, and 60 months post-treatment.

Eligibility Criteria

Age Range: 18 years to No maximum

Preoperative Inclusion Criteria: * 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. * Presence of non-malignant symptomatic unilateral iliofemoral venous obstruction. Preoperative Exclusion Criteria: * Patient has DVT in the target areas with symptom onset date greater than 14 days but less than or equal to 90 days prior to treatment. * Patient is a pregnant or breastfeeding woman, or a woman planning to become pregnant 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 (all must be tested for): 1. uncorrected INR\>2 (not as a result of warfarin or DOAC therapy), OR 2. platelet count \<50,000 or \>1,000,000 cells/mm3, OR 3. 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). * Patient has known homozygous or acquired coagulation defect (e.g., Protein C or Protein S deficiency) that cannot be treated with therapeutic anticoagulation. * Patient has a planned surgical intervention that has the potential to clinically interfere with the endpoints of this treatment (other than pre-stenting procedures such as thrombolysis or thrombectomy) within 30 days prior to or within 30 days after the planned study procedure. Examples include surgical interventions that may impact mobility, and surgical interventions that require cessation of therapeutic antiplatelet or anticoagulation within 30 days following the index procedure. * Patient has had or requires open deep venous surgery in the target limb. * 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. * 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 can be managed, and with an active clinical plan in place 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 \>45. Patients with a BMI of up to 45 may be enrolled provided that diagnostic quality ultrasound of the implant sites can be performed. * Patient is actively undergoing or plans to begin cancer treatment. * Patients with hypercoagulable states that are unwilling to take anticoagulant medications on a long-term basis. * Patient has contraindication to thrombolytics, anticoagulants, or iodinated contrast necessary for the index procedure and long-term medical therapy (contrast pre-medication is acceptable). Intraoperative Inclusion Criteria: * Presence of non-malignant unilateral obstruction of the common femoral vein, external iliac vein, and/or common iliac vein defined as occlusion or at least 50% reduction in target vessel lumen as measured by procedural IVUS and venogram. * 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 only unilateral iliofemoral venous segments with intent to stent all affected iliofemoral segments. Patients with disease extending into the inferior vena cava or contra-lateral iliofemoral veins who are anticipated to require endovascular or surgical treatment within 12 months after investigational device implant will be excluded. * 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.

Interventions

DEVICE

GORE® VIAFORT Vascular Stent

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Conditions

Venous ThrombosesVenous DiseaseVenous Leg UlcerVenous StasisVenous UlcerVenous StenosisVenous OcclusionVein ThrombosisVein OcclusionVein Disease

Locations

Stanford University School of Medicine

Stanford, California 94305

United States

Advanced Heart and Vein (ClinRe)

Thornton, Colorado 80023

United States

Vascular Care Group

Darien, Connecticut 06820

United States

Yale University

New Haven, Connecticut 06519

United States

MedStar Washington Hospital Center

Washington D.C., District of Columbia 20010

United States

Manatee Memorial Hospital

Bradenton, Florida 34208

United States

Northwestern University

Chicago, Illinois 60611

United States

Massachusetts General Hospital

Boston, Massachusetts 02114

United States

Vascular Care Group

Wellesley, Massachusetts 02482

United States

University of Michigan Hospital

Ann Arbor, Michigan 48109

United States

Englewood Hospital & Med Center

Englewood, New Jersey 07631

United States

Holy Name Medical Center

Teaneck, New Jersey 07666

United States

Mount Sinai Medical Center

New York, New York 10029

United States

Stony Brook

Stony Brook, New York 11790

United States

St. Peter's Vascular Associates

Troy, New York 12180

United States

University of North Carolina - Chapel Hill

Chapel Hill, North Carolina 27599

United States

Atrium Health-Sanger Heart and Vascular Institute

Charlotte, North Carolina 28204

United States

NC Heart and Vascular Research

Raleigh, North Carolina 27519

United States

Bethesda North

Cincinnati, Ohio 45242

United States

University Hospitals Cleveland

Cleveland, Ohio 44106

United States

Cleveland Clinic Foundation

Cleveland, Ohio 44195

United States

University of Pittsburgh Medical Center

Pittsburgh, Pennsylvania 14213

United States

The Miriam Hospital

Providence, Rhode Island 02906

United States

UT Southwestern

Dallas, Texas 75390

United States

Sentara General Hospital

Norfolk, Virginia 23507

United States

Overlake Hospital

Bellevue, Washington 98004

United States

Medical College of Wisconsin - Froedtert Hospital

Milwaukee, Wisconsin 53226

United States