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Peripheral Vascular DiseasesPhase 4COBBANANCT00837954

Trial to Evaluate the Hemostatic Effect of Lyostypt® Versus Surgicel® in Arterial Bypass Anastomosis

A Phase 4 study testing Lyostypt® AND Surgicel®, Lyostypt® and Surgicel® in people with Peripheral Vascular Diseases and Hemostasis, run by Aesculap AG at 1 site in Germany.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this trial is to demonstrate that the bleeding time of suture holes after construction of arterial bypass anastomosis is shorter after treatment with Lyostypt® than with Surgicel® Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Peripheral Vascular Diseases, Hemostasis
What is being tested?
Lyostypt® AND Surgicel®, Lyostypt® and Surgicel®
Could I receive a placebo?
No, everyone receives an active treatment
How many people
32 participants
Where
1 siteGermany
Study dates
Feb 2009to Apr 2010
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients with an indication for a peripheral vascular reconstruction due to peripheral vascular disease (PVD) including femoro-femoral, femoro-popliteal and femoro-crural reconstructions or the need of a crossover including femoro-femoral or ilaco-femoro reconstruction.
  • suture hole bleeding of peripheral arterial bypass anastomosis using PTFE graft prosthesis
  • Written informed consent

Who cannot join

  • Emergency surgery
  • Patients with coagulopathy or uremia
  • Reoperation within one month at the same location
  • Pregnant and Breastfeeding Women
  • Known or suspected allergies or hypersensitivity to any of the used devices (e.g. to material of bovine origin)
  • Severe comorbidity (ASA ≥ 4)
Show all 12Show fewer
  • Life expectancy less than 12 months
  • Current immunosuppressive therapy (more than 40 mg of corticoid per day or ezathioprin)
  • Chemotherapy within last 4 weeks
  • Radiotherapy on the treated region within the last 2 months
  • Severe psychiatric or neurologic diseases
  • Lack of compliance

Trial locations and contacts

1 site in 1 country.

Germany1 site
  • Klinikum Hanau GmbH, Gefaesschirurgie

    Hanau, Hesse, 63450

Other trials in Germany

About this study

Official title: Randomized, Controlled, Prospective Trial to Evaluate the Hemostatic Effect of Lyostypt® Versus Surgicel® in Arterial Bypass Anastomosis

The purpose of this trial is to demonstrate that the bleeding time of suture holes after construction of arterial bypass anastomosis is shorter after treatment with Lyostypt® than with Surgicel®

Read the detailed description

Hemostasis in peripheral vascular surgery is made more difficult by the need for direct arterial and arterial graft suturing as well as by systemic anticoagulation to prevent thrombosis during periods of vascular occlusion. Polytetrafluorethylene (PTFE) is one of the most frequently used graft materials for vascular replacement or bypass in the case when no autologous venae are available (1). However, the insufficient elasticity of PTFE and its porosity promote the development of suture hole bleeding (2,3) which can cause considerable loss of blood and prolongation of operations (2).

This study is designed to demonstrate the superiority of Lyostypt® to oxidized cellulose (Surgicel®) for hemostasis of suture hole bleeding in arterial bypass anastomoses after vascular reconstruction. Lyostypt® is an absorbable, wet stable collagen compress made of collagen fibrils of bovine origin. Collagen leads to thrombocyte adhesion and to activation of coagulation factor XII. Therefore collagen is very effective in hemostasis. Collagen is cell-friendly whereas other hemostats significantly disturb cell growth. Advantages of collagen fleece are fast induction of hemostasis, low tissue reaction and fast absorption (15). Furthermore, collagen was shown to be the best overall hemostatic agent in microvascular surgery. Authors concluded that collagen fleece establish faster hemostasis than oxidized cellulose and that it was resorbed faster than oxidized cellulose (15).

Being tested
Lyostypt® AND Surgicel®, Lyostypt®, Surgicel®
Keywords
PTFE Graft, Suture Hole Bleeding, Hemostasis
Medical subject headings
Peripheral Vascular Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Lyostypt® AND Surgicel®Device

    Also called Lyostypt®, Surgicel®

    The investigational products are the hemostats Lyostypt® and Surgicel® (=Tabotamp® ). Lyostypt® will be provided in the size 5cm x 8cm, Surgicel® will be provided in the size 5cm x 7,5cm. The devices will be cut into half.

    Lyostypt® is an absorbable wet-stable collagen compress made of collagen fibrils of bovine origin. Collagen leads to thrombocyte adhesion and to activation of coagulation factor XII.

    Surgicel® absorbable Haemostat is a sterile absorbable knitted fabric prepared by the controlled oxidation of regenerated cellulose. After Surgicel® has been saturated with blood, it swells into a brownish or black gelatinous mass which aids in the formation of a clot, thereby serving as a haemostatic adjunct in the control of local haemorrhage.

  • Lyostypt®Device

    The investigational product is the hemostat Lyostypt®. Lyostypt® will be provided in the size 5cm x 8cm. The devices will be cut into half.

    Lyostypt® is an absorbable wet-stable collagen compress made of collagen fibrils of bovine origin. Collagen leads to thrombocyte adhesion and to activation of coagulation factor XII.

  • Surgicel®Procedure or surgery

    The investigational product is the hemostat Surgicel® (=Tabotamp® ). Surgicel® will be provided in the size 5cm x 7,5cm. The devices will be cut into half.

    Surgicel® absorbable Haemostat is a sterile absorbable knitted fabric prepared by the controlled oxidation of regenerated cellulose. After Surgicel® has been saturated with blood, it swells into a brownish or black gelatinous mass which aids in the formation of a clot, thereby serving as a haemostatic adjunct in the control of local haemorrhage.

Study groups in NCT00837954
Study groupRoleWhat they receive
1Active comparatordistal Anastomosis Lyostypt®, proximal Anastomosis Surgicel®
Receives: Device: Lyostypt® AND Surgicel®
2Active comparatordistal Anastomosis Surgicel®, proximal Anastomosis Lyostypt®
Receives: Device: Lyostypt® AND Surgicel®
3Active comparatordistal and proximal Anastomosis Lyostypt®
Receives: Device: Lyostypt®
4Active comparatordistal and proximal Anastomosis Surgicel®
Receives: Procedure: Surgicel®

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Time to hemostasis

    Measured: Minutes

Secondary outcomes (3)
  1. Number of Complications

    Measured: 30 days after surgery

  2. Postoperative Mortality

    Measured: 30 days after surgery

  3. Efficacy Rating of Study Device evaluated by Surgeon

    Measured: intraoperatively

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Feb 2009 (estimated)
  2. Study startFeb 2009
  3. Primary completionDec 2009
  4. Study completionApr 2010

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
32 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00837954
Sponsor's protocol ID
AAG-G-H-0803
Acronym
COBBANA
Status last verified
May 2015
First submitted
5 Feb 2009
Last updated
28 May 2015
Results posted
No
Data monitoring committee
No

Publications

  • Bellon JM, Bujan J, Contreras LA, Hernando A, Jurado F. Similarity in behavior of polytetrafluoroethylene (ePTFE) prostheses implanted into different interfaces. J Biomed Mater Res. 1996 May;31(1):1-9. doi: 10.1002/(SICI)1097-4636(199605)31:13.0.CO;2-S.

    PubMed 8731143
  • Carney WI Jr, Lilly MP. Intraoperative evaluation of PTFE, Dacron and autogenous vein as carotid patch materials. Ann Vasc Surg. 1987 Dec;1(5):583-6. doi: 10.1016/S0890-5096(06)61445-3.

    PubMed 2974302
  • Zdrahala RJ. Small caliber vascular grafts. Part I: state of the art. J Biomater Appl. 1996 Apr;10(4):309-29. doi: 10.1177/088532829601000402.

    PubMed 8859403
  • Lumsden AB, Heyman ER; Closure Medical Surgical Sealant Study Group. Prospective randomized study evaluating an absorbable cyanoacrylate for use in vascular reconstructions. J Vasc Surg. 2006 Nov;44(5):1002-1009; discussion 1009. doi: 10.1016/j.jvs.2006.06.039. Epub 2006 Oct 3.

    PubMed 17020801
  • Miller CM, Sangiolo P, Jacobson JH 2nd. Reduced anastomotic bleeding using new sutures with a needle-suture diameter ratio of one. Surgery. 1987 Feb;101(2):156-60.

    PubMed 3810486
  • Citrin P, Doscher W, Wise L, Margolis IB. Control of needle hole bleeding with ethyl-cyanoacrylate glue (Krazy Glue). J Vasc Surg. 1985 May;2(3):488-90. doi: 10.1067/mva.1985.avs0020488.

    PubMed 3999241
  • Hait MR, Robb CA, Baxter CR, Borgmann AR, Tippett LO. Comparative evaluation of Avitene microcrystalline collagen hemostat in experimental animal wounds. Am J Surg. 1973 Mar;125(3):284-7. doi: 10.1016/0002-9610(73)90042-1. No abstract available.

    PubMed 4570330
  • Hatsuoka M, Seiki M, Sasaki K, Kashii A. Hemostatic effects of microfibrillar collagen hemostat (MCH) in experimental coagulopathy model and its mechanism of hemostasis. Thromb Res. 1986 May 1;42(3):407-12. doi: 10.1016/0049-3848(86)90269-0. No abstract available.

    PubMed 3520941
  • Silverstein ME, Keown K, Owen JA, Chvapil M. Collagen fibers as a fleece hemostatic agent. J Trauma. 1980 Aug;20(8):688-94. doi: 10.1097/00005373-198008000-00010.

    PubMed 7401211
  • Czerny M, Verrel F, Weber H, Muller N, Kircheis L, Lang W, Steckmeier B, Trubel W. Collagen patch coated with fibrin glue components. Treatment of suture hole bleedings in vascular reconstruction. J Cardiovasc Surg (Torino). 2000 Aug;41(4):553-7.

    PubMed 11052282
  • Joseph T, Adeosun A, Paes T, Bahal V. Randomised controlled trial to evaluate the efficacy of TachoComb H patches in controlling PTFE suture-hole bleeding. Eur J Vasc Endovasc Surg. 2004 May;27(5):549-52. doi: 10.1016/j.ejvs.2004.01.018.

    PubMed 15079782
  • Jackson MR, Gillespie DL, Longenecker EG, Goff JM, Fiala LA, O'Donnell SD, Gomperts ED, Navalta LA, Hestlow T, Alving BM. Hemostatic efficacy of fibrin sealant (human) on expanded poly-tetrafluoroethylene carotid patch angioplasty: a randomized clinical trial. J Vasc Surg. 1999 Sep;30(3):461-6. doi: 10.1016/s0741-5214(99)70073-x.

    PubMed 10477639
  • Taylor LM Jr, Mueller-Velten G, Koslow A, Hunter G, Naslund T, Kline R; Beriplast B Investigators. Prospective randomized multicenter trial of fibrin sealant versus thrombin-soaked gelatin sponge for suture- or needle-hole bleeding from polytetrafluoroethylene femoral artery grafts. J Vasc Surg. 2003 Oct;38(4):766-71. doi: 10.1016/s0741-5214(03)00474-9.

    PubMed 14560228
  • Glickman M, Gheissari A, Money S, Martin J, Ballard JL; CoSeal Multicenter Vascular Surgery Study Group. A polymeric sealant inhibits anastomotic suture hole bleeding more rapidly than gelfoam/thrombin: results of a randomized controlled trial. Arch Surg. 2002 Mar;137(3):326-31; discussion 332. doi: 10.1001/archsurg.137.3.326.

    PubMed 11888460
  • Schonauer C, Tessitore E, Barbagallo G, Albanese V, Moraci A. The use of local agents: bone wax, gelatin, collagen, oxidized cellulose. Eur Spine J. 2004 Oct;13 Suppl 1(Suppl 1):S89-96. doi: 10.1007/s00586-004-0727-z. Epub 2004 Jun 22.

    PubMed 15221572

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Lyostypt® AND Surgicel®, Lyostypt® and Surgicel® in people with Peripheral Vascular Diseases and Hemostasis, run by Aesculap AG at 1 site in Germany.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 28 May 2015. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Time to hemostasis (time frame: Minutes). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00837954, which also lists 28 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 May 2015.

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