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HypertensionNCT02570113

The Peregrine Post-Market Study for the Treatment of Hypertension

A study testing Peregrine System Infusion Catheter in people with Hypertension, run by Ablative Solutions, Inc. at 10 sites in 4 countries.

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 Ablative Solutions, Inc. Peregrine System Infusion Catheter is a catheter-based device which is intended to be used to ablate the afferent and efferent sympathetic nerves serving the kidneys. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Hypertension
What is being tested?
Peregrine System Infusion Catheter
Could I receive a placebo?
No, everyone receives an active treatment
How many people
45 participants
Where
10 sitesin 4 countries
Study dates
Nov 2015to Jul 2019
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adult subject, age 18-80, male or female;
  • Subject has a target treatment vasculature diameter of ≥4 mm and ≤ 7 mm and length of ≥5 mm;
  • Subject has 3 measurements with a mean of office Systolic Blood Pressure of
  • ≥150 mmHg AND office Diastolic Blood Pressure of ≥85 mmHg;
  • Subject has a 24-hour mean systolic Ambulatory Blood Pressure Measurement (ABPM) ≥135 mm Hg with ≥70% valid readings (as determined by measurement device);
  • Subject with hypertension is receiving and adhering to a stable medication regimen of at least 3 anti-hypertensive medications of different classes (for at least 4 consecutive weeks), one of which must be a diuretic;
  • Subject agrees to have all study procedures performed, to comply with medication regimen and is able and willing to comply with all study follow-up visits;
  • Subject has provided written informed consent.

Who cannot join

  • Subject has a contraindication known for conventional percutaneous interventional procedures such as:
  • intolerance for antiplatelet/anticoagulant therapy
  • known allergy to contrast media
  • bleeding disorders (such as bleeding diathesis, thrombocytopenia and severe anemia)
  • Subject has documented severe untreated obstructive sleep apnea (Apnea Hypopnea Index [AHI] ≥30 per hour);
  • Subjects with nephrotic syndrome;
Show all 26Show fewer
  • Subjects on immunosuppressive medications or immunosuppressive doses of steroids;
  • Subject has type 1 diabetes mellitus;
  • Subject is pregnant or nursing or planning to become pregnant;
  • Subject has an eGFR ≤20 mL/min/1.73m2
  • , based on the CKD-EPI equation;
  • Subject has imaging-assessed renal artery anatomy abnormalities or variations based on Investigator's evaluation of the screening images [i.e. MRA/CTA examination and/or renal angiography]) meeting one of the following criteria:
  • Renal artery stenosis >60% of the normal diameter segment (diameter stenosis, compared to the angiographically normal proximal or distal segment);
  • Any renal artery abnormality or disease that, per the physician assessment, precludes the safe insertion of the guiding catheter (such as but not limited to severe renal artery aneurysm, excessive tortuosity, severe renal artery calcification);
  • Previous renal angioplasty associated with stenting or other implants, that, per the physician's assessment, precludes the safe deployment of the Peregrine catheter components in the target treatment segment of the renal artery;
  • Subject has a history of nephrectomy, a single kidney or kidney tumor, or urinary tract obstruction (with potential for hydronephrosis);
  • Subject is known to have a non-functioning kidney or unequal renal size (>2 cm difference in renal length between kidneys associated with a chronic kidney disease or a deterioration of the kidney function);
  • Subject has a renal transplant;
  • Subject has a history of myocardial infarction, unstable angina pectoris, or stroke/TIA within the last six months from planned procedure;
  • Subject has hemodynamically significant valvular heart disease;
  • Subject has heart failure (NYHA III or IV) or has an ejection fraction ≤30%;
  • Subject with chronic atrial fibrillation;
  • Subjects who are allergic or intolerant of the neurolytic agent (such as dehydrated alcohol);
  • Any contraindication to the imaging as required per the protocol;
  • Subject has a life expectancy of <12 months;
  • Subject is currently enrolled in other potentially confounding research, i.e., another therapeutic or interventional research trial. Subjects enrolled in observational registries may still be eligible.

Trial locations and contacts

10 sites in 4 countries.

10 sites in 4 countries

Germany6 sites
  • Charite-Universitaetsmedizin Berlin

    Berlin, 12203

  • Universitätsklinik Erlangen Klinik für Nephrologie/Hypertensiologie

    Erlangen, 91054

  • Elisabeth-Krankenhause

    Essen, 45138

  • CardioVasculares Centrum (CVC) Frankfurt

    Frankfurt, 60389

  • Universitats-Herzzentrum/University Heart Center Klinik fur Kardiologie und Angiologie

    Freiburg im Breisgau, 79106

  • Klinik fur Innere Medizin III

    Homburg, 66421

Other trials in Germany

Poland2 sites
  • Oddzial Kardiologii Inwazyjnej

    Tychy, 43-100

  • Oddizal Kardiologiczno-Angiologiczny PAKS

    Ustroń, 43-450

Other trials in Poland

Belgium1 site
  • Cliniques Universitaires Saint-Luc

    Brussels, 1200

Other trials in Belgium

Czechia1 site
  • Na Homolce Hospital

    Prague, 150 30

Other trials in Czechia

About this study

Official title: A Post-Market Study of Transcatheter Perivascular Renal Denervation for the Treatment of Hypertension Using the Ablative Solutions Inc. Peregrine System™ Infusion Catheter

The Ablative Solutions, Inc. Peregrine System Infusion Catheter is a catheter-based device which is intended to be used to ablate the afferent and efferent sympathetic nerves serving the kidneys. The catheter is inserted via the femoral artery, steered into the renal artery, and then delivers, by infusion from its distal end, a neurolytic agent. This targets the nerve bundles, which are in the adventitia - a sheath surrounding the artery. The aim is to reduce blood pressure in cases of hypertension, including seriously elevated blood pressure which does not respond to drug treatment. This study will evaluate the safety and performance of the device.

Read the detailed description

There is strong evidence in the published literature that the renal nerves are important contributors to hypertension, and that their ablation does not have adverse side-effects.

The literature provides technical, clinical and scientific evidence supporting the use of perivascular renal denervation for a carefully defined patient group.

An existing device (the Medtronic Symplicity catheter) was initially shown to be safe and effective for achieving perivascular renal denervation by delivery of radio-frequency energy. The results of early nonrandomized clinical studies (HTN-1, HTN-2) found that perivascular renal denervation by radio-frequency energy delivery was an effective therapy, associated with very low risks. In other contexts, denervation can also be safely and effectively achieved by neurolytic agents.

The ASI Peregrine System™ Infusion Catheter and the denervation procedure in general is similar enough to the Medtronic Symplicity catheter to enable the use of published data to establish the validity of the design concept of the Peregrine System and estimate the likely levels of risk of side effects. It can be concluded from the literature that the ASI Peregrine System™ will achieve percutaneous renal denervation with a low risk of procedural complications (comparable to accepted percutaneous interventional therapies) and without long-term impairment of renal artery or kidney function or other serious adverse events.

Previous premarket clinical trials have provided support for the safe and effective use of the Peregrine Catheter for the treatment of patients with hypertension. The Peregrine System Infusion Catheter is currently CE marked and the indication for use is "The Peregrine System™ Infusion Catheter is intended for the infusion of a neurolytic agent to achieve a reduction in systemic blood pressure in hypertensive patients." Based upon the literature and previous clinical data, chemical denervation is an appropriate treatment for the specified study population of adults who have hypertension despite taking at least 3 anti-hypertensive drugs of different classes including at least one diuretic.

The objectives of this post-market study are to collect additional safety and performance data pertaining to renal denervation by using dehydrated alcohol as a chemical neurolytic agent delivered into the adventitial/peri-adventitial area of the renal arteries for the purpose of renal denervation, using the Peregrine System™ Infusion Catheter, in patients with hypertension.

In order for the study to be valid, only one chemical neurolytic agent can be used. The Coordinating Investigator has chosen to use dehydrated alcohol (not less than 95% by volume) for therapeutic neurolysis, therefore all participating sites will use this agent.

Conditions
Hypertension
Being tested
Peregrine System Infusion Catheter
Medical subject headings
Hypertension

What participants receive

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

  • Peregrine System Infusion CatheterDevice

    The Peregrine Catheter is inserted bilaterally into the renal arteries and a specified amount of a neurolytic agent is inserted into the vessel walls.

Study groups in NCT02570113
Study groupRoleWhat they receive
Renal Denervation by NeurolysisExperimentalInfusion of 0.6 ml of dehydrated alcohol (not less than 95% by volume) into the peri-adventitial space of the renal artery, to achieve renal denervation by neurolysis, via three simultaneous deployed needles, situated at the distal end of the Peregrine System Infusion Catheter.
Receives: Device: Peregrine System Infusion Catheter

What is being measured

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

  1. Number of Subjects With the Absence of Particular Events as Adjudicated by the CEC Through 1-month Post Procedure:

    The primary safety endpoint is defined by the absence of any of the following events as adjudicated by the CEC through 1-month post procedure:

    1. Peri-procedural major vascular complications;
    2. Major Bleeding as defined by the TIMI Bleeding Classification;
    3. Acute Kidney Injury (AKI) within 1 month of the procedure
    4. Peri-procedural death (within 1 month of the procedure)

    Measured: 1-month

  2. Change in 24-hour Mean Ambulatory Systolic Blood Pressure From Baseline to 6 Months

    The primary performance endpoint is defined as a reduction of 24-hour mean ambulatory systolic blood pressure following treatment at 6 months, as compared to baseline.

    Measured: 6 months

Secondary outcomes (16)
  1. Numbr of Subjects With a Decline in eGFR by >25% From Baseline to 6 Months

    Proportion of subjects with a decline in eGFR by >25% from baseline to 6-month follow-up;

    Measured: 6 months

  2. Change in Serum Creatinine From Baseline to 6 Months

    Change in serum creatinine from baseline to 6-month follow-up

    Measured: 6 months

  3. Number of Participants With New Renal Arterial Stenosis > 60%

    Number of Participants with New renal arterial stenosis > 60% from the baseline at the 6-month follow-up, to be confirmed by the same imaging method used at baseline.

    Measured: 6 months

  4. Number of Subjects With Stroke or Transient Ischemic Attack (TIA) With 1 Month of the Procedure

    Stroke or TIA within 1 month of the procedure

    Measured: 1 month

  5. Number of Subjects With Myocardial Infarction (MI) Within 1 Month of the Procedure

    Myocardial Infarction (MI) within 1 month of the procedure

    Measured: 1 month

  6. Number of Participants With Major Adverse Events (MAE) Through 6 Months Post-Procedure

    Number of Participants with Major Adverse Events (MAE) through 6-month post-procedure. MAE is defined as the occurrence of any of the following:

    1. All-cause death
    2. End stage renal failure
    3. Significant embolic event resulting in end-organ damage or requiring intervention to prevent it
    4. Major Vascular Complications (including major artery dissections)
    5. Significant new renal artery stenosis (>60% diameter stenosis)
    6. Hypertensive crisis (hypertensive emergency only)
    7. Severe hypotension/syncope

    Measured: 6 months

  7. Changes in Antihypertensive Medications at 7 Days, and 1, 3, 6 and 12 Months Post-Procedure

    Changes in antihypertensive medications at 7-day, 1, 3, 6 and 12 months post procedure;

    Measured: 7-day, 1, 3, 6 and 12 months

  8. Changes in Systolic and Diastolic Clinic/Office Blood Pressure

    Changes in systolic and diastolic clinic/office blood pressure following treatment compared to baseline, assessed at 7-day, 1, 3, 6 and 12 months post-procedure.

    Measured: 7-day, 1, 3, 6 and 12 months

  9. Changes in Systolic and Diastolic 24-hour Mean Daytime and Nighttime Ambulatory Blood Pressure

    Changes in systolic and diastolic 24-hour mean daytime and nighttime ambulatory blood pressure, assessed at 1, 3, 6 and 12-month post-procedure.

    Measured: 1, 3, 6 and 12-months

  10. Changes in Diastolic 24-hour Mean Ambulatory Blood Pressure

    Changes in systolic and diastolic 24-hour mean ambulatory blood pressure assessed at 1, 3, 6 and 12-month post-procedure.

    Measured: 1, 3, 6 and 12-months

  11. Changes in Systolic 24-hour Mean Ambulatory Blood Pressure

    Changes in systolic 24-hour mean ambulatory blood pressure assessed at 1, 3 and 12 months postprocedure;

    Measured: 1, 3 and 12 months

  12. Change in eGFR

    Change in eGFR from baseline, to evaluate the progression of Chronic Kidney Disease (CKD) after 1, 3, 6 and 12 months;

    Measured: 1, 3, 6 and 12 months

  13. The Progression of Kidney Disease

    The progression of kidney disease in subjects with ≤60 mL/min/1.73m2 will be evaluated by comparing the change in eGFR during the study to the historical loss (reduction) of eGFR during the 3 years prior to renal denervation for each individual subject;

    Measured: 1, 3, 6, and 12 months

  14. Change in Albuminuria

    Change in albuminuria from baseline to 3 months post-procedure, with additional assessments at each study time point;

    Measured: 3, 6, and 12 months

  15. Change in Albuminuria Categorization

    Change in albuminuria categorization from baseline to 3 months post-procedure, with additional assessments at each study time point;

    Measured: 3, 6, and 12 months

  16. Change in Serum Creatinine and Cystatin-C

    Change in serum creatinine and cystatin-C from baseline to 3 months postprocedure, with additional assessments at each study time point.

    Measured: 3, 6, and 12 months

Timeline

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

  1. First posted7 Oct 2015 (estimated)
  2. Study startNov 2015
  3. Primary completionFeb 2019
  4. Study completionJul 2019

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 N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
45 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02570113
Sponsor's protocol ID
CR0001
Status last verified
Sep 2023
First submitted
6 Oct 2015
Last updated
28 Sep 2023
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Bytyqi V, Kannenkeril D, Striepe K, Bosch A, Karg MV, Schmid A, Schiffer M, Uder M, Schmieder RE. Predicting blood pressure response to renal denervation based on a new approach. J Hypertens. 2025 Mar 1;43(3):413-419. doi: 10.1097/HJH.0000000000003918. Epub 2024 Oct 29.

    PubMed 39526682
  • Mahfoud F, Sievert H, Bertog S, Lauder L, Ewen S, Lengele JP, Wojakowski W, Schmieder R, van der Giet M, Weber MA, Kandzari DE, Parise H, Fischell TA, Pathak A, Persu A. Long-Term Results up to 12 Months After Catheter-Based Alcohol-Mediated Renal Denervation for Treatment of Resistant Hypertension. Circ Cardiovasc Interv. 2021 Sep;14(9):e010075. doi: 10.1161/CIRCINTERVENTIONS.120.010075. Epub 2021 Sep 2.

    PubMed 34470501

Questions about this trial

What is this clinical trial studying?

A study testing Peregrine System Infusion Catheter in people with Hypertension, run by Ablative Solutions, Inc. at 10 sites in 4 countries.

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 8 inclusion and 26 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 Sep 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 10 sites in Germany, Poland, Belgium, Czechia. 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.

Are results available for this study?

Yes. Results are posted in the registry (first posted 28 Sep 2023). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Number of Subjects With the Absence of Particular Events as Adjudicated by the CEC Through 1-month Post Procedure: (time frame: 1-month). The study lists 2 primary outcomes in all. 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 NCT02570113, which also lists 2 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 Sep 2023.

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