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Aortic Aneurysm, ThoracicMONA-LSANCT03738124

Evaluation of the Valiant Mona LSA Thoracic Stent Graft System in Thoracic Aortic Aneurysms and Chronic Dissections

A study testing Valiant Mona LSA Thoracic Stent Graft System in people with Aortic Aneurysm, Thoracic, run by University Hospital, Toulouse at 2 sites in France.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

To ensure adequate seal of currently available stent grafts, a proximal 20 mm of healthy aorta is recommended. Extending the proximal landing zone into the arch by intentional covering of the left subclavian artery (LSA) without revascularization expose to serious neurologic complications. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Aortic Aneurysm, Thoracic
What is being tested?
Valiant Mona LSA Thoracic Stent Graft System
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
2 sitesFrance
Study dates
Jan 2019to Feb 2026
Phase
Interventional
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

  • Subject is at least 18 years of age.
  • Subject understands and has signed an Informed Consent
  • Subject must be considered a candidate for revascularization of the LSA.
  • Subject must be able to tolerate a surgical revascularization of the LSA.
  • Subject has a descending thoracic aneurysm (DTA) which will require coverage of the LSA
  • Subject has a healthy, non-diseased aortic proximal seal zone of at least 10 mm from the left carotid to the LSA and at least 5 mm landing zone distal to the LSA and proximal to the start of the aneurysm/ulcer/or the proximal entry tear for dissection.
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  • Subject has a non-diseased aortic diameter between 25 mm and 42 mm (fusiform/saccular aneurysms or penetrating ulcers) or 28 mm to 44 mm (chronic type B dissections),
  • Subject has a LSA with a diameter between 8 mm and 13 mm.
  • Subject has sufficient landing zone within the LSA to accommodate the BSG without occlusion of any significant vessels
  • Subject has patent brachial arteries, iliac or femoral arteries (without circumferential calcifications and a diameter of ≥ 10mm), or can tolerate a conduit that will allow endovascular access to the aneurysmal site with the delivery system of the appropriate sized device chosen for treatment.
  • Subject has a condition requiring prospective revascularization of the LSA

Who cannot join

  • Subject has an aneurysmal, tortuous, or atherosclerotic LSA, conflicting the branch graft insertion.
  • Subject has an aortic atheroma classified as grade IV or grade V.
  • Subject has prohibitive calcification, occlusive disease, or tortuosity of intended fixation sites.
  • Treatment with the Valiant Mona LSA Thoracic Stent Graft system would require intentional coverage of the left common carotid artery with the stent graft fabric.
  • Subject has significant and/or circumferential aortic mural thrombus at either the proximal or distal attachment sites that would compromise fixation and seal of the device.
  • Subject is a pregnant or breastfeeding female.
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  • Subject has a known allergy or intolerance to the device components.
  • Subject is in acute renal failure or has renal insufficiency with a serum creatinine ≥ 2.0 mg/dL or is on dialysis.
  • Subject has coronary artery disease with unstable angina and has not received treatment.
  • Subject has a connective tissue disease (e.g. Marfan's syndrome, medial degeneration).
  • Subject has active systemic infection and/or a mycotic aneurysm.
  • Subject is currently participating in an investigational drug or device clinical trial that would interfere with the observations of this study.
  • Subject has other medical, social, or psychological problems that, in the opinion of the investigator, will interfere with treatment and follow-up procedures.
  • Subject has a life expectancy of less than 1 year.
  • Subject has a history of bleeding diathesis, coagulopathy, or refuses blood transfusion.
  • Subject has a known hypersensitivity or contraindication to anticoagulants or contrast media, which is not amenable to pre-treatment.

Trial locations and contacts

2 sites in 1 country.

France2 sites
  • Hôpital Timone Adultes

    Marseille, 13385

  • CHU Toulouse, Hôpital Rangueil

    Toulouse, 31059

Other trials in France

About this study

To ensure adequate seal of currently available stent grafts, a proximal 20 mm of healthy aorta is recommended. Extending the proximal landing zone into the arch by intentional covering of the left subclavian artery (LSA) without revascularization expose to serious neurologic complications. Serious risks are also known to accompany subclavian revascularization. The Valiant Mona LSA Thoracic Stent Graft System (Medtronic,Santa Rosa, Calif) consists of a main stent graft and a branch stent graft designed to maintain LSA patency. The purpose of this study is to characterize the safety and effectiveness of this device for the treatment of Aneurysms and chronic Type B dissections of the arch.

Read the detailed description

Stent graft coverage of the left subclavian artery (LSA) may be required to achieve an adequate landing zone in up to 40% of descending thoracic aneurysms (DTAs). To ensure adequate seal of currently available off-the-shelf stent grafts, 20 mm of healthy aorta is recommended between the proximal neck of the aneurysm and the leading edge of the stent graft. Stent graft placement can be facilitated by extending the proximal landing zone into the arch and covering the LSA; however, there may be a higher risk of serious neurologic outcomes (cerebral and paraplegia), although this is still a matter of debate. Serious risks are also known to accompany subclavian revascularization, which may involve bypass or transposition. The Valiant Mona LSA Thoracic Stent Graft System (Medtronic,Santa Rosa, Calif) consists of a main stent graft and a branch stent graft designed to maintain LSA patency while diverting circulation through the encroaching aneurysm.

The purpose of the feasibility study is to characterize the safety of the Valiant Mona LSA Thoracic Stent Graft System, including an assessment of the safety and effectiveness of the device acutely and at the 1-month visit in the identified subject population (Aneurysms and chronic, Type B dissections). A follow up of this population will be annually during 5 years.

This pilot, non-randomized, single-arm prospective study will concern 20 patients. Inclusion criteria required patients with a thoracic aortic aneurysm (TAA) or dissection with an indication of a stent-Graft insertion. Primary end points will be aneurysm-related mortality, stroke, paraplegia, left arm/hand ischemia, and treatment success. Technical success will be assessed by imaging at 1 month, 6 months then annually during 5 years.

Being tested
Valiant Mona LSA Thoracic Stent Graft System
Keywords
stent graft, branch stent graft, thoracic aneurysm, endovascular aortic repair, aortic dissection, Valiant Mona LSA Thoracic Stent Graft System
Medical subject headings
Aortic Aneurysm, Thoracic, Aortic Dissection

What participants receive

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

  • Valiant Mona LSA Thoracic Stent Graft SystemDevice

    The Valiant Mona LSA device is a modular two-component system consisting of a main stent graft (MSG) and a branch stent graft (BSG), delivered separately, designed to maintain LSA perfusion. Briefly, under general anesthesia and after heparin injection, a MSG access is achieved via a femoral artery. A Through-and-through wire access for delivery of the BSG is achieved via a brachial artery. After the placement of the main aortic stent graft in the arch with the cuff at the level of the ostium of the LSA, the BSG is placed through a femoral access.

Study groups in NCT03738124
Study groupRoleWhat they receive
Valiant Mona LSA Thoracic Stent Graft SystemExperimentalThe Valiant Mona LSA Thoracic Stent Graft System is administered.
Receives: Device: Valiant Mona LSA Thoracic Stent Graft System

What is being measured

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

  1. Safety events (aorta related mortality, stroke, paraplegia, left arm/hand ischemia)

    Composite endpoint defined as the occurrence of one of the following events: aorta related mortality, stroke, paraplegia, left arm/hand ischemia

    Measured: 1 month

  2. Effectiveness

    Effectiveness defined as technical success and successful exclusion of the aneurysm or false lumen while maintaining patency of the main stent graft (MSG) and branch stent graft (BSG)

    Measured: 1 month

Secondary outcomes (17)
  1. Aorta related mortality

    Occurrence of aorta related mortality

    Measured: 6 months, 12 months, 24 months, 36 months, 48 months and 60 months

  2. Stroke

    Occurrence of stroke

    Measured: 6 months, 12 months, 24 months, 36 months, 48 months and 60 months

  3. Paraplegia

    Occurrence of paraplegia

    Measured: 6 months, 12 months, 24 months, 36 months, 48 months and 60 months

  4. Left arm/hand ischemia

    Occurrence of left arm/hand ischemia

    Measured: 6 months, 12 months, 24 months, 36 months, 48 months and 60 months

  5. Effectiveness (Successful exclusion of the aneurysm)

    Successful exclusion of the aneurysm

    Measured: 6 months, 12 months, 24 months, 36 months, 48 months and 60 months

  6. Effectiveness (patency)

    False lumen while maintaining patency of the main stent graft (MSG) and branch stent graft (BSG)

    Measured: 6 months, 12 months, 24 months, 36 months, 48 months and 60 months

  7. Duration of the intervention

    Duration of the intervention

    Measured: Day 0

  8. Necessary time for the branch placement

    Necessary time for the branch placement

    Measured: Day 0

  9. Characteristics of the intervention (general anaesthesia)

    General anaesthesia performing

    Measured: Day 0

  10. Characteristics of the intervention (blood loss)

    Blood loss volume

    Measured: Day 0

  11. Characteristics of the intervention (transfusion)

    Transfusion performing

    Measured: Day 0

  12. Duration of the stay in intensive care

    Duration of the stay in intensive care

    Measured: Day 0

  13. Duration of the hospitalization

    Duration of the hospitalization

    Measured: Day 0

  14. Characteristics of the hospitalization (intraoperative complications)

    Occurrence of intraoperative complications

    Measured: Day 0

  15. Quality of life with EuroQol-5D

    The quality of life will be measured with the EuroQol-5D (5 levels) questionnaire

    Measured: Baseline, 6 months, 12 months, 24 months, 36 months, 48 months and 60 months

  16. Minor adverse events

    Occurrence of minor adverse events

    Measured: 1 month, 6 months, 12 months, 24 months, 36 months, 48 months and 60 months

  17. Serious adverse events

    Occurrence of serious adverse events

    Measured: 1 month, 6 months, 12 months, 24 months, 36 months, 48 months and 60 months

Timeline

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

  1. First posted13 Nov 2018
  2. Study startJan 2019 (estimated)
  3. Primary completionMar 2021 (estimated)
  4. Study completionFeb 2026 (estimated)

Why it stopped: Production of the medical device was stopped

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
Device feasibility
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03738124
Sponsor's protocol ID
RC31/18/0234
Acronym
MONA-LSA
Status last verified
Aug 2020
First submitted
8 Nov 2018
Last updated
26 Aug 2020
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Valiant Mona LSA Thoracic Stent Graft System in people with Aortic Aneurysm, Thoracic, run by University Hospital, Toulouse at 2 sites in France.

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 11 inclusion and 16 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: withdrawn, as of the sponsor's last update on 26 Aug 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in France. 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?

The study was withdrawn before enrolling participants, so there are no results.

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?

Safety events (aorta related mortality, stroke, paraplegia, left arm/hand ischemia) (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?
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 26 Aug 2020.

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