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Kidney CalculiNCT03959683

ShockPulse-SE vs. Trilogy Trial: Comparing the Performance of Two Intracorporeal Lithotripters for Removal of Large Renal Calculi

A study testing Trilogy Lithotrite and The ShockPulse-SE Lithotripsy System in people with Kidney Calculi, run by Indiana University at 4 sites in 2 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 purpose of this study is to measure how well two different devices work to break up and remove kidney stones. We are comparing a newer device to an older one to see which one is faster at breaking up kidney stones. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Kidney Calculi
What is being tested?
Trilogy Lithotrite and The ShockPulse-SE Lithotripsy System
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
100 participants
Where
4 sitesin 2 countries
Study dates
19 Feb 2019to 18 Nov 2020
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • ≥ 18 years of age
  • At least one renal stone > 1.5 cm in maximum diameter as measured on preoperative CT scan
  • Patient is scheduled to undergo a percutaneous nephrolithotomy procedure
  • Willing and able to provide informed consent

Who cannot join

  • Pregnant
  • Active urinary tract infection
  • Prior shock wave lithotripsy within 3 months of study procedure
  • Multiple percutaneous access sites are anticipated
  • Unable or unwilling to provide informed consent -

Trial locations and contacts

4 sites in 2 countries.

4 sites in 2 countries

United States3 sites
  • The Ohio State University

    Columbus, Ohio, 43212

  • Indiana University Health Physicians Urology

    Indianapolis, Indiana, 46202

  • Mayo Clinic Hospital

    Phoenix, Arizona, 85054

Other trials in United States

Canada1 site
  • The University of British Columbia

    Vancouver, British Columbia, V5Z 1M9

Other trials in Canada

About this study

Official title: A Prospective Randomized Multicenter Trial Comparing Performance of Two Intracorporeal Lithotripters for Removal of Large Renal Calculi

The purpose of this study is to measure how well two different devices work to break up and remove kidney stones. We are comparing a newer device to an older one to see which one is faster at breaking up kidney stones. We hypothesize that the Trilogy will increase the stone clearance rate by 25% compared to the Shockpulse-SE

Read the detailed description

Large and complex renal calculi, defined as those with a maximum diameter of ≥ 1.5 cm, can be removed from the upper urinary tract by percutaneous nephrolithotomy but the stones usually require fragmentation in order to remove them through the access site. There are a number of commercially available intracorporeal lithotripters used to fragment or break kidney stones to allow elimination including pneumatic, ultrasonic, and combination devices. Each technology has its own relative advantages and disadvantages.

New versions of intracorporeal lithotripter devices have been introduced with improvements meant to address prior functional limitations such as probe clogging or breaking and cumbersome hand piece design.

The Trilogy lithotrite is the newest generation device stone fragmentation device from Boston Scientific. The Trilogy device uses unique technology to efficiently fragment and remove stone material, superior to other devices on the market based on preliminary bench testing. From Olympus, the ShockPulse-SE Lithotripsy System (Cybersonics, Erie, PA, USA) is a constant ultrasonic wave energy lithotripter with intermittent shock wave (ballistic/mechanical) energy. The ShockPulse-SE has a single probe design with an OD of 3.76 mm which allows for larger sized stone fragments to be vacuumed from the urothelium. The larger, single lumen also allows for a high flow rate to reduce probe clogging events. The end result is faster stone clearance rates based on in vitro studies.

The objective of this study is to compare the performance, as measured by the stone clearance rate at time of percutaneous nephrolithotomy, of the ShockPulse-SE Lithotripsy System to the Trilogy lithotrite when used for large complex renal calculi.

The Trilogy has been FDA cleared for fragmentation of urinary tract calculi in the kidney, ureter, and bladder. Trilogy is a combined piezoelectric/pneumatic device capable of fragmenting calculi and aspirating stone debris. The novel technology in Trilogy has been demonstrated in bench testing to more quickly disintegrate stones compared to other devices.

The ShockPulse-SE Lithotripsy System has been FDA cleared fragmentation of urinary tract calculi in the kidney, ureter, and bladder. The ShockPulse-SE System is an electromechanical device capable of fragmenting calculi and aspirating stone debris. The novel technology in the ShockPulse-SE Lithotripsy System uses a single transducer and proprietary ShockPulse technology to generate both low-frequency mechanical impacts and high-frequency ultrasonic energy which quickly disintegrates stones.

Study Objectives To compare the performance, as measured by the stone clearance rate at time of percutaneous nephrolithotomy, of the ShockPulse-SE Lithotripsy System to the Trilogy Lithotrite.

Study Endpoints Primary Endpoint Stone clearance rate defined as the kidney stone surface area measured by preoperative computed tomography (CT) scan divided by the time to remove the targeted stone burden.

Time to remove the targeted stone burden is measured at time the lithotripter unit starts fragmenting the stone to time all fragments are removed from the kidney based on visual inspection. This is prior to final visual inspection of the kidney with a flexible nephroscope.

Additional Endpoints

  1. Device malfunctions
  2. All complications measured by the Clavien Classification of Surgical Complications Stone free status as defined by the presence or absence of stone material on postoperative day 1 CT imaging This study is a post-market, prospective, randomized, multicenter, 2-arm, comparative trial.

Scale and Duration A total of 100 participants will be enrolled and treated at 4 study sites (3 USA, 1 Canada). Two sites will enroll 16 participants and 2 will enroll at least 18 participants. Each subject will be followed for approximately 6-12 weeks after the study procedure. It is anticipated for the entire study to last approximately 12 months.

Treatment Assignment The participants will be block randomized 1:1 to either stone removal with the Trilogy or the ShockPulse-SE device. All randomization will occur at the central study site via computer randomization by the statistician to limit selection bias.

Justification for the Study Design This study will compare performance of two devices for the treatment of large renal calculi. The study has been designed as a prospective, multi-centric, randomized, comparative study. The intent of this design is to minimize bias and to allow for statistical comparison of the two treatment groups.

Point of Enrollment A participant will be considered enrolled in the study if they meet all eligibility criteria and after the participant signs and dates the informed consent form (ICF). No study-related procedures can take placed until the ICF is signed.

Withdrawal All participants enrolled in the clinical study (including those withdrawn from the clinical study or lost to follow-up) shall be accounted for and documented. If a participant withdraws from the clinical investigation, the reason(s) shall be reported. If such withdrawal is due to problems related to study device safety or performance, the investigator shall ask for the participant's permission to follow his/her status/condition outside of the clinical study.

Reasons for withdrawal include:

  • Physician discretion
  • Participant choice to withdraw consent
  • Lost to follow-up
  • If the participant dies due to any cause

While study withdrawal is discouraged, participants may withdraw from the study at any time, with or without reason, and without prejudice to further treatment.

If any treated study patient is unable to return to the study center after treatment, efforts will be made to obtain complete follow-up information from the patient's primary physician. The reason for a patient's failure to return for the necessary follow-up visits or for a patient's discontinuance from the study must be determined and recorded in the case report forms (CRF).

All applicable CRFs up to the point of participant withdrawal must be completed. Participants who are "lost to follow up" should have documented attempts to contact them.

Additional data may no longer be collected after the point at which a participant has been withdrawn from the study or withdraws his/her consent, for whatever reason. Data collected up to the point of participant withdrawal may be used for study analysis.

Informed Consent All participants taking part in this clinical study must undergo the informed consent process. Participants must be allowed adequate time to review the consent, raise questions, and make a voluntary decision to participate in the clinical study. Each participant must sign and date the IRB approved informed consent form before any clinical study-related procedures are performed. A copy of signed informed consent form will be provided to the participant for his/her records. A participant's participation in the clinical study begins with the signing and dating of the informed consent form.

Conditions
Kidney Calculi
Being tested
Trilogy Lithotrite, The ShockPulse-SE Lithotripsy System
Medical subject headings
Kidney Calculi

What participants receive

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

  • Trilogy LithotriteDevice

    The Trilogy has been FDA cleared for fragmentation of urinary tract calculi in the kidney, ureter, and bladder. Trilogy is a combined piezoelectric/pneumatic device capable of fragmenting calculi and aspirating stone debris. The novel technology in Trilogy has been demonstrated in bench testing to more quickly disintegrate stones compared to other devices.

  • The ShockPulse-SE Lithotripsy SystemDevice

    The ShockPulse-SE System is an electromechanical device capable of fragmenting calculi and aspirating stone debris. The novel technology in the ShockPulse-SE Lithotripsy System uses a single transducer and proprietary ShockPulse technology to generate both low-frequency mechanical impacts and high-frequency ultrasonic energy which quickly disintegrates stones.

Study groups in NCT03959683
Study groupRoleWhat they receive
Trilogy deviceActive comparatorTrilogy Lithotrite to fragment urinary tract calculi in the kidney, ureter and bladder
Receives: Device: Trilogy Lithotrite
ShockPulse-SEActive comparatorShockPulse-SE Lithotripsy System to fragment urinary calculi in the kidney, ureter and bladder
Receives: Device: The ShockPulse-SE Lithotripsy System

What is being measured

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

  1. Stone Clearance Rate Defined as the Kidney Stone Surface Area Measured by Pre-operative Computed Tomography (CT) Scan Divided by the Time to Remove the Targeted Stone Burden.

    Time to remove the targeted stone burden is measured at time the lithotripter unit starts fragmenting the stone to time all fragments are removed from the kidney based on visual inspection. This is prior to final visual inspection of the kidney with a flexible nephroscope.

    Measured: Postoperative day 1

Secondary outcomes (3)
  1. Device Malfunctions During Intraoperative Device Use as Described by Surgeon Completing the Device Questionnaire.

    any malfunctions during intraoperative device use

    Measured: any malfunctions during intraoperative device use

  2. All Complications Measured by the Clavien Classification of Surgical Complications

    Clavien Grade I: Any deviation from the normal postoperative course without the need for pharmacological treatment or surgical, endoscopic, and radiological interventions. Acceptable therapeutic regiments are: drugs as antiemetics, antipyretics, analgetics, diuretics, electrolytes, and physiotherapy. This grade also includes wound infections opened at the bedside.

    Clavien Grade II: Requiring pharmacologic treatment with drugs other than such allowed for grade I complications. Blood transfusions and total parenteral nutrition are also included.

    Clavien Grade III: Requiring surgical, endoscopic or radiological intervention

    Measured: 90 days

  3. Number of Participants With Stone Free Status as Defined by the Presence or Absence of Stone Material on Postoperative CT Imaging and at Final Follow up

    Stone free status must be assessed postoperative day 1 by CT scan.

    Measured: postoperative day 1

Timeline

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

  1. First posted22 May 2019
  2. Study start19 Feb 2019
  3. Primary completion29 Jul 2020
  4. Study completion18 Nov 2020

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
Randomised
Intervention model
Parallel groups
Model description
Prospective, randomized, multicenter, 2 arm, comparative trial
Masking
Single blind
Who is masked
Participant
Enrolment
100 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03959683
Sponsor's protocol ID
1803658961
Status last verified
Mar 2023
First submitted
16 May 2019
Last updated
12 Apr 2023
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Publications

  • Large T, Nottingham C, Brinkman E, Agarwal D, Ferrero A, Sourial M, Stern K, Rivera M, Knudsen B, Humphreys M, Krambeck A. Multi-Institutional Prospective Randomized Control Trial of Novel Intracorporeal Lithotripters: ShockPulse-SE vs Trilogy Trial. J Endourol. 2021 Sep;35(9):1326-1332. doi: 10.1089/end.2020.1097. Epub 2021 Aug 16.

    PubMed 33843245

Questions about this trial

What is this clinical trial studying?

A study testing Trilogy Lithotrite and The ShockPulse-SE Lithotripsy System in people with Kidney Calculi, run by Indiana University at 4 sites in 2 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 4 inclusion and 5 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 12 Apr 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in United States, Canada. 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 12 Apr 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?

Stone Clearance Rate Defined as the Kidney Stone Surface Area Measured by Pre-operative Computed Tomography (CT) Scan Divided by the Time to Remove the Targeted Stone Burden. (time frame: Postoperative day 1). 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 NCT03959683, which also lists 1 linked publication.

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 12 Apr 2023.

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