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Pulmonary EmbolismNCT05127915

US Pivotal Clinical Study of the Adient Absorbable Filter for the Prevention of Pulmonary Embolism

A study testing Adient absorbable filter + best practice VTE prophylaxis and best practice VTE prophylaxis in people with Pulmonary Embolism, run by Adient Medical at 2 sites in United States.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The objective of the study is to evaluate the safety and efficacy of the Adient absorbable filter for the prevention of pulmonary embolism (PE: blood clot in the lungs). PE claims the lives of over 100,000 Americans each year, more than breast cancer, traffic fatalities and HIV combined. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Pulmonary Embolism
What is being tested?
Adient absorbable filter + best practice VTE prophylaxis and best practice VTE prophylaxis
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
854 participants
Where
2 sitesUnited States
Study dates
27 Jan 2023to 31 Dec 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

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
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Aged 18 years or older
  • Willing to comply with the specified follow-up requirements including contrast enhanced CTs for the 9-month duration of the study
  • For female subjects of childbearing potential: a negative pregnancy test within 48 hours prior to the implantation procedure
  • For the prophylactic cohort, high risk VTE denoted by either:
  • Caprini score > 8 for surgical ICU, Parvizi score ≥ 150 for TKA (total knee replacement), ISS score ≥ 24 for trauma.
  • For the therapeutic cohort, documented VTE per the following:
Show all 9Show fewer
  • Pulmonary thromboembolism when anticoagulants are contraindicated, Failure of anticoagulant therapy in thromboembolic diseases, Emergency treatment following massive pulmonary embolism where anticipated benefits of conventional therapy are reduced.
  • Requirement of temporary PE protection (8 weeks) based on clinical judgment
  • Fully informed subject or caretaker consent having executed an Institutional Review Board (IRB) or approved informed consent.

Who cannot join

  • Expected high VTE risk to extend beyond 8 weeks.
  • Vena cava filter currently implanted
  • History of abdominal or pelvic radiation therapy
  • Previous IVC filter placement/retrieval within 6 months prior to randomization
  • Confirmed positive blood cultures within the last 48 hours if there is bacteremia
  • Known sensitivity to radiographic contrast medium that cannot be adequately prophylactically pre-medicated
Show all 19Show fewer
  • Known allergy or intolerance to IVC filter materials (i.e. PDSII absorbable suture)
  • Pregnant, lactating, or plans to become pregnant during investigation follow-up period
  • Renal insufficiency (GFR < 60) or requiring renal replacement therapy
  • IVC effective diameter (D) <16 mm or >28 mm anywhere within L1-L4, D = √(APLat)
  • Less than 7cm from inferior-most renal vein to the iliac vein confluence
  • Duplication of the IVC
  • Any thrombus or occlusion in IVC on pre-procedural CT cavogram
  • Life expectancy of < 12 months
  • Simultaneous participation in another investigative drug or device trial that has not reached its primary endpoint
  • Other co-morbid condition that, in the opinion of the Investigator, could limit the subject's ability to participate in or would affect the scientific integrity of the study
  • Previously enrolled in a clinical investigation of the Adient filter.
  • For Roll In, patient has advanced heart failure or recent (6 weeks) myocardial infarction. - - -
  • Advanced heart failure is defined by NYHA class IV or AHA/ACC/HFSA stage D or LVEF < 40%. Subjects with MI diagnosed with ECG alone without MI history and symptoms are not excluded.

Trial locations and contacts

2 sites in 1 country.

United States2 sites
  • University of Colorado Anschutz Medical Campus

    Aurora, Colorado, 80045

  • IU Health University Hospital

    Indianapolis, Indiana, 46202

Other trials in United States

About this study

Official title: A Prospective, Multicenter, Pivotal Study With Randomized Controlled Prophylactic and Independent Therapeutic Cohorts to Evaluate the Safety and Efficacy of an Absorbable Vena Cava Filter for Pulmonary Embolism Prevention

The objective of the study is to evaluate the safety and efficacy of the Adient absorbable filter for the prevention of pulmonary embolism (PE: blood clot in the lungs). PE claims the lives of over 100,000 Americans each year, more than breast cancer, traffic fatalities and HIV combined.

Pharmaceutical anticoagulation (blood thinners) that reduce blood clot formation represent the standard of care for treating patients at risk for PE. However, for people who are temporarily unable to use anticoagulants, such as those who have suffered major trauma or those who are scheduled for surgical procedures, inferior vena cava (IVC) filters are used to help protect against PE. These blood filters prevent large blood clots that originate in the deep veins of the legs (deep vein thrombosis (DVT)) from reaching your lungs causing a potentially life-threatening PE.

Read more

Conventional metal IVC filters have been proven effective at reducing the incidence of PE, however, most require retrieval. If not retrieved within a timely manner (months), they can perforate the IVC, impale nearby organs with their barbed struts, and cause blood clots.

In contrast, the Adient absorbable filter traps blood clots similar to conventional metal IVC filters, but following the 8 week protection period, the filter itself breaks down into carbon dioxide and water. Hence no filter retrieval is required and complications are less likely due to the shortened indwell time. Once blood clots are trapped in the absorbable filter, the body's thrombolytic enzymes dissolve the clots within weeks while the filter itself resorbs in 6 to 8 months. The absorbable filter is braided from absorbable suture that has been proven safe over 4 decades.

The question being addressed with the randomized controlled trial portion is whether the placement of the absorbable filter in addition to current best practice PE prevention (sequential compression machines, compression stockings, and anticoagulants when indicated) significantly reduces the incidence of clinically significant PE in high risk subjects.

The absorbable filter will be indicated for the temporary prevention of PE in patients with transient high risk for venous thromboembolism (DVT and/or PE) with or without venous thromboembolic disease and as an enhancement to pharmaceutical anticoagulation and mechanical prophylaxis.

Being tested
Adient absorbable filter + best practice VTE prophylaxis, best practice VTE prophylaxis
Keywords
Vena Cava Filters, Embolic Protection Devices
Medical subject headings
Pulmonary Embolism

What participants receive

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

  • Adient absorbable filter + best practice VTE prophylaxisDevice

    Adient absorbable filter helps prevent PE during an 8 week protection period then gradually breaks down into carbon dioxide and water within 6 to 8 months. The absorbable filter does not require removal.

  • best practice VTE prophylaxisDevice

    Best practice VTE prophylaxis includes sequential compression machines, compression stockings, and anticoagulants (blood thinners) when indicated.

Study groups in NCT05127915
Study groupRoleWhat they receive
TherapeuticExperimentalThe therapeutic arm will include subjects with diagnosed symptomatic VTE (PE and/or DVT). Each subject will receive an Adient absorbable filter to help prevent a subsequent PE. All study subjects will return to the investigation site for the Follow-up Visits at Week 2 (±3 days), Week 10 (±1 week) and Month 9 (±2 weeks). Subjects will be interviewed and examined at each follow-up visit to perform safety and filter status evaluations.
Receives: Device: Adient absorbable filter + best practice VTE prophylaxis
Prophylactic - TestExperimentalThe Prophylactic - Test arm will include subjects who are at transient high risk for PE and do not have diagnosed symptomatic VTE (PE and/or DVT). If randomized into this prophylactic arm, study subjects will receive an Adient absorbable filter to help prevent PE in addition to being administered current best practice PE prevention, namely sequential compression machines, compression stockings, and anticoagulants when indicated. All study subjects will return to the investigation site for the Follow-up Visits at Week 2 (±3 days), Week 10 (±1 week) and Month 9 (±2 weeks). Subjects will be interviewed and examined at each follow-up visit to perform safety and filter status evaluations.
Receives: Device: Adient absorbable filter + best practice VTE prophylaxis
Prophylactic - ControlActive comparatorThe Prophylactic - Control arm will include subjects who are at transient high risk for PE and do not have diagnosed symptomatic VTE (PE and/or DVT). If randomized into this prophylactic arm, study subjects will receive current best practice PE prevention, namely sequential compression machines, compression stockings, and anticoagulants when indicated. All study subjects will return to the investigation site for the Follow-up Visits at Week 2 (±3 days), Week 10 (±1 week) and Month 9 (±2 weeks). Subjects will be interviewed and examined at each follow-up visit.
Receives: Device: best practice VTE prophylaxis

What is being measured

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

  1. Primary Effectiveness Endpoint - Prophylactic Cohort: incidence of new clinically significant PE

    Clinically significant PE includes asymptomatic proximal PE screened at 2 weeks, in addition to symptomatic PE through 8 weeks post index event confirmed by computed tomography (CT) angiography. Proximal PE includes thrombus (blood clots) observed in the pulmonary trunk, main pulmonary arteries, or lobar arteries.

    Measured: 2 weeks for asymptomatic proximal PE screening and through 8 weeks for symptomatic PE

  2. Primary Composite Safety Endpoint - Prophylactic Cohort: incidence of absorbable filter deployment without complications

    Potential complications include: (a) caval thrombotic occlusion within 9 months, (b) all-filter embolization within 9 months, (c) serious filter-related complications within 9 months, (d) filter placement procedural related Series Adverse Events (SAE) within the perioperative period (96 hours), (e) filter placement vascular access site SAE within the perioperative period, (f) symptomatic PE subsequent to filter deployment within 9 months.

    Measured: 96 hours to 9 months depending on the safety parameter

  3. Primary DVT Safety Endpoint - Prophylactic Cohort: incidence of all DVT post index event

    All DVT includes both symptomatic DVT and asymptomatic DVT screened at 2 weeks, 10 weeks and 9 months.

    Measured: 9 months overall duration

  4. Primary Composite Safety and Effectiveness Endpoint - Therapeutic Cohort: composite rate of technical filter placement success without complications

    Potential complications include (a) new symptomatic PE through 8 weeks, (b) filter migration (> 2cm), (c) filter embolization, (d) caval perforation (> 5mm), (e) symptomatic caval thrombosis, and (f) any other symptomatic filter-related complication requiring invasive intervention, or filter related death.

    Measured: 9 months

Secondary outcomes (8)
  1. Incidence of new symptomatic PE through 8 weeks confirmed by CT angiography

    Measured: 8 weeks

  2. Miller Score for symptomatic and asymptomatic PE

    Quantification of the occlusion of the pulmonary vascular bed from a PE.

    Measured: 9 months

  3. Incidence of caval occlusion / thrombosis confirmed by CT cavogram

    Measured: 10 weeks

  4. Incidence of IVC caval stenosis and occlusion confirmed by CT cavogram

    Measured: 9 months

  5. Incidence of common femoral and iliac venous thrombosis ipsilateral to filter insertion site

    Detected on ultrasound.

    Measured: 2 weeks, 10 weeks, and 9 months

  6. Incidence of DVT

    Detected on ultrasound.

    Measured: 2 weeks, 10 weeks, and 9 months

  7. Incidence of major procedure-related or device-related adverse events

    Measured: 9 months

  8. Incidence of major bleeding

    Major bleeding defined by International Society on Thrombosis and Haemostases.

    Measured: 9 months

Timeline

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

  1. First posted19 Nov 2021
  2. Study start27 Jan 2023
  3. Primary completion31 May 2026 (estimated)
  4. Study completion31 Dec 2026 (estimated)

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
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
854 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05127915
Sponsor's protocol ID
PROT-CI2021
Status last verified
Aug 2023
First submitted
9 Nov 2021
Last updated
31 Aug 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Publications

  • Elizondo G, Eggers M, Falcon M, Trevino M, Marrufo R, Perez C, Nunez E, Moreno R, Mitchell A, Sheppard A, Dria S, Jay T, Kirk R, Hovsepian D, Steele J. First-in-Human Study with Eight Patients Using an Absorbable Vena Cava Filter for the Prevention of Pulmonary Embolism. J Vasc Interv Radiol. 2020 Nov;31(11):1817-1824. doi: 10.1016/j.jvir.2020.07.021. Epub 2020 Sep 29.

    PubMed 33008719
  • Eggers M, Rousselle S, Urtz M, Albright R, Will A, Jourden B, Godshalk C, Dria S, Huang S, Steele J. Randomized Controlled Study of an Absorbable Vena Cava Filter in a Porcine Model. J Vasc Interv Radiol. 2019 Sep;30(9):1487-1494.e4. doi: 10.1016/j.jvir.2019.03.010. Epub 2019 Jun 13.

    PubMed 31202677
  • Huang SY, Eggers M, McArthur MJ, Dixon KA, McWatters A, Dria S, Hill LR, Melancon MP, Steele JR, Wallace MJ. Safety and Efficacy of an Absorbable Filter in the Inferior Vena Cava to Prevent Pulmonary Embolism in Swine. Radiology. 2017 Dec;285(3):820-829. doi: 10.1148/radiol.2017161880. Epub 2017 Jul 14.

    PubMed 28708470
  • Dria SJ, Eggers MD. In vitro evaluation of clot capture efficiency of an absorbable vena cava filter. J Vasc Surg Venous Lymphat Disord. 2016 Oct;4(4):472-8. doi: 10.1016/j.jvsv.2016.05.006. Epub 2016 Jul 25.

    PubMed 27639002
  • Eggers MD, McArthur MJ, Figueira TA, Abdelsalam ME, Dixon KP, Pageon LR, Wallace MJ, Huang SY. Pilot in vivo study of an absorbable polydioxanone vena cava filter. J Vasc Surg Venous Lymphat Disord. 2015 Oct;3(4):409-420. doi: 10.1016/j.jvsv.2015.03.004. Epub 2015 Jun 18.

    PubMed 26992619
  • Eggers MD, Reitman CA. In vitro analysis of polymer candidates for the development of absorbable vascular filters. J Vasc Interv Radiol. 2012 Aug;23(8):1023-30. doi: 10.1016/j.jvir.2012.05.039.

    PubMed 22840802

Questions about this trial

What is this clinical trial studying?

A study testing Adient absorbable filter + best practice VTE prophylaxis and best practice VTE prophylaxis in people with Pulmonary Embolism, run by Adient Medical at 2 sites in United States.

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 9 inclusion and 19 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: under way, not looking for participants, as of the sponsor's last update on 31 Aug 2023. 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 United States. 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?

This study is still under way. Results are not available in the source record yet.

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?

Primary Effectiveness Endpoint - Prophylactic Cohort: incidence of new clinically significant PE (time frame: 2 weeks for asymptomatic proximal PE screening and through 8 weeks for symptomatic PE). The study lists 4 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 NCT05127915, which also lists 6 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 31 Aug 2023.

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