Cardiovascular Diseases, Chronic Kidney Diseases, Diabetes Mellitus, Hypertension, Vascular Diseases
Conditions
Brief summary
The purpose of the SPYRAL SWYFT sub-study is to evaluate whether renal denervation with the Symplicity Spyral system performed in the main and first order branch renal arteries yields a shorter procedure time and is as effective in reducing blood pressure than the procedural approach used in the SPYRAL HTN-ON MED and SPYRAL PIVOTAL - SPYRAL HTN-OFF MED clinical studies in an uncontrolled hypertensive population.
Detailed description
SPYRAL SWYFT will evaluate the long-term safety, efficacy, and durability of the Symplicity Spyral system to determine whether renal denervation performed in the main and first order branch renal arteries yields a shorter procedure time and is as effective in reducing blood pressure than the procedural approach used in the SPYRAL HTN-ON MED and SPYRAL PIVOTAL - SPYRAL HTN-OFF MED clinical studies (where all accessible renal arterial vessels between 3 and 8 mm in diameter including accessory, branch and main renal arteries (outside the kidney parenchyma) were targeted for ablation). SPYRAL SWYFT study is conducted under the overarching SPYRAL AFFIRM protocol (NCT05198674), focused on EU and APAC regions.
Interventions
After a renal angiography according to standard procedures, subjects are treated with the renal denervation procedure.
Sponsors
Medtronic Vascular
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Individual is diagnosed with hypertension and has a baseline office systolic blood pressure ≥140 mmHg 2. Individual has a baseline office diastolic blood pressure ≥ 90 mmHg 3. Individual has an average systolic baseline home blood pressure ≥135 mmHg (with ≥7 days of valid pre-procedure measurements) 4. Individual has a valid 24-hour Ambulatory Blood Pressure Measurement at baseline
Exclusion criteria
1. Individual lacks appropriate renal artery anatomy 2. Individual has undergone prior renal denervation 3. Individual has a documented condition that would prohibit or interfere with ability to obtain an accurate blood pressure measurement 4. Individual requires chronic oxygen support or mechanical ventilation other than nocturnal respiratory support for sleep apnea 5. Individual has an estimated glomerular filtration rate (eGFR) of \<45 mL/min/1.73m2 6. Individual has one or more episode(s) of orthostatic hypotension 7. Individual is pregnant, nursing or planning to become pregnant 8. Individual has documented primary pulmonary hypertension 9. Individual has documented type 1 diabetes mellitus or poorly-controlled type 2 diabetes mellitus with glycosylated hemoglobin greater than 8.0%
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Procedure time | Procedure | Procedure time will be compared to the SPYRAL HTN-ON MED and SPYRAL PIVOTAL - SPYRAL HTN-OFF MED procedure times. |
| Office Systolic Blood Pressure Change | 6 months | Office Systolic Blood Pressure (OSBP) change from baseline to 6 months will be compared to the SPYRAL HTN-ON MED and SPYRAL PIVOTAL - SPYRAL HTN-OFF MED study efficacy endpoints using a propensity score stratified baseline blood pressure adjusted analysis at 3 months (OFF MED) and 6 months (ON MED). |
Secondary
| Measure | Time frame |
|---|---|
| Office Systolic Blood Pressure change | From baseline to 3, 6, 12, 24, and 36 months post-procedure |
| Home Blood Pressure change | From baseline to 3, 6, 12, 24, and 36 months post-procedure |
| Change in blood pressure as measured by 24-hour ABPM | From baseline to 3, 6, 12, 24, and 36 months post-procedure |
| Percent of subjects achieving blood pressure control as measured by OBP, HBP and ABPM | From baseline to 3, 6, 12, 24, and 36 months post-procedure |
| Time subject's blood pressure is controlled | Procedure to 36 months post-procedure |
| Change in number of anti-hypertensive medications taken from baseline | From baseline to 3, 6, 12, 24, and 36 months post-procedure |
| Change from baseline in hypertension health status score | From baseline to 3, 6, 12, 24, and 36 months post-procedure. A higher score means a better outcome. |
| Evaluate factors influencing blood pressure response to renal denervation | From baseline to 3, 6, 12, 24, and 36 months post-procedure |
| Evaluation of slope of eGFR | From baseline to 3, 6, 12, 24, and 36 months post-procedure |
| Incidence of safety events, including major adverse events | From baseline to 3, 6, 12, 24, and 36 months post-procedure |
Countries
Australia, Belgium, Germany, Greece, Ireland, Malaysia, Netherlands, Taiwan, United Kingdom
Contacts
CONTACTKelsey Anderson
CONTACTCarly Loudoun
PRINCIPAL_INVESTIGATORDavid Lee, MD
Stanford University
PRINCIPAL_INVESTIGATORKonstantinos Tsioufis, Prof Dr
Hippokration General Hospital of Athens
Outcome results
None listed