Aneurysm of Aorta, Thoracic, Dissection of Aorta, Thoracic, Trauma
Conditions
Brief summary
The goal of this surveillance is to confirm the safety and efficacy of TBE under actual use in the Zone 0/1 lesion on post-marketing usage conditions.
Interventions
Patients who attempted implant of TBE in Zone 0/1 during the enrollment period for each indication (including patients in whom TBE is not placed in Zone 0/1 area).
Sponsors
W.L.Gore & Associates
CMIC Co, Ltd. Japan
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
Those who are suitable for use of TBE according to the Japan package insert. \[Reference: Purpose of Use or Effects of TBE at the time of launch\] The GORE® TAG® Thoracic Branch Endoprosthesis is intended for use in patients with the following diseases of the aortic arch and descending thoracic aortic lesions who fulfill anatomical requirements for treatment of such diseases while preserving blood flow to a single aortic arch target branch vessel. * Thoracic aortic aneurysm * Traumatic transection * Complicated Stanford type A (after surgical repair) and B aortic dissection (including dissecting aortic aneurysm) who have not responded to medical therapy The GORE® TAG® Thoracic Branch Endoprosthesis may be used in combination with designated stent grafts with validated efficacy and safety.
Exclusion criteria
N/A
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Device Technical Success at the Initial Endovascular Procedure | TBE Initial Implant Procedure | All of the following must be met. * Successful access and delivery * Patency of devices * The absence of unanticipated additional procedure related to the device, the TBE implant procedure, or withdrawal of the delivery system |
| Lesion-related Mortality and All-cause Death | 60 Months | Lesion-related Mortality that meet any of the following criteria: * All deaths within 30 days after the revascularization procedure or the TBE implant procedure during the initial hospitalization or secondary procedures resulting from the treated lesion or endovascular treatment (e.g., procedures for retrograde dissection, loss of patency, loss of device integrity, endoleak, migration, aortic dilation, aneurysm rupture) * All deaths related to the treated lesion or device (e.g., aneurysm rupture, retrograde dissection resulting in fatal cardiac tamponade) Not applicable if there is evidence to support no relationship to the lesion. |
| Aortic Rupture of the Treatment Lesion | 60 Months | Rupture in the treated segment of the vessel (e.g., aorta or branch) verified with direct observation or CT / CTA scan. |
| Disabling Stroke | 60 Months | Stroke is the acute onset of symptoms consistent with focal or multifocal central nervous system (CNS) injury caused by vascular blockage resulting in ischemia or vascular rupture resulting in hemorrhage, that: Persists for \> 24 hours or until death |
| Serious Paraplegia | 60 Months | Paraplegia secondary to spinal cord ischemia reported as a serious adverse event from sites. |
| Serious Paraparesis | 60 Months | Paraparesis secondary to spinal cord ischemia reported as a serious adverse event from sites. |
| Renal Failure Requiring Dialysis | 60 Months | Renal failure reported as a serious adverse event by sites and confirmed to require dialysis. |
| Additional Unanticipated Post-procedural Reintervention | 60 Months | Additional unanticipated surgical procedure or endovascular procedure related to TBE, TBE implant procedure, or revascularization procedure for TBE implant after the revascularization procedure or TBE implant procedure. Anticipated or unanticipated status will be determined at the discretion of the investigator. Surgical procedures include conversion to thoracotomy. Endovascular procedures include stent graft implants for endoleaks, aortic enlargement and loss of patency, and procedures on the branch to improve or restore patency. Events will not include access site(s) complications, interventions to address issues related to non-treated area of the index lesion, such as bare stent implant to address bowel ischemia associated with aortic dissection. |
| Serious Device-related Ischemia | 60 Months | Ischemia reported by sites as a serious adverse event determined to be related to the device. |
| Distal Device-related Thromboembolic Serious Adverse Event Requiring Intervention or Surgery | 60 Months | Device-related ischemic adverse events reported by sites as serious adverse events that required bypass surgery, surgical procedures, or amputation, or that resulted in death. |
| Serious New Dissection | 60 Months | New events of aortic dissection reported as serious adverse events by sites. |
| Serious Myocardial Infarction | 60 Months | Myocardial infarction reported as a serious adverse event by the sites. |
| Serious Laryngeal or Phrenic Nerve Injury | 60 Months | Nerve damage events reported by the sites as serious adverse events that required retreatment. |
| Serious Heart Failure/Hypotension | 60 Months | Heart failure or hypotension reported as serious adverse events by the sites. |
| Aortic Enlargement in the Region Encompassed by the Initial Lesion | 60 Months | An increase of 5 mm or more in arterial diameter at the treated area compared to images taken at the first follow-up after the TBE implant procedure. |
| Endoleak | 60 Months | Serious adverse events reported or confirmed by imaging by the sites. The definitions of each type of endoleaks are as follows: * Type I endoleak is defined as a sealing failure at one of the attachment sites of the graft to the vessel wall. Arterial flow therefore leaks alongside the graft and into the perigraft space. * Type Ia: Proximal leak * Type Ib: Distal leak * Type Ic: Inadequate seal at distal landing zone for side branch component * Type II endoleak is defined as retrograde flow from branch arteries arising from the treated segment of the aorta. * Type III endoleak * Type IIIA endoleak : Attachment of aortic components (aortic-aortic). * Type IIIB endoleak : Fabric tear or disruption. * Type IIIC endoleak : Attachment of aortic component-side-branch or side-branch-side-branch * Type IV endoleak is defined as flow through porous fabric. * Indeterminate : Endoleak detected with unknown source. |
| Loss of Device Integrity | 60 Months | Defined as any of the following: * Wire fractures identified in the sealing row stents of the aortic component (AC), branch component (SB) or aortic extender (AE). * Stent kinking: Narrowing of the stent graft associated with demonstrable angulation in any of the stent components, with demonstrable flow * Disruption / tears in the graft component of the stent graft * Transient (compression) or permanent stent-graft collapse (invagination) following complete device deployment, resulting in an overall reduction in the aortic or branch vessel luminal diameter. * If the device loses function due to other malformations |
| Loss of Aortic or Aortic Branch Patency | 60 Months | No flow or contrast detected through the implanted aortic or side branch devices or distal CTAG devices after the TBE implant procedure. |
| Migration | 60 Months | Longitudinal movement of all or part of the device for a distance ≥10 mm, as confirmed by imaging, relative to anatomical landmarks and device positioning at the first post-operative imaging. |
| False Lumen Perfusion through the Primary Entry Tear (Dissection Patients only) | 60 Months | Confirm the presence or absence of blood flow from a proximal aortic source through the primary entry tear into the aortic false lumen, based on imaging. |
| Extension of a Dissection (Proximally or Distally) (Dissection Patients only) | 60 Months | Among the aortic dissections reported by sites as serious adverse events, those in which proximal or distal progression of the lesion from the TBE implant procedure was confirmed on imaging. |
| False Lumen Status in Treated and Untreated Segments (Dissection Patients only) | 60 Months | The thrombosis state of the false lumen at the treated and untreated segments at the TBE implant procedure is confirmed using the following three stages. * Patent is defined as flow present throughout the aortic false lumen in the absence of evidence of thrombus. * Partially thrombosed false lumen is defined as clot within the aortic false lumen that has a residual patent flow channel. * Thrombosed false lumen is defined as complete thrombosis of the aortic false lumen. |
Contacts
CONTACTManami Kaneko
Outcome results
None listed