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Completed

NCT Number: NCT04858802

A Clinical Evaluation of PROPEL® Contour Sinus Implant

The objective of this study is to evaluate the efficacy of PROPEL Contour placement following an in-office frontal sinus balloon dilation (SBD) in patients with chronic rhinosinusitis (CRS)

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Key information

Conditions

Chronic Rhinosinusitis (Diagnosis) Disease Pathologic Processes Pathological Conditions, Signs and Symptoms

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Sacramento ENT/DaVinci Research, LLC, Sacramento, California, United States

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About this study

A post-market, randomized, intra-patient controlled, blinded multicenter study with 80 randomized subjects at up to 20 study centers.

After successful in-office bilateral balloon dilation of the frontal sinus ostium (FSO) using the VenSure™ Nav Balloon Device and Fiagon Cube Navigation System, patients will be randomized to receive one PROPEL Contour Sinus Implant on one side while the contralateral side serves as the control.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patient is 18 years of age or older.
  • Patient is willing and able to comply with protocol requirements.
  • Patient has confirmed diagnosis of CRS per International Consensus Statement on Allergy and Rhinology, Rhinosinusitis 2021 (ICAR:RS) guidelines.
  • Bilateral disease in the frontal sinuses (Lund-Mackay CT score of ≥1 on each side) on CT scan within 90 days prior to the baseline.
  • A successfully completed in-office bilateral balloon dilation of the FSO with no complication on either side that, in the opinion of the clinical investigator is amenable for PROPEL Contour Sinus Implant placement in both FSO

Exclusion criteria

  • Patient has structural obstruction that precludes endoscopic visualization of one or both FSOs prior to implant placement.
  • Expanded amount of ethmoid sinonasal polyps extending beyond the middle meatus (grade > 2) unless reduced 30 days prior to the baseline procedure
  • Oral-steroid dependent condition such as chronic obstructive pulmonary disease (COPD) or other conditions.
  • Known history of allergy or intolerance to corticosteroids or mometasone furoate.
  • Patients with a known hypersensitivity to lactide, glycolide or caprolactone copolymers.
  • Patients with electronic devices in direct connection to the brain or the nervous system such as implantable neurostimulators (e.g. deep brain stimulation), programmable cerebrospinal fluid (CSF) shunts.
  • Patients with monopolar pacemakers (older designs, with lower resistance to interference) or ICD's (implantable cardioverter defibrillator).
  • Patients with implantable, body worn devices such as insulin pumps.
  • Evidence of purulence coming from paranasal sinuses or ostiomeatal complex.
  • Clinical evidence of acute bacterial sinusitis or invasive fungal sinusitis (e.g. bone erosion on prior CT scan, necrotic sinus tissue).
  • Active viral illness (e.g., flu, shingles).
  • Use of parenteral or injected steroids (e.g. Kenalog) 30 days prior to the baseline procedure.
  • Use of oral steroids, budesonide or other sinus steroid irrigations/rinses or drops, nebulized steroids administered nasally 14 days prior to baseline procedure.

Treatment and study plan

PROPEL Contour Sinus Implant

Device

370 mcg mometasone furoate-coated sinus implant

Balloon Sinus Dilation Alone

Procedure

No PROPEL Contour Sinus Implant

Primary outcomes

  1. Difference in FSO Patency by Blinded Reviewer

    Time frame: Day 45

    Side-to-side difference in frontal sinus ostium (FSO) patency at Day 45 based on cross-sectional area of FSO by computed tomography (CT) measurements performed by an independent, blinded reviewer. Cross-sectional area of FSO was measured via computer-assisted segmentation of CT images.

Secondary outcomes

  1. FSO Cross-sectional Area Change From Baseline on CT by an Independent, Blinded Reviewer

    Time frame: Baseline, Day 45, and Day 180

    FSO cross-sectional area change from baseline to Day 45 and change from baseline to Day 180 per CT assessment performed by an independent, blinded reviewer. FSO cross-sectional area was measured via computer-assisted segmentation of CT images.

  2. CT Frontal Sinus Outflow Tract (FSOT) Volume by Blinded Reviewer

    Time frame: Days 45 and 180

    FSOT, referring to the region of the frontal sinus surrounding the FSO, bordered superiorly by the frontal infundibulum and inferiorly by the frontal recess, is assessed by blinded reviewer. FSOT volume was measured via computer-assisted segmentation of CT images.

  3. CT FSO Minimum Diameter by Blinded Reviewer

    Time frame: Days 45 and 180

    CT FSO minimum diameter assessed by blinded independent reviewer to assess extent of the disease in the frontal sinuses. FSO minimum diameter was measured via computer-assisted segmentation of CT images.

  4. CT Zinreich's Modified Lund-Mackay Score for the Frontal Sinus by Blinded Reviewer

    Time frame: Days 45 and 180

    CT Zinreich's modified Lund-Mackay score for the frontal sinus assessed by blinded independent reviewer to assess extent of the disease in the frontal sinuses.

    Zinreich's modified Lund-Mackay scale ranges from 0 to 5. Higher scores indicate a worse outcome.

  5. Number of Sinus Sides Requiring Post-operative Intervention by Clinical Investigators

    Time frame: Days 21, 45, 90 and 180

    Need for post-operative intervention as determined by clinical investigators per endoscopy.

  6. CT Cross-sectional Area of FSO by Blinded Reviewer

    Time frame: Day 180

    CT cross-sectional area of FSO assessed by blinded independent reviewer to assess extent of the disease in the frontal sinuses. Cross-sectional area of FSO was measured via computer-assisted segmentation of CT images.

  7. CT Lund-Mackay Score for the Frontal Sinus by Blinded Reviewer

    Time frame: Days 45 and 180

    CT Lund-Mackay score for the frontal sinus assessed by blinded independent reviewer to assess extent of the disease in the frontal sinuses.

    The Lund-Mackay scale ranges from 0 to 2. Higher scores indicate a worse outcome.

  8. CT Lund-Mackay Score for the Frontal Sinus by Clinical Investigators

    Time frame: Days 45 and 180

    CT Lund-Mackay for the frontal sinus assessed by blinded independent reviewer to assess extent of the disease in the frontal sinuses.

    The Lund-Mackay scale ranges from 0 to 2. Higher scores indicate a worse outcome.

  9. Adhesion/Scarring Grade in the Frontal Recess/FSO by Clinical Investigators

    Time frame: Days 21, 45, 90 and 180

    Endoscopic grading of adhesion/scarring grade in the frontal recess/FSO by clinical investigators.

    The adhesion/scarring grade in the frontal recess/FSO scale ranges from 0 to 4. Higher scores indicate a worse outcome.

  10. Inflammation Score in the Frontal Recess/FSO by Clinical Investigators

    Time frame: Days 21, 45, 90 and 180

    Endoscopic grading of inflammation score in the frontal recess/FSO by clinical investigators.

    Inflammation score in the frontal recess/FSO ranges from 0 to 100. Higher scores indicate a worse outcome.

  11. Polypoid Edema in the Frontal Recess/FSO by Clinical Investigators

    Time frame: Days 21, 45, 90 and 180

    Endoscopic grading of polypoid edema in the frontal recess/FSO by clinical investigators.

    Polypoid edema in the frontal recess/FSO scale ranges from 0 to 3. Higher scores indicate a worse outcome.

  12. Adhesion/Scarring Grade in the Ethmoid Sinus by Clinical Investigators

    Time frame: Day 21, 45, 90, and 180

    Endoscopic grading of adhesion/scarring grade in the ethmoid sinus by clinical investigators.

    The adhesion/scarring grade in the ethmoid sinus scale ranges from 0 to 4. Higher scores indicate a worse outcome.

  13. Polyp Grade in the Ethmoid Sinus by Clinical Investigators

    Time frame: Days 21, 45, 90 and 180

    Endoscopic grading of polyp grade in the ethmoid sinus by clinical investigators.

    Polyp grade in the ethmoid sinus scale ranges from 0 to 3. Higher scores indicate a worse outcome.

  14. CRS Side-specific Symptom Score by Subject

    Time frame: Days 21, 45, 90 and 180

    Subject-reported outcome of chronic rhinosinusitis (CRS) side-specific symptom score.

    The chronic rhinosinusitis side-specific symptom score scale ranges from 0 to 30. Higher scores indicate a worse outcome.

  15. SNOT-22 Score by Subject

    Time frame: Day 180

    Subject-reported outcome of SNOT-22 score.

    The Sino-Nasal Outcome Test, 22 item (SNOT-22) is a validated, disease-specific, symptom-scoring instrument consisting of 22 questions, each scored by the patient on a 6-point scale, ranging from a score of 0 ("no problem") to 5 ("problem as bad as it can be"). The maximum total score for all symptoms is equal to 110.

    Higher scores indicate a worse outcome.

  16. RSI Score by Subject

    Time frame: Day 180

    Subject-reported outcome of RSI score.

    The Rhinosinusitis Symptom Inventory (RSI) scale ranges from 0 to 60. Higher scores indicate a worse outcome.

  17. Implant Delivery Success by Clinical Investigators

    Time frame: Baseline

    Number of subjects who underwent successful access and deployment of the PROPEL Contour Sinus Implant into the FSO. Delivery is considered successful if the procedure concludes with correct implant placement on the intended side, even if a second attempt to place the implant is necessary. An attempted deployment occurs when the investigator introduces the delivery system into the subject's nostril with the intent of placing an implant.

Sponsors and collaborators

Lead sponsor

Intersect ENT

Industry

Registry information

Official study title

The EXPAND Study: A Clinical Evaluation of PROPEL® Contour Sinus Implant Placement in the Frontal Sinus Ostium Following In-office Bilateral Balloon Dilation

Acronym: EXPAND

Important dates

Study start
2021
Primary completion
2022
Study completion
2022
First posted
Apr 26, 2021
Registry last updated
Apr 21, 2023

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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