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Completed

NCT Number: NCT05443919

A Clinical Trial to Evaluate the Efficacy and Safety of TwiFlow-System for Acute Pulmonary Embolism

For a prospective, single-arm clinical study, this study plans to recruit patients with acute pulmonary intravascular embolization, use production of transcatheter pulmonary artery bolt system which named 'TwiFlow-Thrombectomy Catheter System' developed by the MorningSide (NanTong) medical device Co., LTD. on pulmonary artery interventional therapy, for evaluating the efficacy and safety of this novel system in the treatment of patients with pulmonary intravascular embolization disease.

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Key information

Age range

18 year–75 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Atrial shunt implant system

Nantong, Jiangsu, 210046, China

About this study

As a prospective, single-arm clinical study, the investigators plan to evaluate the new production's efficacy and safety which named 'TwiFlow-Thrombectomy Catheter System'. This study will be carried out in Xiamen Cardiovascular Hospital, Xiamen University. A total of 3 subjects are planned to be enrolled. After screening, all subjects will be treated with transcatheter pulmonary artery thrombectomy system, and clinical follow-up will be conducted at 48 hours, 14 days and 30 days after surgery.

Right Ventricular/Left Ventricular decline from baseline to 48 hours after surgery and the incidence of major adverse events (MAE) within 48 hours after surgery were used as primary endpoints. In instrument performance evaluation, the success rate of surgery, postoperative immediate target lesion embolus removal efficiency, pulmonary artery pressure changes before and after operation value, values of arterial oxygen partial pressure changes before and after operation, death rates related to the equipment in 48 hours after surgery, incident rate of bleeding in 48 hours after operation, postoperative clinical deterioration rate in 48 hours after surgery, postoperative pulmonary vascular injury incidence in 48 hours after surgery, the incidence of heart damage injury in 48 hours after surgery, all-cause death rate in 30 days after surgery, and symptomatic Pulmonary Embolization recurrence rate in 30 days after surgery were secondary endpoints.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • 18≤ age ≤75, no gender limitation;
  • patients clinically diagnosed as acute pulmonary embolism requiring pulmonary artery thrombosis clearance;
  • RV/LV ratio ≥0.9;
  • Patients who agreed to participate in the study and voluntarily signed the informed consent.

Exclusion criteria

  • Target vessel diameter < 6.6mm;
  • Calcification, plaque or stenosis of target lesions;
  • Hematocrit < 28%;
  • Patients with a history of chronic pulmonary hypertension;
  • Patients with left bundle branch block;
  • A history of chronic left heart failure and left ventricular ejection fraction ≤30%;
  • Patients with abnormal renal function (serum creatinine > 1.8 mg/dL or >159 umol/L);
  • Patients with known coagulopathy or bleeding tendency (platelet <100×109/L, or INR> 3);
  • Patients who cannot receive antiplatelet or anticoagulant therapy;
  • Patients who underwent cardiovascular or pulmonary open surgery within 7 days before surgery;
  • Patients with intracardiac thrombosis;
  • Patients treated with extracorporeal membrane oxygenation;
  • Patients known to be allergic to contrast agents;
  • Patients with diseases that may cause difficulty in treatment and evaluation (such as malignant tumor, acute infectious disease, sepsis, general condition that cannot tolerate surgery, life expectancy less than one year, etc.);
  • Pregnant and lactating women;
  • Patients who are participating in clinical trials of other drugs or medical devices;
  • Other patients deemed unsuitable for the study by the investigator;

Treatment and study plan

TwiFlow-Thrombectomy Catheter System

Device

Patients with acute pulmonary embolism and meeting the conditions of this clinical trial will accept the pulmonary embolism removal operation by the novel device named 'TwiFlow-Thrombectomy Catheter System'.

Primary outcomes

  1. Right Ventricular/Left Ventricular decline from baseline to 48 hours after surgery

    Time frame: before and 48 hours after surgery

    Right Ventricular (RV) and Left Ventricular (LV) were recorded during the screening period and 48 hours after surgery by echocardiography or pulmonary artery CT (CTPA), and RV/LV and RV/LV reduction were calculated. The target RV/LV reduction from baseline to 48 hours after surgery was at least 0.2

  2. The incidence of major adverse events (MAE) within 48 hours after surgery

    Time frame: 48 hours after surgery

    The incidence of major adverse events (MAE) during and 48 hours after surgery was observed and recorded, and the incidence of MAE was calculated (referring to the definition of MAE). The target incidence of MAE 48 hours after surgery was less than 25%.

    MAE events defined as those occurring within 48 hours of treatment include device-related death, massive bleeding, pulmonary vascular injury, and cardiac injury.

    Haemorrhage: Disabling or life-threatening bleeding, or severe haemodynamic injury.

    Pulmonary vascular injury: Defined as perforation or injury of a major pulmonary artery branch requiring surgical open surgical intervention.

    Cardiac injury: Defined as heart injury requiring surgical open surgical intervention.

Secondary outcomes

  1. instrument performance evaluation

    Time frame: intraoperative period

    Whether the plug remover is delivered to the specified location or not, whether the thrombectomy stent was successfully deployed or not, whether the plug is retracted successfully or not, whether the thrombectomy device safely removed from the body or not. Whether the conveying system delivers to the specified location or not, whether the delivery system safely removed from the body or not.

  2. the success rate of surgery

    Time frame: intraoperative period

    Surgical success was defined as successful thrombectomy without MAE.

  3. postoperative immediate target lesion embolus removal efficiency

    Time frame: before the pulmonary intravascular embolization removal procedure began and after the embolization removal operation end immediately

    Thrombus clearance = (postoperative target vascular diameter - preoperative target vascular diameter)/preoperative target vascular diameter x100%. The thrombus clearance rate of target lesions can be divided into three grades: <50%, 50-90% and > 90% respectively, in which the thrombus clearance rate ≥50% is effective.

  4. pulmonary artery pressure changes before and after operation value

    Time frame: before the pulmonary intravascular embolization removal procedure began and after the embolization removal operation end immediately

    Changes in pulmonary artery pressure before and after operation = postoperative pulmonary artery pressure - preoperative pulmonary artery pressure

  5. values of arterial oxygen partial pressure changes before and after operation

    Time frame: before the pulmonary intravascular embolization removal procedure began and after the embolization removal operation end immediately

    Preoperative and postoperative arterial oxygen partial pressure = postoperative arterial oxygen partial pressure - preoperative arterial oxygen partial pressure

  6. death rates related to the equipment in 48 hours after surgery

    Time frame: 48 hours after surgery

    death rates

  7. incident rate of bleeding in 48 hours after operation

    Time frame: 48 hours after surgery

    incident rate of bleeding

  8. postoperative clinical deterioration rate in 48 hours after surgery

    Time frame: 48 hours after surgery

    Clinical deterioration include instrumentation related events such as unplanned endotracheal intubation, mechanical ventilation, arterial hypotension (>1 hour) or shock, cardiopulmonary resuscitation, significant deterioration of oxygenation, and emergency surgical embolectomy

  9. postoperative pulmonary vascular injury incidence in 48 hours after surgery

    Time frame: 48 hours after surgery

    Pulmonary vascular injury: Defined as perforation or injury of a major pulmonary artery branch requiring surgical open surgical intervention.

  10. the incidence of heart damage injury in 48 hours after surgery

    Time frame: 48 hours after surgery

    Cardiac injury: Defined as heart injury requiring surgical open surgical intervention.

  11. all-cause death rate in 30 days after surgery

    Time frame: 30 days after surgery

    all-cause death

  12. symptomatic Pulmonary Embolization recurrence rate in 30 days after surgery

    Time frame: 30 days after surgery

    patients present with pulmonary embolism again

Sponsors and collaborators

Lead sponsor

Morningside (Nantong) Medical Co.,Ltd

Other

Collaborators

  • Xiamen Cardiovascular Hospital, Xiamen University

Registry information

Official study title

An Exploratory Study to Evaluate the Safety and Efficacy of a Novel Transcatheter Pulmonary Thrombectomy System Which Named 'TwiFlow' for Acute Pulmonary Embolism

Acronym: TwiFlow

Important dates

Study start
2022
Primary completion
2022
Study completion
2023
First posted
Jul 5, 2022
Registry last updated
May 15, 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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