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Completed

NCT Number: NCT01662856

Safety and Efficacy Study of Fibrin Sealant Grifols as an Adjunct to Hemostasis During Peripheral Vascular Surgery

The purpose of this study is to demonstrate that the application of Fibrin Sealant Grifols provides a measurable benefit when compared to hemostasis achieved through conventional surgical technique (suture) and by standard hemostatic action, such as mechanical pressure through manual compression. This study has a Preliminary Part (I) in which all subjects are treated with Fibrin Sealant Grifols and a Primary Part (II) in which subjects are randomized in a 2:1 ratio to either Fibrin Sealant Grifols or manual compression.

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Key information

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

501, Miskolc, Hungary

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Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Hemoglobin (Hgb) ≥ 8.0 g/dL at Baseline (within 24 hours prior to surgical procedure).
  • Require elective (non-emergency), primary, open (non-laparoscopic; non-endovascular) peripheral vascular surgery.
  • Require one of the following peripheral vascular procedures involving proximal end-to-side arterial anastomosis utilizing coated or uncoated Polytetrafluoroethylene grafts: a) Femoral-femoral bypass grafting, b) Femoral-popliteal bypass grafting, c) Femoral-distal bypass grafting, d) Ilio-iliac bypass grafting, e) Ilio-femoral bypass grafting, f) Ilio-popliteal bypass grafting, g) Aorto-iliac bypass grafting, h) Aorto-femoral bypass grafting, i)Axillo-femoral bypass grafting, and j) Upper extremity vascular access for hemodialysis.
  • A target bleeding site can be identified.
  • Target bleeding site has moderate arterial bleeding.

Exclusion criteria

  • Undergoing a re-operative procedure.
  • Undergoing other vascular procedures during the same surgical session (stenting and/or endarterectomy of the same artery are allowed).
  • Have an infection in the anatomic surgical area.
  • Have a history of severe (e.g. anaphylactic) reactions to blood or to any blood-derived product.
  • Have previous known sensitivity to any Fibrin Sealant Grifols, heparin, or protamine component.
  • Females who are pregnant or nursing a child at Baseline (within 24 hours prior to surgical procedure).
  • Have undergone a therapeutic surgical procedure within 30 days from the screening visit.
  • Target bleeding site cannot be identified.
  • Target bleeding site has mild or severe arterial bleeding.
  • Occurrence of major intraoperative complications that require resuscitation or deviation from the planned surgical procedure.
  • Intraoperative change in planned surgical procedure, which results in subject no longer meeting preoperative inclusion and/or exclusion criteria.

Treatment and study plan

Fibrin Sealant Grifols

Biological

Combination of 3 mL fibrinogen and 3 mL thrombin in separate syringes assembled on a syringe holder (6 mL of solution in total).

Manual Compression

Procedure

Direct manual compression of target bleeding site with gauze/laparotomy pads.

Primary outcomes

  1. Proportion of Subjects Achieving Hemostasis by Four Minutes After Treatment Start

    Time frame: From start of treatment until 4 minutes after treatment start

    Subjects achieving hemostasis at the target bleeding site by 4 minutes following the start of treatment without the occurrence of re-bleeding until the completion of surgical closure.

Secondary outcomes

  1. Time to Hemostasis (TTH)

    Time frame: From start of treatment until 10 minutes after treatment start

    Time in minutes for achievement of hemostasis at the target bleeding site measured from the start of treatment until 10 minutes after treatment start.

    In the Fibrin Sealant Grifols treatment group, the median TTH was calculated based on the estimated survival function S(t), and it is the smallest time at which S(t) is at or below 50%. The 95% CI for the median TTH, on the other hand, was calculated based on the CI for the survival function S(t). The 95% CI for the median TTH was the set of all time points for which the 95% CI of the survival function contains 0.5 (since median is the 50% percentile). Sometimes, the confidence limits for the median cannot be estimated. In our case, the hemostasis was assessed on a discrete scale, and it happened that for all the time points assessed none of the 95% CI of the survival function S(t) contained 0.5. As a result, neither the lower nor the upper limit could be estimated.

    All calculations were performed using SAS PROC LIFETEST

  2. Cumulative Proportion of Subjects Having Achieved Hemostasis at the Target Bleeding Site by Specified Time Points

    Time frame: From start of treatment until 10 minutes after treatment start

    Cumulative proportion of subjects having achieved hemostasis by each of the following time points:

    • At 5 minutes following start of study treatment
    • At 7 minutes following start of study treatment
    • At 10 minutes following start of study treatment
  3. Prevalence of Treatment Failures

    Time frame: From start of treatment until 10 minutes after treatment start

    Protocol-defined bleeding at the target bleeding site after the start of treatment or the use of alternative hemostatic treatments (with exception of reversal of heparin) or maneuvers at the target bleeding site after the start of treatment.

Sponsors and collaborators

Lead sponsor

Instituto Grifols, S.A.

Industry

Registry information

Official study title

A Prospective, Single-blind, Randomized, Phase III Study to Evaluate the Safety and Efficacy of Fibrin Sealant Grifols (FS Grifols) as an Adjunct to Hemostasis During Peripheral Vascular Surgery

Important dates

Study start
2012
Primary completion
2015
Study completion
2015
First posted
Aug 10, 2012
Registry last updated
Apr 6, 2017

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.