Patient case: 63-year-old female with aortic aneurysm; genetic feature: ACTA2

Clinical trial: ECLIPSE Feasibility Trial (Ensure's Vascular Closure Device Speeds Hemostasis Trial) EU

Summary: To assess the safety and feasibility of the 7F Ensure Medical Vascular Closure Devices to facilitate hemostasis in patients undergoing diagnostic or interventional procedures.

Detailed description: Multi-center (up to 6 European sites), non-blinded, non-randomized, feasibility study with a 2-month enrollment period and 30-day clinical follow-up.
  60 patients (plus up to 36 "roll-in" device training patients) undergoing diagnostic or interventional coronary or peripheral procedures utilizing a 7F arterial puncture in the common femoral artery. Patients are excluded if they have a previous target artery closure with any closure device, recent myocardial infarction or thrombolytic therapy, treatment with thrombin-specific anticoagulants or low molecular weight heparin, fluoroscopically visible calcium or atherosclerosis ≤ 1 cm of puncture site, or planned target site access ≤ 30 days.

Eligibility: Inclusion Criteria:
  -  Patient is between 18 and 85 years of age
  -  Patient/legal representative provides written informed consent
  -  Patient is scheduled for a coronary or peripheral diagnostic or interventional procedure
  -  Patient is able to undergo emergent vascular surgery if a complication related to the VCD necessitates such surgery
  -  Patient has a 7F arterial puncture located in the common femoral artery
  -  Target vessel has a lumen diameter ≥ 5 mm
  -  Patient is willing and able to complete follow-up
  -  Catheterization procedure is planned and elective
  Exclusion Criteria:
  -  Arterial puncture in the femoral artery of both legs
  -  Prior target artery closure with any closure device or closure with manual compression ≤ 30 days prior to the cardiac or peripheral catheterization procedure
  -  Patients with a history of significant bleeding or with any known or documented bleeding disorders, such as Thrombocytopenia (with < 100,000 platelet count), Von Willebrand's disease, anemia (Hgb < 10 g/dL, Hct < 30%), thrombasthenia, decreased fibrinogen (< 200 mg/dL), and Factor V deficiency
  -  Acute ST-elevation myocardial infarction ≤ 48 hours prior to the cardiac or peripheral catheterization procedure
  -  Uncontrolled hypertension (BP ≥ 180/110 mmHg)
  -  Heparinized patients with elevated pre-closure ACT level:> 250 seconds with GP IIb/IIIa inhibitor > 300 seconds no GP IIb/IIIa inhibitor
  -  Patient is ineligible for in-lab catheterization lab introducer sheath removal
  -  Concurrent participation in another investigational device or drug trial
  -  Thrombolytic therapy (e.g. streptokinase, urokinase, t-PA) ≤ 24 hours prior to the cardiac or peripheral catheterization procedure
  -  Angiomax (bivalirudin) or other thrombin-specific anticoagulants or low molecular weight heparin ≤ 24 hours prior to the cardiac or peripheral catheterization procedure
  -  Evidence of a preexisting hematoma, arteriovenous fistula, or pseudoaneurysm at the access site prior to start of femoral artery closure procedure
  -  Prior femoral vascular surgery or vascular graft in region of access site or contralateral common femoral artery
  -  The targeted femoral artery is tortuous or requires an introducer sheath length > 11 cm
  -  Fluoroscopically visible calcium, atherosclerotic disease, or stent ≤ 1 cm of the puncture site that would interfere with the placement of the VCD's plug
  -  Difficulty in obtaining vascular access resulting in multiple arterial punctures and/or posterior arterial puncture
  -  Antegrade puncture
  -  BMI > 40 kg/m2
  -  Symptomatic leg ischemia in the target vessel limb including severe claudication (< 50 meter) or weak/absent pulse
  -  Targeted femoral artery diameter stenosis ≥ 50%
  -  Pre-existing severe non-cardiac systemic disease or pre-existing terminal illness
  -  Planned arterial access at the same access site ≤ 30 days following the femoral artery closure procedure
  -  Patient has known allergy to any materials used in the VCD
  -  Patient is known to require an extended hospitalization (e.g. patient is undergoing CABG surgery)
  -  Pre-existing systemic or cutaneous infection
  -  Prior or recent use of an intra-aortic balloon pump through the arterial access site
  -  Cardiogenic shock (hemodynamic instability requiring intravenous medications or mechanical support) experienced during or immediately post-catheterization
  -  Patient is unable to ambulate at baseline
  -  Patient is known or suspected to be pregnant, or is lactating
  -  Patient has already participated in this trial
  -  Patient has known allergy to contrast medium
  -  Patient is unavailable for follow-up
  -  Any angiographic or clinical evidence that the investigator feels would place the patient at increased risk with the use of the VCD
  -  Required simultaneous ipsilateral or contralateral venous puncture

Relevance to patient case: not relevant