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Trial registered on ANZCTR
Registration number
ACTRN12610000158066
Ethics application status
Approved
Date submitted
16/02/2010
Date registered
18/02/2010
Date last updated
28/05/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
Efficacy, feasibility and safety of the CINCOR system for the prevention of Contrast-Induced Nephropathy (CIN) in patients with chronic kidney disease undergoing diagnostic and therapeutic percutaneous coronary interventional (PCI) procedures
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Scientific title
Assessment of the retrieval of contrast agent using the CINCOR System in patients with chronic kidney disease undergoing a coronary diagnostic or interventional procedure requiring the use of iodinated contrast media.
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Secondary ID [1]
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Osprey Medical Protocol - TP-6160 / CINCOR Feasibility Trial II
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Contrast-Induced Nephropathy in patients with chronic kidney disease and scheduled to undergo a coronary diagnostic or interventional procedure requiring the use of iodinated contrast media
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Condition category
Condition code
Renal and Urogenital
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0
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Kidney disease
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Cardiovascular
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0
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Coronary heart disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The Osprey Medical CINCOR System utilizes catheter system along with institutional vacuum in which contrast media (CM) injected into the left coronary arteries is retrieved from the coronary sinus (CS). The
investigational device works by retrieving contrast agent prior to reaching the systemic circulation and the kidneys thereby helping to avoid the development of contrast induced nephropathy (CIN).
The removal catheter will be in place in the coronary sinus for the duration of the PCI procedure (approximately 1 to 2 hours). Each collection episode will require that the vacuum is activated for approximately 8-12 seconds. It is anticipated that up to 12 collection episodes will occur during a PCI procedure.
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Intervention code [1]
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Prevention
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Intervention code [2]
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Treatment: Devices
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Comparator / control treatment
Single arm study, no comparator. All patients will undergo standard of care treatment, peri-procedural hydration, for the prevention of CIN.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Retrieval of contrast agent. Success criterion for this endpoint is 40% or greater retrieval of contrast agent. This criterion will be assessed by analyzing collected blood for iodine content by inductively coupled plasma optical emission spectroscopy (ICP-OES)
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Assessment method [1]
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Timepoint [1]
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Measured on the day of the coronary procedure.
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Secondary outcome [1]
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To describe the safety of the device by summarising all system- and procedure-related adverse events and estimating the serious system- and procedure-related serious adverse event free rate. Adverse events evaluated include:
Death, Arrhythmia (including ventricular tachycardia and ventricular fibrillation), Myocardial infarction, Pericardial hemorrhage/tamponade requiring treatment, Coronary sinus perforation, dissection, or occlusion, Blood loss requiring transfusion, Other events related to partial coronary sinus occlusion and suction. These events will be evaluated using standard medical techniques including electrocardiogram (ECG), angiography, clinical laboratory tests, and patient interview.
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Assessment method [1]
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Timepoint [1]
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Evaluated through 30 days post-procedure. This endpoint will be evaluated at all scheduled and unscheduled study visits. Scheduled post-procedure visits occur at 1, 4, and 30 days post-procedure.
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Eligibility
Key inclusion criteria
1. The subject is at least 18 years of age.
2. The subject is a candidate for a diagnostic or therapeutic coronary percutanous coronary interventional (PCI) procedure of the left coronary artery (left main, left anterior descending coronary artery and/or left circumflex artery or branches of these vessels) anticipated to utilize at least 50 mL of iodinated contrast media.
3. The subject has documented chronic kidney disease and an estimated estimated glomerular filtration rate (eGFR) > 15 and < 60 mL/min/1.73m2 [as determined by the Modification of Diet on Renal Disease (MDRD) equation].
4. The subject (or subject’s legal representative) is willing and able to provide appropriate informed consent.
5. The subject is willing and able to comply with the requirements of the study protocol,
including the predefined follow-up evaluations.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. The subject is currently undergoing renal dialysis.
2. The subject is in acute renal failure or has unstable renal function based on clinical findings and/or a known change in serum creatinine of greater than or equal to 0.5mg/dL or greater than or equal to 25% within 7 days prior to enrolment compared to the last serum creatinine measurement on record.
3. The subject has received contrast media within 7 days prior to the procedure day or a second imaging study of any type which will require iodinated contrast is planned within the 4 days following the protocol-defined procedure.
4. The subject has a known allergy to iodine-based contrast agents that cannot be adequately pre-medicated (patients with a history of true anaphylaxis may not be enrolled).
5. The subject has a known bleeding diathesis (e.g. thrombocytopenia [<100,000 cells/mm3], heparin-induced thrombocytopenia, haemophilia, or von Willebrand disease, any history of intracranial bleeding, or gastrointestinal bleeding gross genitourinary bleeding).
6. The subject is currently on intravenous heparin that cannot be discontinued at least 4 hours before the procedure, intravenous bivalirudin that cannot be discontinued at least 4 hours before the procedure, intravenous abciximab that cannot be discontinued at least 24 hours before the procedure, intravenous tirofiban or eptifibatide that cannot be discontinued at least 6 hours before the procedure, or has received any low molecular weight heparin within 12 hours or factor Xa antagonist (including fondaparinux) within 24 hours of the procedure.
7. The subject is hypotensive (systolic blood pressure < 90 mmHg not corrected by intravenous saline) or requiring intravenous pressors and/or intra-aortic balloon counterpulsation.
8. The subject has decompensated heart failure requiring intravenous diuretic, inotropic, vasopressor or intraaortic balloon support in the previous 7 days.
9. The subject has had recent (within last 72 hours) acute myocardial infarction as defined in the “Universal Definition of Myocardial Infarction”:
a. Detection of rise and/or fall of cardiac biomarkers (preferably troponin) with at least one value above the 99th percentile of the upper reference limit and at least one of the following
i. Symptoms of ischemia
ii. Electrocardiogram (ECG) changes indicative of new ischemia (new ST-T changes or new left bundle branch block)
iii. Development of pathological Q waves in the ECG
iv. Imaging evidence of new loss of viable myocardium or new regional wall motion abnormality
10. The subject requires an intra aortic balloon pump.
11. The subject has an International Normalized Ratio (INR) > 1.8 pre-procedure.
12. The subject has an active bacterial infection within the last month.
13. The subject has haemoglobin (Hb) < 10.0 g/dL within one (1) week of the procedure.
14. The subject is known to be or suspected to be pregnant, or is lactating (all women of child-bearing potential must have a negative pregnancy test within 72 hours before participating in this protocol).
15. The subject has a life expectancy of less than twelve (12) months.
16. The subject has a pacemaker lead, percutaneous mitral annuloplasty or other device placed within the coronary sinus that would limit the ability to successfully cannulated the coronary sinus.
17. The subject has an unstable clinical situation precluding placement or operation of the Osprey Medical CINCOR System.
18. The subject is currently participating in another investigational device or drug study that has not completed its primary endpoint.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
15/04/2010
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
10
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Osprey Medical Inc
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Address [1]
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121 5th Avenue NW
St Paul, MN 55112
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Country [1]
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United States of America
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Primary sponsor type
Commercial sector/Industry
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Name
Osprey Medical Pty Ltd
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Address
Level 4, 167 Eagle Street
Brisbane 4000
Queensland
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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The Alfred Ethics Committee
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Ethics committee address [1]
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Ethics committee country [1]
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Date submitted for ethics approval [1]
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22/02/2010
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Approval date [1]
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Ethics approval number [1]
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Summary
Brief summary
The purpose of this clinical study is to evaluate the effectiveness of the procedure for contrast removal as well as describe the safety and device performance of the Osprey Medical CINCOR Contrast Removal System, in patients with chronic kidney disease who are schedule to undergo diagnostic or therapeutic percutaneous coronary interventional procedures.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Suzanne Williams
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Address
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Mobius Medical Pty Ltd
Level 32
1 Market Street
Sydney NSW 2000
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Country
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Australia
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Phone
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+61 2 9275 8838
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Fax
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+61 2 9275 8800
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dan Mans
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Address
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7600 Executive Drive, Eden Prairie, MN, 55344
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Country
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United States of America
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Phone
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1-952-955-8236
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Fax
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1-952-955-8171
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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