LEOPARD: Post-Market Study to Assess Outcomes of Patients Treated With AFX System Compared to Other EVAR Devices

Sponsor
Endologix (Industry)
Overall Status
Active, not recruiting
CT.gov ID
NCT02407457
Collaborator
(none)
455
56
2
90.1
8.1
0.1

Study Details

Study Description

Brief Summary

The objective of this post-market trial is to evaluate Endologix AFX endovascular AAA system with anatomical fixation against other approved Endovascular systems with proximal fixation. Multiple U.S clinical centers will be involved in the trial to include a broad range of experience. Imaging data will be evaluated by an independent core lab.

Condition or Disease Intervention/Treatment Phase
  • Device: AFX EVAR AAA Graft System
  • Device: FDA Approved EVAR AAA Graft Systems
N/A

Detailed Description

This trial is a prospective, randomized, multi-center trial, intended to evaluate the outcomes of contemporary EVAR (Endovascular Aneurysm Repair) in a real world population. The trial is designed to compare the anatomically stabilized AFX Endograft System to a reference group of proximally fixated EVAR devices. Patients will be randomized between the two groups.

Randomization will be 1:1. Each investigator will select one comparator device of their choice before enrolling the first patient. The study will sequentially evaluate non-inferiority and superiority hypotheses.

Up to 80 sites with experience in EVAR and up to 800 subjects will participate in this study.

Study Design

Study Type:
Interventional
Actual Enrollment :
455 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
Multicenter, Post-Market Study to Assess Outcomes of Patients Treated With the AFX System Compared to Other EVAR Devices for Endovascular Abdominal Aortic Aneurysm Repair: LEOPARD
Actual Study Start Date :
Mar 1, 2015
Actual Primary Completion Date :
Oct 1, 2018
Anticipated Study Completion Date :
Sep 1, 2022

Arms and Interventions

Arm Intervention/Treatment
Active Comparator: AFX EVAR AAA Graft System

Subjects randomized to receive the Endologix AFX Endovascular Graft System for implantation to repair Abdominal Aortic Aneurysm via femoral access.

Device: AFX EVAR AAA Graft System
Endvovascular Abdominal Aneurysm Repair (EVAR) using commerically available, FDA approved endovascular graft systems implanted via femoral access.

Active Comparator: FDA Approved EVAR AAA Graft Systems

Subjects randomized to receive the comparator AAA Endovascular Graft System for implantation to repair Abdominal Aortic Aneurysm via femoral access.

Device: FDA Approved EVAR AAA Graft Systems

Outcome Measures

Primary Outcome Measures

  1. Number of Patients With Absence of Aneurysm Related Complications (ARC) [1 year]

    ARC is a composite of the most relevant EVAR outcomes and includes: Peri-Operative Death (< 30 days) Rupture Conversion to OSR Endoleaks; post-operative Migration (≥ 10mm) Aneurysm Enlargement (≥ 5mm) Endograft Limb Occlusions Reinterventions for device- or aneurysm-related complications

Secondary Outcome Measures

  1. The Number of MAEs [At 30 days, 12 months, and annually up to five years]

    Major Adverse Events

  2. The Number of Aneurysm Related Complications (ARC) [Post 12 Months up to Five Years]

    ARC is a composite outcome

  3. The Number of Participants With Aneurysm Related Mortality [Up to Five Years]

    Death related to the aneurysm

  4. Number of Endoleaks Classified by Type [Up to Five Years]

    All Endoloeaks

  5. Loss of Neck Apposition as Measured by Length in mm [Up to Five Years]

    Loss of Neck Apposition as measured by length in mm

  6. Number of AAA Related Secondary Procedures [Up to Five Years]

    Number of AAA related secondary procedures

  7. Number of Device Integrity Events [Up to Five Years]

    Number of device integrity events from device fractures and technical observations related to the stent graft

  8. Number of Adjunctive Procedures Necessitated During the Implant Procedure. [Up to Five Years]

    Number of adjunctive procedures done during the implant procedure

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years and Older
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  1. Male or female at least 18 years old

  2. Subjects with minimum of 2 year life expectancy

  3. Subjects have signed the informed consent document for data release

  4. Subjects with infrarenal AAA who are assessed by the Investigator to be eligible for endovascular Abdominal Aortic Aneurysm Repair with the trial devices.

Exclusion Criteria:
  1. Currently participating in another study where primary endpoint has not been reached yet

  2. Known allergy to any of the device components

  3. Pregnant (females of childbearing potential only)

  4. Subjects with pre-existing EVAR, e.e. in need of repair/intervention of a previously failed EVAR

Contacts and Locations

Locations

Site City State Country Postal Code
1 Eliza Coffee Medical Center Florence Alabama United States 35630
2 Huntsville Hospital Huntsville Alabama United States 35801
3 Banner Good Samaritan Hospital Phoenix Arizona United States 85006
4 Carondelet Heart and Vascular Institute Tucson Arizona United States 85745
5 Central Arkansas Veteran's Healthcare System Little Rock Arkansas United States 72205
6 Long Beach VA Hospital Long Beach California United States 90822
7 Sacramento Vascular Sugeons Sacramento California United States 95816
8 Kaiser - Santa Clara Santa Clara California United States 95051
9 Penrose St. Francis Health Colorado Springs Colorado United States 80907
10 Hartford Hospital New Britain Connecticut United States 61110
11 Yale University New Haven Connecticut United States 48097
12 Mayo Jacksonville Jacksonville Florida United States 32224
13 Mount Sinai Medical Center Miami Beach Florida United States 33140
14 Vascular Institute of Central Florida Orlando Florida United States 32803
15 Sarasota Vascular Specialists Sarasota Florida United States 34232
16 USF/Tampa VA Tampa Florida United States 33606
17 Emory/Grady Atlanta Georgia United States 30303
18 Navicent Health Medical Center Macon Georgia United States 31201
19 Peachtree Vascular Specialists Stockbridge Georgia United States 30281
20 Prairie Education & Research Cooperative Springfield Illinois United States 62701
21 Cadence Physician Group Winfield Illinois United States 60190
22 Parkview Research Center Fort Wayne Indiana United States 46845
23 Franciscan - St. Francis Hospital Indianapolis Indiana United States 46237
24 University of Iowa Healthcare Iowa City Iowa United States 52246
25 The Iowa Clinic Cardiovascular Services West Des Moines Iowa United States 50266
26 Surgical Care Associates Louisville Kentucky United States 40207
27 Cardiovascular Research Foundation of Louisiana Baton Rouge Louisiana United States 70808
28 Baton Rouge Vascular Specialty Center Baton Rouge Louisiana United States 70809
29 VA Maryland Health Care System Baltimore Maryland United States 21201
30 Peninsula Regional Medical Center Salisbury Maryland United States 21801
31 Massachusetts General Hospital Boston Massachusetts United States 02114
32 St. Joseph Mercy Ann Arbor Ypsilanti Michigan United States 48197
33 Hattiesburg Clinic Hattiesburg Mississippi United States 39402
34 North MS Medical Center Tupelo Mississippi United States 38801
35 University of Missouri Columbia Missouri United States 65212
36 Kansas City Vascular North Kansas City Missouri United States 64116
37 Saint Louis University Saint Louis Missouri United States 63124
38 The Vascular Group Albany New York United States 12208
39 VA Western New York Healthcare System Buffalo New York United States 14215
40 Wake Forest Winston-Salem North Carolina United States 27157
41 University Hospitals Cleveland Medical Center Cleveland Ohio United States 44106
42 Cleveland Clinic Cleveland Ohio United States 44195
43 Innovation Center, Kettering Health Network Kettering Ohio United States 45429
44 Neo Vascular (Lake West) Willoughby Ohio United States 44094
45 Geisinger Medical Center Danville Pennsylvania United States 17822
46 Hospital of the University of Pennsylvania Philadelphia Pennsylvania United States 19104
47 Thomas Jefferson University Philadelphia Pennsylvania United States 19107
48 North Central Heart Sioux Falls South Dakota United States 57108
49 Cardiothoracic & Vascular Surgeons Austin Texas United States 78756
50 University of Texas Health Houston Texas United States 77030
51 University of Vermont Medical Center Burlington Vermont United States 05401
52 Sentara Vascular Specialists Norfolk Virginia United States 23507
53 Peacehealth Southwest Medical Center Vancouver Washington United States 98664
54 University of Wisconsin Madison Wisconsin United States 53792
55 Medical College of Wisconsin Milwaukee Wisconsin United States 53226
56 Clement J. Zablocki VA Medical Center Milwaukee Wisconsin United States 53295

Sponsors and Collaborators

  • Endologix

Investigators

  • Principal Investigator: Christopher Kwolek, MD, Endologix

Study Documents (Full-Text)

More Information

Publications

Responsible Party:
Endologix
ClinicalTrials.gov Identifier:
NCT02407457
Other Study ID Numbers:
  • CP-0011
First Posted:
Apr 3, 2015
Last Update Posted:
Nov 30, 2021
Last Verified:
Nov 1, 2021
Studies a U.S. FDA-regulated Drug Product:
No
Studies a U.S. FDA-regulated Device Product:
Yes
Additional relevant MeSH terms:

Study Results

Participant Flow

Recruitment Details
Pre-assignment Detail
Arm/Group Title AFX EVAR AAA Graft System FDA Approved EVAR AAA Graft Systems
Arm/Group Description Subjects randomized to receive the Endologix AFX Endovascular Graft System for implantation to repair Abdominal Aortic Aneurysm via femoral access. AFX EVAR AAA Graft System: Endvovascular Abdominal Aneurysm Repair (EVAR) using commerically available, FDA approved endovascular graft systems implanted via femoral access. Subjects randomized to receive the comparator AAA Endovascular Graft System for implantation to repair Abdominal Aortic Aneurysm via femoral access. FDA Approved EVAR AAA Graft Systems
Period Title: Baseline
STARTED 235 220
COMPLETED 235 220
NOT COMPLETED 0 0
Period Title: Baseline
STARTED 235 220
COMPLETED 229 213
NOT COMPLETED 6 7
Period Title: Baseline
STARTED 231 219
COMPLETED 211 194
NOT COMPLETED 20 25
Period Title: Baseline
STARTED 227 208
COMPLETED 194 180
NOT COMPLETED 33 28
Period Title: Baseline
STARTED 218 194
COMPLETED 184 159
NOT COMPLETED 34 35
Period Title: Baseline
STARTED 198 175
COMPLETED 156 137
NOT COMPLETED 42 38
Period Title: Baseline
STARTED 181 156
COMPLETED 100 95
NOT COMPLETED 81 61
Period Title: Baseline
STARTED 123 113
COMPLETED 31 36
NOT COMPLETED 92 77

Baseline Characteristics

Arm/Group Title AFX EVAR AAA Graft System FDA Approved EVAR AAA Graft Systems Total
Arm/Group Description Subjects randomized to receive the Endologix AFX Endovascular Graft System for implantation to repair Abdominal Aortic Aneurysm via femoral access. AFX EVAR AAA Graft System: Endvovascular Abdominal Aneurysm Repair (EVAR) using commerically available, FDA approved endovascular graft systems implanted via femoral access. Subjects randomized to receive the comparator AAA Endovascular Graft System for implantation to repair Abdominal Aortic Aneurysm via femoral access. FDA Approved EVAR AAA Graft Systems Total of all reporting groups
Overall Participants 235 220 455
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]
72
(8)
72
(8)
72
(8)
Sex: Female, Male (Count of Participants)
Female
23
9.8%
28
12.7%
51
11.2%
Male
212
90.2%
192
87.3%
404
88.8%
Race/Ethnicity, Customized (Count of Participants)
Caucasian
225
95.7%
199
90.5%
424
93.2%
Non-caucasian
10
4.3%
21
9.5%
31
6.8%
ASA Classification (Count of Participants)
ASA Class 1/2
71
30.2%
62
28.2%
133
29.2%
ASA Class 3/4/5
164
69.8%
158
71.8%
322
70.8%

Outcome Measures

1. Primary Outcome
Title Number of Patients With Absence of Aneurysm Related Complications (ARC)
Description ARC is a composite of the most relevant EVAR outcomes and includes: Peri-Operative Death (< 30 days) Rupture Conversion to OSR Endoleaks; post-operative Migration (≥ 10mm) Aneurysm Enlargement (≥ 5mm) Endograft Limb Occlusions Reinterventions for device- or aneurysm-related complications
Time Frame 1 year

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title AFX EVAR AAA Graft System FDA Approved EVAR AAA Graft Systems
Arm/Group Description Subjects randomized to receive the Endologix AFX Endovascular Graft System for implantation to repair Abdominal Aortic Aneurysm via femoral access. AFX EVAR AAA Graft System: Endvovascular Abdominal Aneurysm Repair (EVAR) using commerically available, FDA approved endovascular graft systems implanted via femoral access. Subjects randomized to receive the comparator AAA Endovascular Graft System for implantation to repair Abdominal Aortic Aneurysm via femoral access. FDA Approved EVAR AAA Graft Systems
Measure Participants 235 220
Count of Participants [Participants]
195
83%
175
79.5%
2. Secondary Outcome
Title The Number of MAEs
Description Major Adverse Events
Time Frame At 30 days, 12 months, and annually up to five years

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title
Arm/Group Description
3. Secondary Outcome
Title The Number of Aneurysm Related Complications (ARC)
Description ARC is a composite outcome
Time Frame Post 12 Months up to Five Years

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title
Arm/Group Description
4. Secondary Outcome
Title The Number of Participants With Aneurysm Related Mortality
Description Death related to the aneurysm
Time Frame Up to Five Years

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title
Arm/Group Description
5. Secondary Outcome
Title Number of Endoleaks Classified by Type
Description All Endoloeaks
Time Frame Up to Five Years

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title
Arm/Group Description
6. Secondary Outcome
Title Loss of Neck Apposition as Measured by Length in mm
Description Loss of Neck Apposition as measured by length in mm
Time Frame Up to Five Years

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title
Arm/Group Description
7. Secondary Outcome
Title Number of AAA Related Secondary Procedures
Description Number of AAA related secondary procedures
Time Frame Up to Five Years

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title
Arm/Group Description
8. Secondary Outcome
Title Number of Device Integrity Events
Description Number of device integrity events from device fractures and technical observations related to the stent graft
Time Frame Up to Five Years

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title
Arm/Group Description
9. Secondary Outcome
Title Number of Adjunctive Procedures Necessitated During the Implant Procedure.
Description Number of adjunctive procedures done during the implant procedure
Time Frame Up to Five Years

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title
Arm/Group Description

Adverse Events

Time Frame AEs are collected through 5 year follow-up visit.
Adverse Event Reporting Description
Arm/Group Title AFX EVAR AAA Graft System FDA Approved EVAR AAA Graft Systems
Arm/Group Description Subjects randomized to receive the Endologix AFX Endovascular Graft System for implantation to repair Abdominal Aortic Aneurysm via femoral access. AFX EVAR AAA Graft System: Endvovascular Abdominal Aneurysm Repair (EVAR) using commerically available, FDA approved endovascular graft systems implanted via femoral access. Subjects randomized to receive the comparator AAA Endovascular Graft System for implantation to repair Abdominal Aortic Aneurysm via femoral access. FDA Approved EVAR AAA Graft Systems
All Cause Mortality
AFX EVAR AAA Graft System FDA Approved EVAR AAA Graft Systems
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 56/235 (23.8%) 45/220 (20.5%)
Serious Adverse Events
AFX EVAR AAA Graft System FDA Approved EVAR AAA Graft Systems
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 140/235 (59.6%) 129/220 (58.6%)
Blood and lymphatic system disorders
Bleeding 14/235 (6%) 15 16/220 (7.3%) 19
Cardiac disorders
cardiac 47/235 (20%) 63 36/220 (16.4%) 59
Gastrointestinal disorders
GI 13/235 (5.5%) 14 12/220 (5.5%) 14
General disorders
Miscellaneous 42/235 (17.9%) 55 45/220 (20.5%) 55
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Malignancies 28/235 (11.9%) 30 19/220 (8.6%) 20
Nervous system disorders
neurological 19/235 (8.1%) 27 20/220 (9.1%) 20
Renal and urinary disorders
Renal 13/235 (5.5%) 13 17/220 (7.7%) 18
Respiratory, thoracic and mediastinal disorders
pulmonary 34/235 (14.5%) 45 26/220 (11.8%) 44
Skin and subcutaneous tissue disorders
Wound 4/235 (1.7%) 4 6/220 (2.7%) 8
Vascular disorders
Aneurysm Rupture 0/235 (0%) 0 0/220 (0%) 0
Device 23/235 (9.8%) 28 19/220 (8.6%) 24
Vascular 26/235 (11.1%) 35 30/220 (13.6%) 38
Other (Not Including Serious) Adverse Events
AFX EVAR AAA Graft System FDA Approved EVAR AAA Graft Systems
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 51/235 (21.7%) 56/220 (25.5%)
Blood and lymphatic system disorders
anemia 6/235 (2.6%) 6 1/220 (0.5%) 1
Cardiac disorders
Cardiac 0/235 (0%) 0 0/220 (0%) 0
Gastrointestinal disorders
GI 1/235 (0.4%) 1 0/220 (0%) 0
General disorders
miscellaneous 3/235 (1.3%) 3 2/220 (0.9%) 2
Nervous system disorders
Neurological 3/235 (1.3%) 3 1/220 (0.5%) 1
Renal and urinary disorders
Renal 3/235 (1.3%) 4 2/220 (0.9%) 2
Skin and subcutaneous tissue disorders
wound 0/235 (0%) 0 1/220 (0.5%) 1
Vascular disorders
Device 36/235 (15.3%) 37 42/220 (19.1%) 44
vascular 7/235 (3%) 7 9/220 (4.1%) 9

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

Principal Investigators are NOT employed by the organization sponsoring the study.

PI shall be free to publish Institution's data/results from the Clinical Study at time of multicenter results published, notification that publication is not planned, or 18 months after the study conclusion at all centers, whichever occurs first.

Results Point of Contact

Name/Title Sharone Trifskin
Organization Endologix, Inc.
Phone 949-599-8860
Email strifskin@endologix.com
Responsible Party:
Endologix
ClinicalTrials.gov Identifier:
NCT02407457
Other Study ID Numbers:
  • CP-0011
First Posted:
Apr 3, 2015
Last Update Posted:
Nov 30, 2021
Last Verified:
Nov 1, 2021