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This study aims to confirm that the benefit-risk assessment of the GORE® EXCLUDER® Thoracoabdominal Branch Endoprosthesis (TAMBE Device) remains positive in real-world use and to ensure the adequacy of the TAMBE Device training program.
A maximum of 300 adult subjects will be enrolled at up to 60 U.S. centers, with a minimum of 70 subjects enrolled at study centers with no prior experience using the TAMBE Device. Subjects will have follow-up at 1 month, 6 months, 12 months and annually thereafter through 10 years post implant.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Single Arm | Other | Treatment with GORE® EXCLUDER® Thoracoabdominal Branch Endoprosthesis (TAMBE Device) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| GORE® EXCLUDER® Thoracoabdominal Branch Endoprosthesis (TAMBE Device) | Device | Treatment with the GORE® EXCLUDER® Thoracoabdominal Branch Endoprosthesis (TAMBE Device) in patients with Pararenal Abdominal Aortic Aneurysms and Thoracoabdominal Aortic Aneurysms |
| Measure | Description | Time Frame |
|---|---|---|
| Co-Primary Endpoint #1: Technical Success | All of the qualifying criteria are met (in the absence of surgical conversion or mortality, type I or type III endoleak, branch occlusion, or graft limb obstruction):
| Time of index procedure |
| Co-Primary Endpoint #2: Clinical Success | All of the following qualifying criteria are met from the initiation of the index procedure through 12 months post-index procedure:
| Index procedure through 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Target Vessel Technical Success | Successful catheterization and stent placement in all intended target vessels. Note: For this study, technical success will be reported for the overall procedure and specifically for the vessels targeted for treatment with the branch components (this "target vessel technical success" definition). | 30 days, 6 months, annually through 10 years |
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Inclusion Criteria:
The subject is / has:
Exclusion Criteria:
The subject is / has:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Stanford Hospital | Stanford | California | 94305 | United States |
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| ID | Term |
|---|---|
| D017544 | Aortic Aneurysm, Abdominal |
| D000094624 | Aortic Aneurysm, Thoracoabdominal |
| ID | Term |
|---|---|
| D001014 | Aortic Aneurysm |
| D000783 | Aneurysm |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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| Secondary Clinical Success | Initial clinical success that is interrupted by a treatment failure and is successfully corrected with secondary reintervention (e.g., a patient undergoes a successful treatment of a type I, II, or III endoleak). | 30 days, 6 months, annually through 10 years |
| Assisted Primary Clinical Success | Clinical success that is obtained initially and continuously maintained with additional secondary reinterventions thus no interruption to initial clinical success. | 30 days, 6 months, annually through 10 years |
| Thirty-Day Mortality | Any death that occurs during the procedure, within the index procedure hospital stay, or within the first 30 days post-index procedure. | 30 days |
| Lesion-Related Mortality | Any death that occurs within the first 30 days, or any death that results from lesion rupture, aorta-related complications (e.g., infection, occlusion, dissection, hematoma), or a complication of a secondary intervention. | 30 days, 6 months, annually through 10 years |
| Major Adverse Events (MAEs) | Includes any of the following:
| 30 days, 6 months, annually through 10 years |
| Secondary interventions | Any Reintervention: Any repeated vascular or nonvascular procedure on the index device (TAMBE Device or any stent or stent graft in contact with any TAMBE component). • Note: Reintervention will be classified as "major", "minor", or "nonvascular" based on the definitions below. Major Reintervention: Deployment of proximal or distal extensions, removal of the device, use of thrombectomy or thrombolysis, and any major open surgical procedure. Minor Reintervention: Endovascular procedures (percutaneous transluminal angioplasty, atherectomy, stenting) without thrombectomy or thrombolysis, interventions to treat branch vessel stenosis, interventions to treat type II endoleaks or branch-related endoleaks, and minor surgical revisions (patch angioplasty) of the access vessels. Nonvascular Reinterventions: Any reinterventions that would not be considered "major reintervention" or "minor reintervention" based on the above definitions. | Time of index procedure |
| Intraprocedural Complications | Any vessel perforation, dissection, or occlusion during target vessel cannulation and/or stenting. | 30 days, 6 months, annually through 10 years |
| Kink | Objective documentation of demonstrable angulation (localized angle of less than 90 degrees when measured along the centerline) in any of the stent components or native target vessel | 30 days, 6 months, annually through 10 years |
| Stenosis | Objective documentation of presence of narrowing with demonstrable flow in any of the components | 30 days, 6 months, annually through 10 years |
| Occlusion | Objective documentation of presence of complete stent occlusion with or without minimal flow into a targeted vessel. Note: Occlusions will be stated if they occurred in the aortic component, in a branch component, or in a contralateral leg component used to treat the aortic disease. | 30 days, 6 months, annually through 10 years |
| Target Vessel Instability | Any death or rupture related to side branch complication (e.g., endoleak) or any secondary intervention indicated to treat a branch-related complication, including endoleak, disconnection, kink, stenosis, occlusion, or rupture. | 30 days, 6 months, annually through 10 years |
| Secondary Patency | Endovascular restoration of patency after occlusion of the side branch, stent, or stent graft has already occurred. Note: Conversion to bypass or inability to treat by endovascular means defines loss of secondary patency. | 30 days, 6 months, annually through 10 years |
| Primary Assisted Patency | Endovascular intervention performed to maintain patency in the presence of stenosis before occlusion. | 30 days, 6 months, annually through 10 years |
| Primary Patency | Uninterrupted patency with no occlusion or procedure performed to maintain patency on the stent or native target vessel. Note: Interventions intended to treat endoleak or stent disconnection do not count as loss of primary patency. | 30 days, 6 months, annually through 10 years |
| D001018 |
| Aortic Diseases |