The Xlumena AXIOS Stent and Delivery System is an investigational device in the USA, and this study is being conducted under an Investigational Device Exemption (IDE) granted by the US Food and Drug Administration (FDA). The study design is prospective, multi-center, non-blinded, single-arm (nonrandomized) study. Up to 10 sites in the United States, European Community and/or Japan will enroll a total of 24 patients. A majority of the patients will be enrolled in the United States. Patients will be followed at (approximately) 30 days and/or 60 days depending upon pseudocyst resolution confirmation, at 1-week post-stent removal,and possibly at 3 and 6 month post-stent removal.
OBJECTIVE: To demonstrate the safety and effectiveness of the Xlumena AXIOS Stent and Delivery System for endoscopic drainage of pancreatic pseudocysts in patients with symptomatic pancreatic pseudocysts that are greater than or equal to 6 cm (≥6cm) in diameter, have ≥ 70% fluid contents and are adherent to the bowel wall. STUDY DESIGN: Prospective, multi-center, non-blinded, single-arm (nonrandomized) study KEY ENDPOINTS: Safety: The safety endpoint is freedom from major complications through the duration of the 1-week post-stent removal study period, defined as: 1. Access site-related bleeding requiring transfusion; 2. Access site-related infection requiring intravenous or intramuscular antibiotics and/or extended hospitalization; 3. Surgery for access-site related perforation; 4. Stent migration/dislodgement into the pseudocyst or enteral lumen; 5. Tissue injury, defined as ulceration to the submucosa at site of stent implant as observed to persist through 1-week post-stent removal. 6. Serious adverse event classified as implant-associated or implant/endoscopic procedure-associated; Effectiveness: 1. Stent lumen patency at 30 days and/or 60 days 2. Stent removability at 30 days and/ or 60 days. 3. Technical success, defined as: placement of the AXIOS stent using the AXIOS delivery system and removal of the AXIOS stent using a standard endoscopic snare. 4. Clinical success, defined as: at least a 50% decrease in pseudocyst size, based on radiographic analysis, at 30 days and/or 60 days. PATIENT POPULATION: Patients between 18 and 75 years of age, suitable for transluminal drainage of symptomatic pancreatic pseudocysts that are greater than or equal to 6 cm in diameter and adherent to the bowel wall are candidates for study treatment. FOLLOW-UP SCHEDULE: Clinical follow-up evaluations of study endpoints will be conducted at 30 days and/or 60 days, 1 week post stent removal and possibly at 3 and 6 months post stent removal. PLANNED NUMBER OF PATIENTS, SITES \& REGIONS: The target enrollment for the study is 24 subjects. Study will be conducted at up to 10 investigational sites in the United States, Japan and/or the European Community. A majority of the patients will be enrolled in the United States.
The AXIOS Stent \& Delivery System study is a prospective, multi-center, non-blinded, single-arm(nonrandomized) study that will be conducted at up to 10 sites in the United States, European Community and/or Japan will enroll a total of 24 patients. A majority of the patients will be enrolled in the United States. Patients between the age of 18 and 75 scheduled for endoscopic drainage of symptomatic pancreatic pseudocysts that are equal or greater than 6 cm in diameter, adherent to the bowel wall, and have ≥ 70% fluid contents are potential study candidates. Study patients will undergo the following clinical follow-up evaluations of study endpoints conducted at 30 days, 60 days, 1 week post stent removal and possibly at 3 and 6 months post stent removal.
California Pacific Medical Center (CPMC)
San Francisco, California, United States
Unversity of Colorado Denver
Aurora, Colorado, United States
Borland-Groover Clinic
Jacksonville, Florida, United States
University of Chicago Medical Center (UCMC)
Chicago, Illinois, United States
Safety - Freedom From Major Complications: Access Site-related Bleeding
Subjects are free of access site-related bleeding requiring transfusion
Time frame: Through the duration of the 1-week post-stent removal study period
Safety - Freedom From Major Complications: Access Site-related Infection
Subjects are free of access site-related infection requiring intravenous or intramuscular antibiotics and/or extended hospitalization
Time frame: Through the duration of the 1-week post-stent removal study period
Safety - Freedom From Major Complications: Perforation
Subjects are free of surgery for access-site related perforation
Time frame: Through the duration of the 1-week post-stent removal study period
Safety - Freedom From Major Complications: Stent Migration/Dislodement
Treated subjects are free of stent migration/ dislodgement into the pseudocyst or enteral lumen
Time frame: Through the duration of the 1-week post-stent removal study period
Safety - Freedom From Major Complications: Tissue Injury
Subjects are free of tissue injury (ulceration to the submucosa) at stent site persisting through 1-week post-stent removal.
Time frame: Through the duration of the 1-week post-stent removal study period
Safety - Freedom From Major Complications: SAE's
Treated subjects are free of serious adverse event classified as implant-associated or implant/endoscopic procedure-associated.
Time frame: Through the duration of the 1-week post-stent removal study period
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Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
30
Cornell University
New York, New York, United States
Thomas Jefferson University
Philadelphia, Pennsylvania, United States
Hospital Costa del Sol
Marbella, Spain
Effectiveness: Stent Lumen Patency at 30 Days and/or 60 Days
Stent lumen patency at 30 days and/or 60 days.
Time frame: Up to 60 days
Effectiveness: Stent Removability at 30 Days and/or 60 Days
AXIOS stent removal was indicated at the time of pseudocyst resolution (≤ 3 cm diameter) or at 60 the day post procedure visit. Scheduled examination for pseudocyst resolution was designated at 30 days for removal if the pseudocyst resolution criterion was met. Otherwise, the stent was left in place for removal at the 60 day visit.
Time frame: Up to 60 days
Effectiveness: Technical Success
Placement of the AXIOS Stent using the AXIOS Delivery System and removal of the AXIOS Stent using a standard endoscopic snare.
Time frame: Up to 60 days
Clinical Success
Clinical success is defined as at least a 50% decrease in pseudocyst size, based on radiographic analysis, at 30 days and/or 60 days.
Time frame: Up to 60 days