This study aims to evaluate the safety (incidence of adverse events including serious adverse events and clinical significant laboratory abnormalities) of personalized tissue engineered veins (P-TEV) with valves implanted in patients with severe chronic venous insufficiency (CVI). For each patient a segment of the femoral vein containing the non-functioning valve will be surgically replaced with a single P-TEV containing a functioning valve.
The advanced therapy medicinal product (ATMP) described herein is a personalized tissue- engineered vein (P-TEV) graft for use in surgical implantation to replace a defective or missing part of a patient's vein. In this specific application a P-TEV graft with a functioning venous bicuspid valve is implanted to replace a nonfunctioning venous valve in the femoral vein of a patient suffering from severe CVI. The P-TEV graft for surgical implantation is 4-6 cm in length. The P-TEV drug substance consists of an extracellular matrix (ECM) scaffold in the form of a decellularized (DC) allogeneic vein scaffold which is populated with autologous components from the patient's own peripheral whole blood (PWB) in an ATMP manufacturing process performed under GMP. As the allogeneic immunogenic material has been removed from the donated vein segment by DC and as the perfusion uses autologous PWB, no immunosuppression is required. Successful implantation and treatment should prevent the reverse blood flow, decrease blood pooling in the lower leg, and thereby alleviate symptoms such as swelling, pain, and ulcers.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
15
Replacement of vein with failing valves with personalized tissue engineering vein containing functional valves
Junta de Andalusia
Seville, Spain
RECRUITINGThrombosis leading to occlusion of the graft measured by Color Duplex Ultrasound
Ultrasonographic evaluation of occlusions of the graft.
Time frame: 12 months
Infection leading to surgical excision of the graft measured by blood samples
White blood cells count: \>10 x10E9/L, C- Reactive Protein (CRP): \>4 mg/L, sedimentation rate: \>12mm).
Time frame: 12 months
Infection leading to surgical excision of the graft measured by Color Duplex Ultrasound
Ultrasonographic examination to assess infection of the graft
Time frame: 12 months
Infection leading to surgical excision of the graft measured by Computer Tomography
Infection of the graft assessed by Computer Tomography
Time frame: 12 months
Reporting of surgical complications
Perioperative surgical complications related to the implanted graft (technical failure leading to surgical failure).
Time frame: 12 months
Change in symptoms assessed according to VCSS (Venous Clinical Severity Score)
The VCSS includes 9 hallmarks of venous disease, each scored on a severity scale from 0 (absent) to 3 (severe), plus a category for compression with higher scores representing greater compliance (still scale 0-3).
Time frame: 12 months
Change in symptoms assessed according to CEAP classification (clinical, etiologic, anatomic, pathophysiologic)
CEAP classification is assessed on scale from C0 (No visible or palpable signs of venous disease) to C6 (Active venous ulcer).
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Time frame: 12 months
Health Related Quality of Life assessed by VEINES questionnaire
Responses are made on a 2- to 7-point scale that rates intensity, frequency, and agreement. Higher scores are associated with better quality-of-life.The focus of VEINES is on physical symptoms as opposed to psychological or social aspects.
Time frame: 12 months
Health Related Quality of Life assessed by EQ-5D-5L questionnaire
EQ-5D-5L is a standardized self-assessment instrument for health status.It has two components; health state description and evaluation. The first part contains 5 items with five levels of response regarding five dimensions (mobility, hygiene, activities, pain and anxiety).The five questions are compounded into a health index according to a mathematical formula validated against the population in several countries.The second part of the questionnaire comprises a standard vertical 20-cm VAS that is calibrated from 'the worst health you can imagine' (scored 0) at its base to 'the best health you can imagine' (scored 100) at its apex. Respondents are asked to 'mark an X on the scale to indicate how your health is TODAY' and to write the number in an adjoining box.
Time frame: 12 months
Durability of the P-TEV assessed by Color Duplex Ultrasound
The time period in which the valve contained in the implant retains its function verified by ultrasonographic examination.
Time frame: 12 months
Vessel dilatation in the implant assessed by Duplex Color Ultrasound
Ultrasonographic examination of vessel dilatation
Time frame: 12 months
Flow abnormalities in the implant assessed by Duplex Color Ultrasound
Ultrasonographic examination of flow abnormalities
Time frame: 12 months
Wall degeneration in the implant assessed by Duplex Color Ultrasound
Ultrasonographic examination of wall degeneration
Time frame: 12 months