The goal of this Prospective Trial of Paclitaxel-Coated Pulmonary Balloon for the Treatment of Benign Airway Obstruction (OXYGEN-1) is to evaluate clinical safety and potential efficacy of the Airiver Pulmonary DCB in the treatment of benign central airway stenosis.
Benign central airway stenosis/obstruction, including stenosis of the subglottic area, trachea, and bronchi, is related to significant morbidity due to dyspnea and impaired quality of life. It is hypothesized that Airiver pulmonary drug-coated balloon (DCB) will improve patient outcome in the bronchoscopic treatment of benign airway obstruction, and, as an adjunct to standard of care, will prolong airway patency compared to the standard of care alone. This is a prospective, multi-center, single-arm, open-label, safety \& feasibility, OUS first in human study for safety and potential efficacy.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
45
Subjects with benign airway stenosis will be treated by Airiver pulmonary DCB at index procedure
Israeli-Georgian Medical Research Clinic Helsicore
Tbilisi, Georgia
Primary safety: Freedom from major adverse device events (MADE) post index procedure through 30 days.
MADE is defined as: * Airway perforation (Pneumothorax) * Pneumomediastinum * Massive bleeding * Mediastinitis requiring the need for IV antibiotics and / or hospitalization * Respiratory distress or asphyxia requiring intubation or reintervention * Evidence of negative local tissue reaction to paclitaxel Subjects failing any component of the primary safety endpoint will be considered a safety failure, and subjects who remain event free through 30 days will be considered safety successes. Primary safety will be assessed as the proportion of subjects free from the primary safety event.
Time frame: 30 days
Primary efficacy: Freedom from symptom-driven target lesion reintervention (TLR) due to recurrence of stenosis through 6 months
The incidence of subjects free from symptom-driven TLR will be assessed via Kaplan-Meier survival analysis.
Time frame: 6 months
Incidence of, and time to, symptom-driven target lesion reintervention through 12 months.
assessed via Kaplan-Meier survival analysis.
Time frame: 12 months
Bronchoscopic target lesion patency (Myer-Cotton airway grading system) change through 12 months.
Grade 1 - 0-50% obstruction Grade 2 - 51-70% obstruction Grade 3 - 71-99% obstruction Grade 4 - No detectable lumen.
Time frame: 12 months
Spirometry (FEV1) change through 12 months
A spirometry will be compared at baseline vs follow-ups. Lower readings indicate more significant obstruction.
Time frame: 12 months
mMRC (Modified Medical Research Council) dyspnea scale change through 12 months
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The grade range is from 0-4. Higher grades indicate worse respiratory disability.
Time frame: 12 months.
Quality of life (QOL) change: Patient report outcomes (SF-12) through 12 months
Converting SF-12 Item Responses to Physical and Mental Standardized Values. Higher scores indicate better health
Time frame: 12 months
Clinical pharmacokinetics of paclitaxel by 10 days
plasma paclitaxel concentration will be assessed per predesignated time points.
Time frame: 10 days