This research conducted by EMBOBIO SAS is intended for patients with bleeding or at risk of bleeding in the abdominal-pelvic region requiring embolization. The EmboBio device (embolization implant) is a Class IIb medical device that is not CE marked (meaning that it is not yet commercially available on the European market). The objective of the study is to demonstrate the safety and performance of the EmboBio medical embolization device in humans in order to obtain CE marking, the European authorization required for the commercialization of medical devices. Safety will be assessed by collecting data on events that may be related to the device, and the device will be considered effective if the target arteries are completely occluded (blocked) at the end of the operation. The plan is to include 45 patients (men and women aged 18 or over who have given their consent to participate in the study) requiring embolization in the abdominal-pelvic region in French hospitals over a period of 12 months. The patient's full participation is requested for a period of approximately 6 months.
Abdominopelvic bleeding may occur in different and various circumstances, in a spontaneous way, after a trauma, in a neoplasic context, after a visceral aneurysm's rupture, during or after a surgical treatment. They require fast and effective treatment, as they can be rapidly life-threatening, and that's where embolization steps in. Embolization is a recent interventional radiology technique whose objective is the occlusion of arterial or venous vessels. Unlike so-called conventional surgical techniques, it is a minimally invasive treatment consisting in endovascular navigation using catheters and microcatheters to reach target vessels where the embolic agent is delivered. The choice of the embolic agent is guided by the indication of the procedure as well as the embolization site. Available permanent embolic agents include calibrated microparticles, metallic implants (coils, plugs) and bioglue. Although the ideal embolic agent does not exist, the choice of material remains a fundamental step in embolization procedures, and the development of new agents is an important avenue of research. The choice of the embolic agent for bleeding control is based on the site of bleeding, the size of the artery, how fast the bleeding can be controlled but also the time required for embolic agent preparation, its price and the physician's preference. In this indication, the most often used permanent embolic agents are coils. Known adverse device effects of coils are risks of migration, non-target embolization, infection and damage to the wall vessels. With the urgency of climate change and the demand for natural products in reaction to the overconsumption of chemicals for decades, both food and health industries have experienced a very strong demand for products with a biological process, both respectful of the environment in its design, and of the organism in its distribution. In this context, it seems appealing and important to develop new agents designed from new materials. Indeed, the use of organic materials is a game-changer that is both innovative and promising. More than these aspects, the development of organic embolic material seems necessary to improve the biocompatibility of implantable medical devices with the organism. To conclude, the best embolic agent for abdominopelvic bleeding should provide a fast and effective long-term occlusion of the bleeding arteries, be safe, prepared speedily, easy to use, cheap and ecofriendly. Embobio has been designed and developed to meet all these expectations. Embobio is the first organic agent designed for permanent embolization. We demonstrated in a preclinical study that this new agar-agar embolization implant is easy to use and effective in stopping bleeding in a hemorrhagic shock model, making it well-suited for emergency interventional radiology procedures.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
45
Embolization with the device Embobio
Rate of Serious Adverse Device Effects (SADE)
The primary endpoint of the pilot stage is the rate of SADE (serious adverse events, probably or certainly related to investigational device deficiencies) within 24 hours.
Time frame: 24 hours
Rate of technical success
The primary performance endpoint is the technical success defined by the successful achievement of embolization of the target artery/arteries, and the absence of extravasation of contrast of target artery/arteries after arterial embolization at the end of the procedure.
Time frame: At the end of the procedure
Description of procedural data : dosimetry
Dosimetry data during the procedure
Time frame: At the end of the procedure
Description of procedural data : quantity of Embobio
Quantity of Embobio used for embolization
Time frame: At the end of the procedure
Description of procedural data : time to bleeding control
Time needed to control the bleeding
Time frame: At the end of the procedure
Description of procedural data : procedure duration
Total duration of the procedure
Time frame: At the end of the procedure
Rate of adverse events and adverse device effects
The rate of adverse events, serious adverse events and adverse device effects, up to 1 week.
Time frame: 1 week
Rate of immediate clinical success
Immediate clinical success will be defined as the successful achievement of embolization, and the absence of extravasation of contrast after arterial embolization at the end of the procedure
Time frame: At the end of the procedure
Rate of clinical success
Clinical success will be defined as the absence of rebleeding of target artery(ies) requiring reintervention (repeat embolization or additional surgery) within 7 days.
Time frame: 7 days
Mortality rate
Mortality rate related to device use, embolization procedure and pathology at 7 days
Time frame: 7 days
Name and number of the potentiel other devices used to achieve occlusion
Name and number of the devices used to achieve occlusion (other than Embobio) and whether their use was anticipated or due to investigational device failure.
Time frame: At the end of the procedure
Interventional Radiologist's satisfaction questionnaire
(translated from French) Q1. Did you achieve the expected embolization results? * Yes * Partially * No Q2. How would you rate the ease of handling Embobio? * Difficult * Average * Easy * Very easy Q3. How would you describe the ease of injection? * Very good * Good * Average * Poor Q4. How do you find the speed of occlusion? * Very good * Good * Average * Poor Q5. How do you find the use of Embobio compared to other agents (coils, particles)? * More difficult * Equivalent * Easier
Time frame: At the end of the procedure
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