NobleStitch EL STITCH Trial is a PFO Comparative Trial (STITCH)
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ClinicalTrials.gov Identifier: NCT04339699 |
Recruitment Status :
Recruiting
First Posted : April 9, 2020
Last Update Posted : April 22, 2021
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Foramen Ovale, Patent Stroke, Ischemic | Device: NobleStitch EL Suture Mediated Closure System Device: Amplatzer PFO Occluder | Not Applicable |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 640 participants |
Allocation: | Non-Randomized |
Intervention Model: | Parallel Assignment |
Intervention Model Description: | A 640 participants indicated for percutaneous transcatheter closure of a PFO to reduce risk of recurrent Ischemic Stroke; between ages 18 - 60 years, who have had a Cryptogenic Stroke due to Paradoxical Embolism. To be conducted both in the USA and the European Union. |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | STITCH - Prospective Multi Center Comparative Parallel Concurrent Study of the NobleStitch EL Compared to FDA Approved Amplatzer Occluder Device for Closure of Patent Foramen Ovale to Prevent Recurrent Ischemic Stroke |
Actual Study Start Date : | December 1, 2020 |
Estimated Primary Completion Date : | December 31, 2021 |
Estimated Study Completion Date : | April 30, 2026 |

Arm | Intervention/treatment |
---|---|
Active Comparator: NobleStitch EL
Participants treated with the NobleStitch EL device
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Device: NobleStitch EL Suture Mediated Closure System
Percutaneous closure of Patent Foramen Ovale (PFO) using NobleStitch EL suture Medicate Closure System |
Active Comparator: Amplatzer PFO Occluder
Participants treated with the Amplatzer PFO Occluder device
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Device: Amplatzer PFO Occluder
Percutaneous closure of Patent Foramen Ovale (PFO) using Amplatzer PFO Occluder |
- Effective PFO closure rate of the NobleStitch EL [ Time Frame: 6 months ]Effectiveness PFO closure rate of NobleStitch EL suture mediated closure with medical management compared to Amplatzer PFO occluder with medical management for PFO closure. Effective PFO closure rate defined as Grade 0 or 1 shunt at rest and during Valsalva at 6 month post closure attempts
- Decreased event rate of recurrent ischemic stroke following PFO closure using NobleStitch EL [ Time Frame: 5 years ]Safety of NobleStitch EL suture mediated closure system as compared to Amplatzer PFO Occluder Procedural and device related adverse event rate at 6 month follow up recurrent ischemic stroke through 5 years follow up
- The occurrence of recurrent ischemic stroke post procedural of patent foramen ovale closure [ Time Frame: 5 Years ]Examination of Recurrent Ischemic Stroke through 5 year follow up. Comparison of the rate of Stroke associated with the NobleStitch EL procedure to that expected with medical management

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Ages Eligible for Study: | 18 Years to 60 Years (Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Provision of signed and dated informed consent form
- Stated willingness to comply with all study procedures and availability for the duration of the study
- Male or female ages 18 - 60 years old
- A PFO and a Cryptogenic Stroke verified by a neurologist
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Stroke is defined as an acute focal neurological deficit, presumed to be due to focal ischemia, and either:
- Symptoms persisting ≥24 hours, or
- Symptoms persisting <24 hours with Magnetic Resonance or CT findings of a new, neuroanatomical relevant infarct
- Cryptogenic stroke was defined as a stroke of unknown cause
- Prolonged cardiac rhythm monitoring (recommended 30 days and not less than 24 hours required)
- Intra and extracranial artery imaging: Magnetic Resonance Angiography, CT angiography, or contrast angiography, or contrast angiography or echocardiography of the carotid arteries to rule out ischemic stroke associated with atherosclerotic plaque, arterial dissection, or other vascular diseases. (The aortic arch may also be evaluated by TEE).
- Hypercoagulable state assessment to rule out an underlying hypercoagulable state
Exclusion Criteria:
- Female participant who is pregnant, lactating or planning a pregnancy during the course of the study
- Age <18 or > 60 years of age
- Previous myocardial infarction or unstable angina within 6 months
- Clinically significant mitral or aortic valve stenosis or severe regurgitation
- Left Ventricular Ejection Fraction <50 percent
- Progressive neurological dysfunction or reduced life expectancy
- Contrast allergy
- Atrial Septal Defect (baseline left to right shunt assessed by TEE or other congenital heart diseases
- Active Endocarditis
- Perspective participants with known causes of Ischemic Stroke
- Arterial dissection
- Contraindicated or unsuitable for antiplatelet agents or oral anticoagulants
- Perspective participants with prosthetic heart valves
- Uncontrolled diabetes Mellitus
- Pulmonary hypertension
- Uncontrolled systemic hypertension
- Intracranial pathology
- Neurological deficits not due to stroke that may affect neurologic assessments
- Active autoimmune disease
- Active infection
- Alcohol and/or drug abuse
- A requirement for chronic anticoagulation therapy that cannot be discontinued
- Anatomic features (inability to achieve vascular access)

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04339699
Contact: James A Thompson, MD | 703-876-8410 | Jim_Thompson@MEDNAX.com | |
Contact: Stephanie M Garafalo, RN BSN CCRC | 708-776-2018 | Stephanie.Garafalo@inova.org |
United States, Virginia | |
Inova Cardiovascular Institute | Recruiting |
Falls Church, Virginia, United States, 22042 | |
Contact: Stephanie Gerolafo, RN | |
Contact: James Thompson, MD | |
Principal Investigator: James Thompson, MD |
Study Director: | Anthony A Nobles, PhD | Nobles Medical Technologies II Inc |
Responsible Party: | HeartStitch.Com |
ClinicalTrials.gov Identifier: | NCT04339699 |
Other Study ID Numbers: |
748824-0819 |
First Posted: | April 9, 2020 Key Record Dates |
Last Update Posted: | April 22, 2021 |
Last Verified: | April 2021 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | Yes |
Plan Description: | Individual participant data (IPD) from the completed STITCH clinical trial that underlie the results reported in the Study, shall after deidentification (text, tables, figures, and appendices). |
Supporting Materials: |
Study Protocol |
Time Frame: | Immediately the following publication and ending 24 months after publication |
Access Criteria: | Will be available to Investigators whose proposed use of the data has been approved by an independent review committee identified for this purpose. It will be available for Individual participant data meta-analysis |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | Yes |
Patent Foramen Ovale Stroke |
Stroke Ischemic Stroke Foramen Ovale, Patent Cerebrovascular Disorders Brain Diseases Central Nervous System Diseases Nervous System Diseases Vascular Diseases |
Cardiovascular Diseases Heart Septal Defects, Atrial Heart Septal Defects Heart Defects, Congenital Cardiovascular Abnormalities Heart Diseases Congenital Abnormalities |