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Safety and Efficacy Study of Fibrin Sealant Grifols as an Adjunct to Hemostasis During Peripheral Vascular Surgery

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ClinicalTrials.gov Identifier: NCT01662856
Recruitment Status : Completed
First Posted : August 10, 2012
Results First Posted : April 6, 2017
Last Update Posted : April 6, 2017
Sponsor:
Information provided by (Responsible Party):
Grifols Biologicals, LLC ( Instituto Grifols, S.A. )

Study Description
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Brief Summary:
The purpose of this study is to demonstrate that the application of Fibrin Sealant Grifols provides a measurable benefit when compared to hemostasis achieved through conventional surgical technique (suture) and by standard hemostatic action, such as mechanical pressure through manual compression. This study has a Preliminary Part (I) in which all subjects are treated with Fibrin Sealant Grifols and a Primary Part (II) in which subjects are randomized in a 2:1 ratio to either Fibrin Sealant Grifols or manual compression.

Condition or disease Intervention/treatment Phase
Vascular Surgical Bleeding Biological: Fibrin Sealant Grifols Procedure: Manual Compression Phase 3

Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 225 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Primary Purpose: Treatment
Official Title: A Prospective, Single-blind, Randomized, Phase III Study to Evaluate the Safety and Efficacy of Fibrin Sealant Grifols (FS Grifols) as an Adjunct to Hemostasis During Peripheral Vascular Surgery
Study Start Date : August 2012
Actual Primary Completion Date : December 2015
Actual Study Completion Date : December 2015

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Bleeding

Arms and Interventions
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Arm Intervention/treatment
Experimental: Fibrin Sealant Grifols
Fibrin Sealant Grifols consisting of 3 mL fibrinogen and 3 mL thrombin in separate syringes assembled on a syringe holder (6 mL of solution in total).
 Biological: Fibrin Sealant Grifols
Combination of 3 mL fibrinogen and 3 mL thrombin in separate syringes assembled on a syringe holder (6 mL of solution in total).
Active Comparator: Manual Compression
Direct manual compression of target bleeding site with gauze/laparotomy pads.
 Procedure: Manual Compression
Direct manual compression of target bleeding site with gauze/laparotomy pads.


Outcome Measures
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Primary Outcome Measures :
  1. Proportion of Subjects Achieving Hemostasis by Four Minutes After Treatment Start [ Time Frame: From start of treatment until 4 minutes after treatment start ]
    Subjects achieving hemostasis at the target bleeding site by 4 minutes following the start of treatment without the occurrence of re-bleeding until the completion of surgical closure.


Secondary Outcome Measures :
  1. Time to Hemostasis (TTH) [ Time Frame: From start of treatment until 10 minutes after treatment start ]

    Time in minutes for achievement of hemostasis at the target bleeding site measured from the start of treatment until 10 minutes after treatment start.

    In the Fibrin Sealant Grifols treatment group, the median TTH was calculated based on the estimated survival function S(t), and it is the smallest time at which S(t) is at or below 50%. The 95% CI for the median TTH, on the other hand, was calculated based on the CI for the survival function S(t). The 95% CI for the median TTH was the set of all time points for which the 95% CI of the survival function contains 0.5 (since median is the 50% percentile). Sometimes, the confidence limits for the median cannot be estimated. In our case, the hemostasis was assessed on a discrete scale, and it happened that for all the time points assessed none of the 95% CI of the survival function S(t) contained 0.5. As a result, neither the lower nor the upper limit could be estimated.

    All calculations were performed using SAS PROC LIFETEST


  2. Cumulative Proportion of Subjects Having Achieved Hemostasis at the Target Bleeding Site by Specified Time Points [ Time Frame: From start of treatment until 10 minutes after treatment start ]

    Cumulative proportion of subjects having achieved hemostasis by each of the following time points:

    • At 5 minutes following start of study treatment
    • At 7 minutes following start of study treatment
    • At 10 minutes following start of study treatment

  3. Prevalence of Treatment Failures [ Time Frame: From start of treatment until 10 minutes after treatment start ]
    Protocol-defined bleeding at the target bleeding site after the start of treatment or the use of alternative hemostatic treatments (with exception of reversal of heparin) or maneuvers at the target bleeding site after the start of treatment.


Eligibility Criteria
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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Hemoglobin (Hgb) ≥ 8.0 g/dL at Baseline (within 24 hours prior to surgical procedure).
  • Require elective (non-emergency), primary, open (non-laparoscopic; non-endovascular) peripheral vascular surgery.
  • Require one of the following peripheral vascular procedures involving proximal end-to-side arterial anastomosis utilizing coated or uncoated Polytetrafluoroethylene grafts: a) Femoral-femoral bypass grafting, b) Femoral-popliteal bypass grafting, c) Femoral-distal bypass grafting, d) Ilio-iliac bypass grafting, e) Ilio-femoral bypass grafting, f) Ilio-popliteal bypass grafting, g) Aorto-iliac bypass grafting, h) Aorto-femoral bypass grafting, i)Axillo-femoral bypass grafting, and j) Upper extremity vascular access for hemodialysis.
  • A target bleeding site can be identified.
  • Target bleeding site has moderate arterial bleeding.

Exclusion Criteria:

  • Undergoing a re-operative procedure.
  • Undergoing other vascular procedures during the same surgical session (stenting and/or endarterectomy of the same artery are allowed).
  • Have an infection in the anatomic surgical area.
  • Have a history of severe (e.g. anaphylactic) reactions to blood or to any blood-derived product.
  • Have previous known sensitivity to any Fibrin Sealant Grifols, heparin, or protamine component.
  • Females who are pregnant or nursing a child at Baseline (within 24 hours prior to surgical procedure).
  • Have undergone a therapeutic surgical procedure within 30 days from the screening visit.
  • Target bleeding site cannot be identified.
  • Target bleeding site has mild or severe arterial bleeding.
  • Occurrence of major intraoperative complications that require resuscitation or deviation from the planned surgical procedure.
  • Intraoperative change in planned surgical procedure, which results in subject no longer meeting preoperative inclusion and/or exclusion criteria.
Contacts and Locations
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Information from the National Library of Medicine

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): NCT01662856


Locations
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Sponsors and Collaborators
Instituto Grifols, S.A.
More Information
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Responsible Party: Instituto Grifols, S.A.
ClinicalTrials.gov Identifier: NCT01662856    
Other Study ID Numbers: IG1101
First Posted: August 10, 2012    Key Record Dates
Results First Posted: April 6, 2017
Last Update Posted: April 6, 2017
Last Verified: February 2017
Keywords provided by Grifols Biologicals, LLC ( Instituto Grifols, S.A. ):
Vascular Surgery
Fibrin Sealant
Polytetrafluoroethylene (PTFE) grafts
Additional relevant MeSH terms:
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Hemorrhage
Pathologic Processes
Fibrin Tissue Adhesive
Hemostatics
Coagulants