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ECLIPSE Trial: Ensure’s Vascular Closure Device Speeds Hemostasis S. Chiu Wong MD Director, Cardiac Catheterization Laboratories New York Presbyterian Hosp.- Cornell Campus Professor of Medicine Weill Medical College of Cornell University SCAI / ACCi2 2008 Late Breaking Trial April 2 nd Chicago, IL
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ECLIPSE Trial Eclipse ® Closure Device The investigational ExoSeal device (Cordis, Miami FL) is a novel 3rd generation 6 Fr. extra- vascular closure device with a painless deployment mechanism that delivers a poly-glycolic acid (PGA) “felt-like” plug atop the femoral artery anchored by the neuro-vascular bundle sheath.
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U.S. multicenter pivotal study comparing ExoSeal and manual compression with 2:1 randomization was performed to assess the safety and efficacy of ExoSeal in patients undergoing 6Fr. diagnostic and interventional coronary/peripheral procedures ECLIPSE Trial ECLIPSE Trial Design
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Two primary effectiveness endpoints to be tested for superiority: –Time to hemostasis (TTH) –Time to ambulation (TTA) Primary safety endpoint to be tested for non- inferiority: –30-day combined rate of access site related complications including bleeding, infection, ischemia or injury requiring medical or surgical treatment ECLIPSE Trial Objectives
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ECLIPSE Trial Patient Enrollment ExoSeal ® 6F VCD (17 U.S. Sites) N = 488 Randomized N = 401 Roll-in N = 87 ExoSeal ® (N=267)Mannual Compression (n=134) Withdrawn N = 10 (7.5%) 30-day FU N=253 ( 94.8%) 30-day FU N=124 (92.5%) Withdrawn N = 14 (5.2%) Withdrawn N = 5 (2.7%) 30 day FU N = 82 (94.3%)
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ECLIPSE Trial Results: Primary Effectiveness Endpoints Roll-in (N=87) ExoSeal ® (N=267) MC (N=134) p-value Procedure Success95.4%91.8%91.0%0.8500 Device Success95.4%89.1%-- TTH (min.) 4.68 19.44.38 11.620.05 22.5 <0.0001 TTA (hr.) 1.98 2.592.54 5.026.24 13.34 0.0028 TT Eligibility for Hospital Discharge (hr.) 9.72 14.212.57 13.916.26 27.5 0.1540 TT Hospital Discharge (hr.) 13.64 18.516.77 19.819.35 29.2 0.3612 TT Device Deployment (min.) 0.94 1.131.01 2.12--
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ECLIPSE Trial Results: Primary 30-Day Safety Endpoints Roll-in (N=87) ExoSeal ® (N=266) MC (N=134) Composite Major Adverse Event0.0% Vascular Repair0.0% Access Site Related Bleeding Requiring Transfusion 0.0% Access Site Related Infection Requiring Treatment 0.0% Any New Documented Ipsilateral Lower Extremity Ischemia 0.0% Surgery for Access Site-Related Nerve Injury 0.0%
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In this multi-center randomized trial in pts following 6 Fr. diagnostic/interventional procedures, a significant reduction in the TTH and TTA (primary effectiveness endpoints) was achieved in pts treated with the investigational ExoSeal device compared with MC Device deployment was achieved promptly in about 1 minute on average following procedure There was no difference in procedural success rates in both the ExoSeal ® and MC groups Remarkably, there were no 30-day combined access site related complications (primary safety endpoint) reported in either treatment cohort Exoseal is non-inferior to MC in composite major adverse event at the pre-specified 4% margin level Exoseal ® compares favorably to manual compression for arteriotomy site management post 6 Fr. invasive/interventional procedures. ECLIPSE Trial Conclusions
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