Evaluation of the Safety and Effectiveness of the CereVasc® eShunt® System in Normal Pressure Hydrocephalus

Launched by CEREVASC INC · Jul 5, 2024

Keywords

ClinConnect Summary

This clinical trial is looking at the safety and effectiveness of a new treatment called the CereVasc® EShunt® System for patients with Normal Pressure Hydrocephalus (NPH). NPH is a condition where excess fluid builds up in the brain, causing issues with walking, memory, and bladder control. The trial is open to adults aged 60 and older who have had trouble walking for at least three months and show specific signs of NPH through medical tests, such as MRI scans. Participants must be willing to attend scheduled visits and provide consent for the study.

If eligible, participants will receive either the EShunt treatment or standard care and will be monitored closely throughout the study. The goal is to see how well the EShunt works in improving symptoms related to NPH. It’s important to note that certain health conditions or prior surgeries may prevent individuals from joining the study, so a thorough screening will be conducted. This trial is currently recruiting participants, and those interested should discuss it with their healthcare provider for more information.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• Each subject must meet the following criteria:
• • 1. Patients ≥60 years old on the day of study informed consent
• • 2. Patient or legally authorized representative is able and willing to provide written informed consent
• • 3. History or evidence of gait impairment with a duration ≥3 months
• 4. Clinical presentation consistent with NPH including two or more of the clinical triad (i.e., history of gait disturbance, progressive mental deterioration, and urinary urgency or incontinence), together with all of the following:
• • 1. Brain MRI signs of ventricular enlargement disproportionate to cerebral atrophy (Evans' Index \>0.3) and the absence of severe hippocampal atrophy,
• • 2. Pre-procedure spinal tap test or lumbar drain with subsequent gait disturbance improvement (Timed Up and Go Test) of at least 20%,
• • 3. CSF opening pressure ≥8 cmH2O,
• • 4. Baseline cognitive evaluation assessed by Montreal Cognitive Assessment (MoCA) test score ≥12
• • 5. Patient is willing and able to attend all scheduled visits and comply with study procedures.
• • 6. Confirmation of anatomy suitable for the eShunt procedure, as determined by evaluation of pre-procedure imaging (CT and MRI) and approved by an independent anatomical screening committee.
• Exclusion Criteria:
• Each subject may not:
• • 1. Be unable to walk 10 meters (33 feet) with or without an assistive device
• • 2. Be diagnosed with obstructive hydrocephalus
• • 3. Have an active systemic infection or infection detected in CSF
• • 4. Have had prior or existing shunts, endoscopic third ventriculostomy, or any previous surgical intervention for hydrocephalus
• • 5. Demonstrate hypersensitivity or contraindication to heparin or radiographic contrast agents against which the subject cannot be adequately pre-medicated, desensitized or where no alternative is available
• • 6. Have occlusion or stenosis of the internal jugular vein which would prohibit access to the IPS
• • 7. Present with venous distension in the neck on physical exam
• • 8. Have medical conditions associated with prolonged elevation of jugular venous pressure, including jugular vein stenosis or stricture, right sided heart failure, cirrhosis of the liver, arteriovenous fistulas in the arm for dialysis purposes, or an arterial venous fistula or malformation in the neck or brain
• • 9. Have history of bleeding diatheses, coagulopathy or refuse to consent for blood transfusion in cases of emergency
• • 10. Have had an ischemic stroke or transient ischemic attack within 180 days of eShunt procedure
• • 11. Have documented evidence of a deep vein thrombosis superior to the popliteal vein
• • 12. Have intrinsic blood clotting disorder
• • 13. Have medical conditions requiring anticoagulation which is unable to be managed to allow for surgical procedure
• • 14. Have presence of a posterior fossa tumor or mass
• • 15. Have a life expectancy \<1 year
• • 16. Be currently participating in another interventional (drug, device, etc.) research project that may confound the results of this study.
• • 17. Have established diagnosis of neurodegenerative diseases such as Parkinson's disease, Alzheimer's disease, or Lewy body dementia
• • 18. Be diagnosed with schizophrenia or any psychiatric diagnosis (including depression) that may complicate outcome evaluation
• • 19. Need an intracranial neurosurgical procedure within 180 days of study index procedure
• • 20. Be unwilling or unable to comply with follow-up requirements
• • 21. Have mRS of 0, 5, or 6