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A Multi-center Clinical Trial of the Misago™ Self-Expanding Stent System for Superficial Femoral Artery (OSPREY)

Primary Purpose

Peripheral Vascular Disease

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Misago™ Self-Expanding Stent System
Sponsored by
Terumo Medical Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peripheral Vascular Disease focused on measuring atherosclerotic stenosis, occlusions, Superficial Femoral Artery, SFA

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

Pre-procedure:

  1. Female or male age greater than or equal to 18 years and of legal consent.
  2. Subjects must be willing to comply with the specified follow-up evaluation schedule.
  3. Informed consent (signed and dated) prior to any study-related evaluation or procedures.
  4. Symptomatic leg ischemia without tissue loss by Rutherford classification (category 2, 3 or 4).
  5. Resting ABI of <0.9, or abnormal exercise ABI.
  6. De novo lesion(s) (one or multiple lesions) with >50% stenosis, or occlusion which require treatment, and a total lesion length of >40 mm and <150 mm of the above-the-knee SFA in one limb. The target lesion should be treatable with no more than two overlapping stents, minimizing the stent overlap up to 10 mm (by visual estimate).
  7. All lesions are at least 3 cm above the knee joint, defined as the distal end of the femur at the knee joint, and at least 2 cm distal to the origin of the profunda artery.
  8. Reference vessel diameter of >4.0 mm and <7.0 mm.
  9. Target lesion length of > 40 mm and <150 mm.
  10. Patent popliteal artery (no stenosis > 50%) and at least one patent tibioperoneal run-off vessel with < 50% stenosis confirmed by angiography within 30 days of enrollment.

Exclusion Criteria:

  1. Pre-existing autoimmune disease.
  2. Pre-existing terminal illness with life expectancy of less than three (3) years.
  3. Participation in another investigational device or therapeutic intervention trial within the past three (3) months.
  4. Previous enrollment in this study.
  5. Previous bypass surgery or stenting in the SFA or distally.
  6. Scheduled for a staged procedure to treat lesions within the aorta or run-off after enrollment.
  7. Co-existing aneurysmal disease of the aorta, iliac artery, SFA, or popliteal arteries requiring treatment.
  8. Any inflow disease of the ipsilateral pelvic arteries (more than 50 percent stenosis or occlusion) that has not been treated prior to enrollment (Treatment of iliac arteries before SFA intervention is permitted, except for common femoral stenosis).
  9. A recent (< 6 week) history of clinically significant gastrointestinal bleeding, major surgery, myocardial infarction or untreated coagulopathy.
  10. Known sensitivity or allergy to aspirin, radiographic contrast agents (that cannot be pre-treated adequately), nitinol, gold, or both heparin and bivalirudin.
  11. Angiographic evidence of acute thrombus.
  12. Sudden worsening of symptoms in the last 30 days.
  13. Subjects with acute/chronic renal dysfunction or estimated glomerular filtration rate (eGFR) <30 ml/min. Chronic hemodialysis subjects are not eligible for this protocol.
  14. Severe calcification or excessive tortuosity at target lesion.
  15. Subjects unable to tolerate anticoagulant therapy or antiplatelet therapy.
  16. Women who are currently pregnant. (A negative pregnancy test for female subjects of child bearing potential is required).
  17. The target lesion(s) cannot be successfully crossed with a guide wire.*
  18. Lower extremity deep venous thrombosis in the study limb within the prior 30 days.
  19. Chronic venous disease with active or recent (< 30 day) skin ulceration.
  20. Known or suspected active systemic infection.
  21. Two (2) months previous history of non-hemorrhagic stroke and or history of hemorrhagic stroke.
  22. Treatment that requires access via upper extremity, popliteal artery, or pedal artery.
  23. Evidence of severe or uncontrolled systemic disease of any condition which in the investigator's opinion makes it undesirable for the subject to participate in the trial or which would jeopardize compliance with the protocol.
  24. Use of re-entry, ablative, or atherectomy devices to cross the lesion.*

Sites / Locations

  • University Of Alabama
  • Cardiology Associates of Mobile
  • Central Arkansas Veteran's Healthcare System
  • Long Beach VA Healthcare Center
  • Christiana Care
  • Bradenton Cardiology Center
  • Florida Research Network
  • First Coast Cardiovascular Institute
  • Coastal Vascular and Interventional, PLLC
  • Cardiovascular Associates
  • Midwest Cardiovascular Research Foundation
  • University of Iowa Healthcare
  • Kings Daughters Medical Center
  • Michigan Heart
  • Hunterdon Cardiovascular Associates
  • Columbia University Medical Center
  • Hillsboro Cardiology
  • Central Bucks Specialists
  • St. Mary Medical Centere Research Institute
  • Pinnacle Health Cardiovascular Institute
  • Berks Cardiologists, Ltd
  • Medical University of South Carolina
  • South Carolina Heart Center
  • Wellmont CVA Heart Institute
  • Premier Clinical Reesearch
  • East Tennessee Cardiovascular Research-Turkey Creek Medical Center
  • Amarillo Heart Clinical Research Institute
  • University of Virginia
  • Centra Cardiovascular Group
  • Sentara Medical Group
  • Columbia- St. Mary's

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Misago™ Self-Expanding Stent System

Arm Description

Outcomes

Primary Outcome Measures

Primary Effectiveness Endpoint
The primary effectiveness endpoint was defined as stent patency at 12 months as evidenced by absence of TLR and a peak systolic velocity ratio < 2.0 from DUS obtained within the 12 months visit window.
Primary Safety Endpoint
The primary safety endpoint for this study was freedom from major adverse events (MAE) at 30 days post-procedure. MAE was defined as TLR, amputation of the treated limb, or death.

Secondary Outcome Measures

Primary Effectiveness Endpoint in Modified Intent-to-Treat (mITT) Cohort
Primary effectiveness endpoint was defined as absence of TLR and stent patency at 12 months as evidenced by a peak systolic velocity ratio < 2.0 from DUS obtained within the 12 months visit window. Because patency beyond the 12 months visit window may be considered as patency at 12 months, the out-of-window patency is imputed as treatment success. The modified intention to treat (mITT) cohort had 226 subjects (excluded subjects with unknown primary effectiveness endpoint).
Primary Effectiveness Endpoint Using a Peak Systolic Velocity Ratio of ≤ 2.4 (i.e., Modified VIVA Criteria) in the mITT Cohort
The primary effectiveness endpoint was defined as absence of TLR and stent patency at 12 months as evidenced by a peak systolic velocity ratio < 2.0 from duplex ultrasound. Additional considerations were made using a more contemporary approach to evaluate stent patency using a peak systolic velocity ratio (PSVR) ≤ 2.4 (i.e., modified VIVA criteria). This outcome evaluated the modified intent-to-treat (mITT) cohort comprised of 226 subjects (excluded subjects with unknown primary effectiveness endpoint)
Occurrence of Target Lesion Revascularization
The occurrence of clinically driven Target Lesion Revascularization (TLR) was measured at 12 months post-procedure. Clinically driven defined as: More than 50 percent stenosis with worsening symptoms, OR More than 70 percent stenosis without symptoms
Device Related Peri-Procedural Complications
Peri-procedural (prior to discharge) measure of success (i.e., patency and none of the following: death, stroke, MI, embolization, thrombosis, and occlusion)
Technical Success
Technical Success defined by the following conditions: Successful delivery of the stent at the lesion site Stent(s) successfully deployed in lesion with adequate lesion coverage
Procedural Success
Procedural success defined as: attainment of < 30% residual stenosis of the target lesion and no peri-procedural complications defined as: death, stroke, myocardial infarction, emergent surgical revascularization, significant distal embolization in target limb, and thrombosis of target vessel
Clinical Success
Clinical success defined as: relief or improvement from baseline symptoms as measured by the Rutherford score for chronic limb ischemia at 30 days as compared to baseline
Major Adverse Events (MAEs) Through 12 Months Post-procedure
The incidence of MAEs occurring within 12 months of the procedure. MAE is defined as target lesion revascularization (TLR), amputation of the treated limb, or death.
Stent Fracture at 12 Months
Occurrence of stent fracture as determined by core laboratory analysis

Full Information

First Posted
May 4, 2010
Last Updated
October 17, 2017
Sponsor
Terumo Medical Corporation
Collaborators
ClinLogix. LLC, Massachusetts General Hospital, Beth Israel Deaconess Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT01118117
Brief Title
A Multi-center Clinical Trial of the Misago™ Self-Expanding Stent System for Superficial Femoral Artery
Acronym
OSPREY
Official Title
A Multi-center Clinical Trial of the Misago™ Self-Expanding Stent System for Superficial Femoral Artery
Study Type
Interventional

2. Study Status

Record Verification Date
October 2017
Overall Recruitment Status
Completed
Study Start Date
July 2010 (undefined)
Primary Completion Date
July 2013 (Actual)
Study Completion Date
April 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Terumo Medical Corporation
Collaborators
ClinLogix. LLC, Massachusetts General Hospital, Beth Israel Deaconess Medical Center

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
OSPREY is a multi-center, single arm, non-randomized, prospective clinical trial. Subjects will undergo a superficial femoral artery (SFA) stent procedure using the Misago™ Peripheral Self Expanding stent once all of the inclusion and none of the exclusion criteria are met. The stent efficacy and safety will be evaluated immediately post procedure, and at 30 days, 6, 12, 24, and 36 months post procedure. A subject is considered enrolled into the OSPREY study after he/she signs the informed consent and meets all inclusion/exclusion criteria. The study objectives are to demonstrate that efficacy and safety of this novel stent design are not inferior to historical Percutaneous Transluminal Angioplasty (PTA) and stent outcomes and meet the performance goals as published in the objective performance goals by Rocha-Singh, et al. This is a multi-center, single arm, non-randomized, prospective clinical trial of the Misago™ Self-Expanding Stent System for the treatment of atherosclerotic stenosis and occlusions of the SFA. The primary endpoint of stent patency will be evaluated at 12 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peripheral Vascular Disease
Keywords
atherosclerotic stenosis, occlusions, Superficial Femoral Artery, SFA

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
276 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Misago™ Self-Expanding Stent System
Arm Type
Experimental
Intervention Type
Device
Intervention Name(s)
Misago™ Self-Expanding Stent System
Other Intervention Name(s)
Misago, OSPREY
Intervention Description
Transcatheter placement of an intravascular stent(s)
Primary Outcome Measure Information:
Title
Primary Effectiveness Endpoint
Description
The primary effectiveness endpoint was defined as stent patency at 12 months as evidenced by absence of TLR and a peak systolic velocity ratio < 2.0 from DUS obtained within the 12 months visit window.
Time Frame
12 Months post-procedure
Title
Primary Safety Endpoint
Description
The primary safety endpoint for this study was freedom from major adverse events (MAE) at 30 days post-procedure. MAE was defined as TLR, amputation of the treated limb, or death.
Time Frame
30 days post-procedure
Secondary Outcome Measure Information:
Title
Primary Effectiveness Endpoint in Modified Intent-to-Treat (mITT) Cohort
Description
Primary effectiveness endpoint was defined as absence of TLR and stent patency at 12 months as evidenced by a peak systolic velocity ratio < 2.0 from DUS obtained within the 12 months visit window. Because patency beyond the 12 months visit window may be considered as patency at 12 months, the out-of-window patency is imputed as treatment success. The modified intention to treat (mITT) cohort had 226 subjects (excluded subjects with unknown primary effectiveness endpoint).
Time Frame
12 Months post-procedure
Title
Primary Effectiveness Endpoint Using a Peak Systolic Velocity Ratio of ≤ 2.4 (i.e., Modified VIVA Criteria) in the mITT Cohort
Description
The primary effectiveness endpoint was defined as absence of TLR and stent patency at 12 months as evidenced by a peak systolic velocity ratio < 2.0 from duplex ultrasound. Additional considerations were made using a more contemporary approach to evaluate stent patency using a peak systolic velocity ratio (PSVR) ≤ 2.4 (i.e., modified VIVA criteria). This outcome evaluated the modified intent-to-treat (mITT) cohort comprised of 226 subjects (excluded subjects with unknown primary effectiveness endpoint)
Time Frame
12 Months post-procedure
Title
Occurrence of Target Lesion Revascularization
Description
The occurrence of clinically driven Target Lesion Revascularization (TLR) was measured at 12 months post-procedure. Clinically driven defined as: More than 50 percent stenosis with worsening symptoms, OR More than 70 percent stenosis without symptoms
Time Frame
12 Months post-procedure
Title
Device Related Peri-Procedural Complications
Description
Peri-procedural (prior to discharge) measure of success (i.e., patency and none of the following: death, stroke, MI, embolization, thrombosis, and occlusion)
Time Frame
Prior to Hosptial Discharge
Title
Technical Success
Description
Technical Success defined by the following conditions: Successful delivery of the stent at the lesion site Stent(s) successfully deployed in lesion with adequate lesion coverage
Time Frame
Intra-procedure
Title
Procedural Success
Description
Procedural success defined as: attainment of < 30% residual stenosis of the target lesion and no peri-procedural complications defined as: death, stroke, myocardial infarction, emergent surgical revascularization, significant distal embolization in target limb, and thrombosis of target vessel
Time Frame
Intra-procedure
Title
Clinical Success
Description
Clinical success defined as: relief or improvement from baseline symptoms as measured by the Rutherford score for chronic limb ischemia at 30 days as compared to baseline
Time Frame
30 days post-procedure
Title
Major Adverse Events (MAEs) Through 12 Months Post-procedure
Description
The incidence of MAEs occurring within 12 months of the procedure. MAE is defined as target lesion revascularization (TLR), amputation of the treated limb, or death.
Time Frame
12 Months post-procedure
Title
Stent Fracture at 12 Months
Description
Occurrence of stent fracture as determined by core laboratory analysis
Time Frame
12 Months post-procedure

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Pre-procedure: Female or male age greater than or equal to 18 years and of legal consent. Subjects must be willing to comply with the specified follow-up evaluation schedule. Informed consent (signed and dated) prior to any study-related evaluation or procedures. Symptomatic leg ischemia without tissue loss by Rutherford classification (category 2, 3 or 4). Resting ABI of <0.9, or abnormal exercise ABI. De novo lesion(s) (one or multiple lesions) with >50% stenosis, or occlusion which require treatment, and a total lesion length of >40 mm and <150 mm of the above-the-knee SFA in one limb. The target lesion should be treatable with no more than two overlapping stents, minimizing the stent overlap up to 10 mm (by visual estimate). All lesions are at least 3 cm above the knee joint, defined as the distal end of the femur at the knee joint, and at least 2 cm distal to the origin of the profunda artery. Reference vessel diameter of >4.0 mm and <7.0 mm. Target lesion length of > 40 mm and <150 mm. Patent popliteal artery (no stenosis > 50%) and at least one patent tibioperoneal run-off vessel with < 50% stenosis confirmed by angiography within 30 days of enrollment. Exclusion Criteria: Pre-existing autoimmune disease. Pre-existing terminal illness with life expectancy of less than three (3) years. Participation in another investigational device or therapeutic intervention trial within the past three (3) months. Previous enrollment in this study. Previous bypass surgery or stenting in the SFA or distally. Scheduled for a staged procedure to treat lesions within the aorta or run-off after enrollment. Co-existing aneurysmal disease of the aorta, iliac artery, SFA, or popliteal arteries requiring treatment. Any inflow disease of the ipsilateral pelvic arteries (more than 50 percent stenosis or occlusion) that has not been treated prior to enrollment (Treatment of iliac arteries before SFA intervention is permitted, except for common femoral stenosis). A recent (< 6 week) history of clinically significant gastrointestinal bleeding, major surgery, myocardial infarction or untreated coagulopathy. Known sensitivity or allergy to aspirin, radiographic contrast agents (that cannot be pre-treated adequately), nitinol, gold, or both heparin and bivalirudin. Angiographic evidence of acute thrombus. Sudden worsening of symptoms in the last 30 days. Subjects with acute/chronic renal dysfunction or estimated glomerular filtration rate (eGFR) <30 ml/min. Chronic hemodialysis subjects are not eligible for this protocol. Severe calcification or excessive tortuosity at target lesion. Subjects unable to tolerate anticoagulant therapy or antiplatelet therapy. Women who are currently pregnant. (A negative pregnancy test for female subjects of child bearing potential is required). The target lesion(s) cannot be successfully crossed with a guide wire.* Lower extremity deep venous thrombosis in the study limb within the prior 30 days. Chronic venous disease with active or recent (< 30 day) skin ulceration. Known or suspected active systemic infection. Two (2) months previous history of non-hemorrhagic stroke and or history of hemorrhagic stroke. Treatment that requires access via upper extremity, popliteal artery, or pedal artery. Evidence of severe or uncontrolled systemic disease of any condition which in the investigator's opinion makes it undesirable for the subject to participate in the trial or which would jeopardize compliance with the protocol. Use of re-entry, ablative, or atherectomy devices to cross the lesion.*
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
John F Angle, MD
Organizational Affiliation
University of Virginia
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Of Alabama
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States
Facility Name
Cardiology Associates of Mobile
City
Fairhope
State/Province
Alabama
ZIP/Postal Code
36532
Country
United States
Facility Name
Central Arkansas Veteran's Healthcare System
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72205
Country
United States
Facility Name
Long Beach VA Healthcare Center
City
Long Beach
State/Province
California
ZIP/Postal Code
90822
Country
United States
Facility Name
Christiana Care
City
Newark
State/Province
Delaware
ZIP/Postal Code
19718
Country
United States
Facility Name
Bradenton Cardiology Center
City
Bradenton
State/Province
Florida
ZIP/Postal Code
34205
Country
United States
Facility Name
Florida Research Network
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32605
Country
United States
Facility Name
First Coast Cardiovascular Institute
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32216
Country
United States
Facility Name
Coastal Vascular and Interventional, PLLC
City
Pensacola
State/Province
Florida
ZIP/Postal Code
32504
Country
United States
Facility Name
Cardiovascular Associates
City
Elk Grove Village
State/Province
Illinois
ZIP/Postal Code
60007
Country
United States
Facility Name
Midwest Cardiovascular Research Foundation
City
Davenport
State/Province
Iowa
ZIP/Postal Code
52803
Country
United States
Facility Name
University of Iowa Healthcare
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Facility Name
Kings Daughters Medical Center
City
Ashland
State/Province
Kentucky
ZIP/Postal Code
41101
Country
United States
Facility Name
Michigan Heart
City
Ypsilanti
State/Province
Michigan
ZIP/Postal Code
48197
Country
United States
Facility Name
Hunterdon Cardiovascular Associates
City
Flemington
State/Province
New Jersey
ZIP/Postal Code
08822
Country
United States
Facility Name
Columbia University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Hillsboro Cardiology
City
Hillsboro
State/Province
Oregon
ZIP/Postal Code
97123
Country
United States
Facility Name
Central Bucks Specialists
City
Doylestown
State/Province
Pennsylvania
ZIP/Postal Code
18901
Country
United States
Facility Name
St. Mary Medical Centere Research Institute
City
Langhorne
State/Province
Pennsylvania
ZIP/Postal Code
19047
Country
United States
Facility Name
Pinnacle Health Cardiovascular Institute
City
Wormleysburg
State/Province
Pennsylvania
ZIP/Postal Code
17043
Country
United States
Facility Name
Berks Cardiologists, Ltd
City
Wyomissing
State/Province
Pennsylvania
ZIP/Postal Code
19610
Country
United States
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29401
Country
United States
Facility Name
South Carolina Heart Center
City
Columbia
State/Province
South Carolina
ZIP/Postal Code
29204
Country
United States
Facility Name
Wellmont CVA Heart Institute
City
Kingsport
State/Province
Tennessee
ZIP/Postal Code
37660
Country
United States
Facility Name
Premier Clinical Reesearch
City
Knoxville
State/Province
Tennessee
ZIP/Postal Code
37909
Country
United States
Facility Name
East Tennessee Cardiovascular Research-Turkey Creek Medical Center
City
Knoxville
State/Province
Tennessee
ZIP/Postal Code
37934
Country
United States
Facility Name
Amarillo Heart Clinical Research Institute
City
Amarillo
State/Province
Texas
ZIP/Postal Code
79106
Country
United States
Facility Name
University of Virginia
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22908
Country
United States
Facility Name
Centra Cardiovascular Group
City
Lynchburg
State/Province
Virginia
ZIP/Postal Code
24501
Country
United States
Facility Name
Sentara Medical Group
City
Norfolk
State/Province
Virginia
ZIP/Postal Code
23507
Country
United States
Facility Name
Columbia- St. Mary's
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53211
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
17377972
Citation
Rocha-Singh KJ, Jaff MR, Crabtree TR, Bloch DA, Ansel G; VIVA Physicians, Inc. Performance goals and endpoint assessments for clinical trials of femoropopliteal bare nitinol stents in patients with symptomatic peripheral arterial disease. Catheter Cardiovasc Interv. 2007 May 1;69(6):910-9. doi: 10.1002/ccd.21104.
Results Reference
background
PubMed Identifier
26483003
Citation
Ohki T, Angle JF, Yokoi H, Jaff MR, Popma J, Piegari G, Kanaoka Y; OSPREY investigators. One-year outcomes of the U.S. and Japanese regulatory trial of the Misago stent for treatment of superficial femoral artery disease (OSPREY study). J Vasc Surg. 2016 Feb;63(2):370-6.e1. doi: 10.1016/j.jvs.2015.08.093. Epub 2015 Oct 17.
Results Reference
derived
PubMed Identifier
23210876
Citation
Schulte KL, Kralj I, Gissler HM, Bagnaschino LA, Buschmann I, Pernes JM, Haage P, Goverde P, Beregi JP, Valka M, Boudny J, Geibel T, Velkoborsky M, Zahringer M, Paetzel C, Fanelli F, Muller-Hulsbeck S, Zeller T, Langhoff R. MISAGO 2: one-year outcomes after implantation of the Misago self-expanding nitinol stent in the superficial femoral and popliteal arteries of 744 patients. J Endovasc Ther. 2012 Dec;19(6):774-84. doi: 10.1583/JEVT-12-3861MR.1.
Results Reference
derived

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A Multi-center Clinical Trial of the Misago™ Self-Expanding Stent System for Superficial Femoral Artery

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