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Single Arm Study With a Nitinol Self-Expanding Paclitaxel-Eluting Stent to Treat BTK Arteries (PES-BTK-70)

Primary Purpose

Peripheral Arterial Disease

Status
Completed
Phase
Phase 2
Locations
Belgium
Study Type
Interventional
Intervention
Self-expandable drug eluting stent
Sponsored by
Flanders Medical Research Program
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peripheral Arterial Disease focused on measuring Critical limb ischemia, Rest pain, Minor tissue loss, Below the knee

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patient presenting with rest pain or minor tissue loss (Rutherford Clinical Category 4 or 5)
  • Patient is willing to comply with specified follow-up evaluations at the specified times
  • Patient is >18 years old
  • Patient understands the nature of the procedure and provides written informed consent, prior to enrolment in the study
  • Patient has a projected life-expectancy of at least 12 months
  • Patient is eligible for treatment with a Self-Expanding Paclitaxel-Eluting stent
  • Male, infertile female, or female of child bearing potential practicing an acceptable method of birth control with a negative pregnancy test within 7 days prior to study procedure
  • Evidence at screening of ≥50% de novo lesion (or restenosis after previous PTA) in the infrapopliteal arteries, confirmed by angiography
  • Reference vessel diameter visually estimated to be ≥3.0mm and ≤4.5mm
  • Identifiable distal target vessel which upon completion of the intervention, is anticipated to provide reconstitution of blood flow to the foot.
  • Guidewire successfully traversed lesion
  • Length of target lesion is <50mm

Exclusion Criteria:

  • Untreated flow-limiting inflow lesions
  • Perioperative unsuccessful ipsilateral percutaneous vascular procedure to treat inflow disease just prior to enrollment
  • Has had a previous peripheral bypass affecting the target limb
  • Major distal amputation (above the transmetatarsal) in the study limb or non-study limb
  • Non-atherosclerothic disease resulting in occlusion (e.g. embolism, Buerger's disease, vasculitis)
  • Patient has a contra-indication or known untreated allergy to anti-platelet therapy, anticoagulants, thrombolytic drugs or any other drug anticipated to be used
  • Patient has hypersensitivity to contrast or device material that cannot be adequately pretreated
  • Patient has known uncontrollable hypercoagulable condition, or refuses blood transfusion
  • Life expectancy of less than 12 months
  • Patient is currently participating in an investigational drug or another device study that may clinically interfere with the study endpoints
  • Patient has other co-morbid condition(s) that in the judgment of the physician precludes safe percutaneous intervention
  • Has end-stage renal disease defined as undergoing hemodialysis for kidney failure
  • Known allergy to contrast media that cannot be adequately pre-medicated prior to the study procedure
  • Patient with known hypersensitivity to heparin, including those patients who have had a previous incidence of heparin-induced thrombocytopenia (HIT)type II
  • Treatment of ipsilateral non-study inflow lesions with other materials than regular guidewires, regular PTA balloons, bare metal stents and/or paclitaxel-coated stents
  • Additional treatments of the study lesion requiring materials/procedures other than standard guidewires, regular PTA balloons and/or a Self-Expanding Paclitaxel-Eluting stent (e.g. thrombectomy, re-entry catheters, CTO-wires, cutting balloon, cryoballoon, etc)

Sites / Locations

  • Imelda Hospital
  • UZA
  • RZ Heilig-Hartziekenhuis
  • OLV Ziekenhuis
  • AZ Sint-Blasius

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Self-expandable drug eluting stent

Arm Description

Self-Expanding Paclitaxel-Eluting stent

Outcomes

Primary Outcome Measures

Primary patency
Primary patency rate at 6 months, defined by duplex ultrasound measurement of peak systolic velocity ratio ≤2.0 at the target lesion(s) with no clinically-driven reintervention within the treated segment, verified by Core Lab
Primary patency
Primary patency at 12 months, defined as absence of restenosis (≥50% stenosis) or occlusion within the originally treated lesion based on angiography, verified by Core Lab

Secondary Outcome Measures

Technical success
Technical success, defined as the ability to cross and dilate the lesion to achieve residual angiographic stenosis no greater than 30% by visual assessment
Procedural success
Procedural success, defined as the ability to achieve <30% final residual stenosis of the target lesion by visual estimation (angio) and the absence of any in-hospital Major Adverse Events (MAE, defined as clinically-driven target vessel revascularization, major unplanned amputation of the treated limb, and all-cause mortality)
MAE (Major Adverse Event)
MAE at 1, 6 and 12 months Major Adverse Events (MAE) include (but are not limited to) death myocardial infarction stroke emergent surgical revascularization of the target vessel repeat vascularization of the target vessel major amputation bleeding complication requiring transfusion
SAE (Serious Adverse Event)
Other SAEs at discharge, 1, 6 and 12 months A Serious Adverse Event (SAE) is defined as an Adverse Event which: results in death is life-threatening results in persistent or significant disability/incapacity requires in-patient hospitalization or unduly prolonged hospitalization. necessitates an intervention to prevent a permanent impairment of a body function or permanent damage to a body structure. is a congenital abnormality/birth defect, a fetal distress or fetal death results in malignancy
Improvement of Rutherford classification
Improvement in Rutherford Clinical Category at 12 months, defined as an improvement in clinical status indicated by a decrease of one or more in Rutherford Clinical Category at 12 months compared to baseline, that is attributable to the treated limb (in cases of bilateral disease)
Improvement in Ankle-Brachial Index
Improvement in Ankle-Brachial Index at 12 months, defined as an increase in the ankle-brachial index (ABI) at 1 year compared to baseline in subjects with compressible arteries and baseline ABI<0.9
Primary Patency
Primary patency rate at 1 and 12 months, defined by duplex ultrasound measurement of peak systolic velocity ratio ≤2.0 at the target lesion(s) with no clinically-driven reintervention within the treated segment
Secondary patency
Secondary patency rate at 1, 6 and 12 months, defined by duplex ultrasound peak systolic velocity ratio ≤2.0 maintained by repeat percutaneous intervention
Limb salvage rate
Limb salvage rate, defined as 1 minus major amputation rate (major amputation is defined as at or above ankle, as opposed to minor amputation being at or below metatarsus preserving functionality of foot
Target Lesion Revascularisation
Target lesion revascularization (TLR), defined as a repeat intervention to maintain or re-establish patency within the region of the treated arterial vessel plus 5mm proximal and distal to the treated lesion edge.

Full Information

First Posted
June 18, 2012
Last Updated
March 6, 2015
Sponsor
Flanders Medical Research Program
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1. Study Identification

Unique Protocol Identification Number
NCT01630070
Brief Title
Single Arm Study With a Nitinol Self-Expanding Paclitaxel-Eluting Stent to Treat BTK Arteries
Acronym
PES-BTK-70
Official Title
A Prospective, Multi-center, Single Arm Study With a Nitinol Self-Expanding Paclitaxel-Eluting Stent in the Treatment of Atherosclerotic Tibial-peroneal Arteries
Study Type
Interventional

2. Study Status

Record Verification Date
March 2015
Overall Recruitment Status
Completed
Study Start Date
January 2012 (undefined)
Primary Completion Date
October 2013 (Actual)
Study Completion Date
October 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Flanders Medical Research Program

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The objective of this clinical study is to evaluate the immediate and long-term (up to 12 month) safety and effectiveness of a Nitinol Self-Expanding Paclitaxel-Eluting stent for the treatment of patients with critical limb ischemia (i.e. rest pain or non-healing foot ulcers) due to the presence of arterial lesions in the below-the-knee arteries of maximally 50mm long.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peripheral Arterial Disease
Keywords
Critical limb ischemia, Rest pain, Minor tissue loss, Below the knee

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
70 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Self-expandable drug eluting stent
Arm Type
Experimental
Arm Description
Self-Expanding Paclitaxel-Eluting stent
Intervention Type
Device
Intervention Name(s)
Self-expandable drug eluting stent
Other Intervention Name(s)
Self-Expanding Paclitaxel-Eluting stent
Intervention Description
Self-Expanding Paclitaxel-Eluting stent
Primary Outcome Measure Information:
Title
Primary patency
Description
Primary patency rate at 6 months, defined by duplex ultrasound measurement of peak systolic velocity ratio ≤2.0 at the target lesion(s) with no clinically-driven reintervention within the treated segment, verified by Core Lab
Time Frame
6 months
Title
Primary patency
Description
Primary patency at 12 months, defined as absence of restenosis (≥50% stenosis) or occlusion within the originally treated lesion based on angiography, verified by Core Lab
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Technical success
Description
Technical success, defined as the ability to cross and dilate the lesion to achieve residual angiographic stenosis no greater than 30% by visual assessment
Time Frame
procedure (day 0)
Title
Procedural success
Description
Procedural success, defined as the ability to achieve <30% final residual stenosis of the target lesion by visual estimation (angio) and the absence of any in-hospital Major Adverse Events (MAE, defined as clinically-driven target vessel revascularization, major unplanned amputation of the treated limb, and all-cause mortality)
Time Frame
Procedure (day 0)
Title
MAE (Major Adverse Event)
Description
MAE at 1, 6 and 12 months Major Adverse Events (MAE) include (but are not limited to) death myocardial infarction stroke emergent surgical revascularization of the target vessel repeat vascularization of the target vessel major amputation bleeding complication requiring transfusion
Time Frame
1, 6 and 12 months
Title
SAE (Serious Adverse Event)
Description
Other SAEs at discharge, 1, 6 and 12 months A Serious Adverse Event (SAE) is defined as an Adverse Event which: results in death is life-threatening results in persistent or significant disability/incapacity requires in-patient hospitalization or unduly prolonged hospitalization. necessitates an intervention to prevent a permanent impairment of a body function or permanent damage to a body structure. is a congenital abnormality/birth defect, a fetal distress or fetal death results in malignancy
Time Frame
discharge, 1, 6 and 12 months
Title
Improvement of Rutherford classification
Description
Improvement in Rutherford Clinical Category at 12 months, defined as an improvement in clinical status indicated by a decrease of one or more in Rutherford Clinical Category at 12 months compared to baseline, that is attributable to the treated limb (in cases of bilateral disease)
Time Frame
12 months
Title
Improvement in Ankle-Brachial Index
Description
Improvement in Ankle-Brachial Index at 12 months, defined as an increase in the ankle-brachial index (ABI) at 1 year compared to baseline in subjects with compressible arteries and baseline ABI<0.9
Time Frame
12 months
Title
Primary Patency
Description
Primary patency rate at 1 and 12 months, defined by duplex ultrasound measurement of peak systolic velocity ratio ≤2.0 at the target lesion(s) with no clinically-driven reintervention within the treated segment
Time Frame
1 and 12 months
Title
Secondary patency
Description
Secondary patency rate at 1, 6 and 12 months, defined by duplex ultrasound peak systolic velocity ratio ≤2.0 maintained by repeat percutaneous intervention
Time Frame
1, 6 and 12 months
Title
Limb salvage rate
Description
Limb salvage rate, defined as 1 minus major amputation rate (major amputation is defined as at or above ankle, as opposed to minor amputation being at or below metatarsus preserving functionality of foot
Time Frame
Procedure, 1, 6 and 12 months
Title
Target Lesion Revascularisation
Description
Target lesion revascularization (TLR), defined as a repeat intervention to maintain or re-establish patency within the region of the treated arterial vessel plus 5mm proximal and distal to the treated lesion edge.
Time Frame
Procedure (day 0), 1, 6 and 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient presenting with rest pain or minor tissue loss (Rutherford Clinical Category 4 or 5) Patient is willing to comply with specified follow-up evaluations at the specified times Patient is >18 years old Patient understands the nature of the procedure and provides written informed consent, prior to enrolment in the study Patient has a projected life-expectancy of at least 12 months Patient is eligible for treatment with a Self-Expanding Paclitaxel-Eluting stent Male, infertile female, or female of child bearing potential practicing an acceptable method of birth control with a negative pregnancy test within 7 days prior to study procedure Evidence at screening of ≥50% de novo lesion (or restenosis after previous PTA) in the infrapopliteal arteries, confirmed by angiography Reference vessel diameter visually estimated to be ≥3.0mm and ≤4.5mm Identifiable distal target vessel which upon completion of the intervention, is anticipated to provide reconstitution of blood flow to the foot. Guidewire successfully traversed lesion Length of target lesion is <50mm Exclusion Criteria: Untreated flow-limiting inflow lesions Perioperative unsuccessful ipsilateral percutaneous vascular procedure to treat inflow disease just prior to enrollment Has had a previous peripheral bypass affecting the target limb Major distal amputation (above the transmetatarsal) in the study limb or non-study limb Non-atherosclerothic disease resulting in occlusion (e.g. embolism, Buerger's disease, vasculitis) Patient has a contra-indication or known untreated allergy to anti-platelet therapy, anticoagulants, thrombolytic drugs or any other drug anticipated to be used Patient has hypersensitivity to contrast or device material that cannot be adequately pretreated Patient has known uncontrollable hypercoagulable condition, or refuses blood transfusion Life expectancy of less than 12 months Patient is currently participating in an investigational drug or another device study that may clinically interfere with the study endpoints Patient has other co-morbid condition(s) that in the judgment of the physician precludes safe percutaneous intervention Has end-stage renal disease defined as undergoing hemodialysis for kidney failure Known allergy to contrast media that cannot be adequately pre-medicated prior to the study procedure Patient with known hypersensitivity to heparin, including those patients who have had a previous incidence of heparin-induced thrombocytopenia (HIT)type II Treatment of ipsilateral non-study inflow lesions with other materials than regular guidewires, regular PTA balloons, bare metal stents and/or paclitaxel-coated stents Additional treatments of the study lesion requiring materials/procedures other than standard guidewires, regular PTA balloons and/or a Self-Expanding Paclitaxel-Eluting stent (e.g. thrombectomy, re-entry catheters, CTO-wires, cutting balloon, cryoballoon, etc)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marc Bosiers, MD
Organizational Affiliation
AZ Sint-Blasius
Official's Role
Principal Investigator
Facility Information:
Facility Name
Imelda Hospital
City
Bonheiden
State/Province
Antwerp
ZIP/Postal Code
2820
Country
Belgium
Facility Name
UZA
City
Edegem
State/Province
Antwerp
ZIP/Postal Code
2650
Country
Belgium
Facility Name
RZ Heilig-Hartziekenhuis
City
Tienen
State/Province
Antwerp
ZIP/Postal Code
3300
Country
Belgium
Facility Name
OLV Ziekenhuis
City
Aalst
State/Province
East-Flanders
ZIP/Postal Code
9300
Country
Belgium
Facility Name
AZ Sint-Blasius
City
Dendermonde
State/Province
East-Flanders
ZIP/Postal Code
9200
Country
Belgium

12. IPD Sharing Statement

Citations:
PubMed Identifier
28351310
Citation
Bosiers M, Callaert J, Keirse K, Hendriks JMH, Peeters P, Verbist J, Maene L, Beelen R, Deloose K. One-Year Outcomes of the Paclitaxel-Eluting, Self-Expanding Stentys Stent System in the Treatment of Infrapopliteal Lesions in Patients With Critical Limb Ischemia. J Endovasc Ther. 2017 Jun;24(3):311-316. doi: 10.1177/1526602817697319. Epub 2017 Mar 9.
Results Reference
derived

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Single Arm Study With a Nitinol Self-Expanding Paclitaxel-Eluting Stent to Treat BTK Arteries

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