LEVANT 2 Safety Registry
Primary Purpose
Peripheral Artery Disease, Femoropopliteal Artery Occlusion, Femoropopliteal Stenosis
Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Lutonix Drug Coated Balloon
Standard PTA Balloon
Sponsored by
About this trial
This is an interventional treatment trial for Peripheral Artery Disease
Eligibility Criteria
Clinical Inclusion Criteria:
- Male or non-pregnant female ≥18 years of age;
- Rutherford Clinical Category 2-4;
Patient is willing to provide informed consent, is geographically stable and comply with the required follow up visits, testing schedule and medication regimen;
Angiographic Lesion Inclusion Criteria:
- Length ≤15 cm;
- Up to two focal lesions or segments within the designated 15 cm length of vessel may be treated (e.g. two discrete segments, separated by several cm, but both falling within a composite length of <15 cm);
- ≥70% stenosis by visual estimate;
- Lesion location starts ≥1 cm below the common femoral bifurcation and terminates distally ≤2 cm below the tibial plateau AND ≥1 cm above the origin of the TP trunk;
- De novo lesion(s) or non-stented restenotic lesion(s) >90 days from prior angioplasty procedure;
- Lesion is located at least 3 cm from any stent, if target vessel was previously stented;
- Target vessel diameter between ≥4 and ≤6 mm and able to be treated with available device size matrix;
- Successful, uncomplicated (without use of a crossing device) antegrade wire crossing of lesion;
- A patent inflow artery free from significant lesion (≥50% stenosis) as confirmed by angiography (treatment of target lesion acceptable after successful treatment of inflow artery lesions); NOTE: Successful inflow artery treatment is defined as attainment of residual diameter stenosis ≤30% without death or major vascular complication.
- At least one patent native outflow artery to the ankle, free from significant (≥50%) stenosis as confirmed by angiography that has not previously been revascularized (treatment of outflow disease is NOT permitted during the index procedure);
- Contralateral limb lesion(s) cannot be treated within 2 weeks before and/or planned 30 days after the protocol treatment in order to avoid confounding complications;
- No other prior vascular interventions within 2 weeks before and/or planned 30 days after the protocol treatment.
Exclusion Criteria:
Patients will be excluded if ANY of the following conditions apply:
- Pregnant or planning on becoming pregnant or men intending to father children;
- Life expectancy of <5 years;
- Patient is currently participating in an investigational drug or other device study or previously enrolled in this study; NOTE: Enrollment in another clinical trial during the follow up period is not allowed.
- History of hemorrhagic stroke within 3 months;
- Previous or planned surgical or interventional procedure within 2 weeks before or within 30 days after the index procedure;
- History of MI, thrombolysis or angina within 2 weeks of enrollment;
- Rutherford Class 0, 1, 5 or 6;
- Renal failure or chronic kidney disease with MDRD GFR ≤30 ml/min per 1.73 m2 (or serum creatinine ≥2.5 mg/L within 30 days of index procedure or treated with dialysis);
- Prior vascular surgery of the index limb, with the exception of remote common femoral patch angioplasty separated by at least 2 cm from the target lesion;
- Inability to take required study medications or allergy to contrast that cannot be adequately managed with pre- and post-procedure medication;
- Anticipated use of IIb/IIIa inhibitor prior to randomization;
- Ipsilateral retrograde access;
- Composite lesion length is >15 cm or there is no normal proximal arterial segment in which duplex flow velocity can be measured;
- Significant inflow disease. Successful treatment of inflow disease allowed prior to target lesion treatment;
- Known inadequate distal outflow (>50 % stenosis of distal popliteal and/or all three tibial vessels), or planned future treatment of vascular disease distal to the target lesion;
- Sudden symptom onset, acute vessel occlusion, or acute or sub-acute thrombus in target vessel;
- Severe calcification that renders the lesion un-dilatable;
- Use of adjunctive treatment modalities (i.e. laser, atherectomy, cryoplasty, scoring/cutting balloon, etc.).
Sites / Locations
- Mission Cardiovascular Research Institute
- Metro Health Hospital
- Jackson Heart Clinic/St. Dominic's Hospital
- Mercy Hospital
- Holy Name Medical Center
- New York Presbyterian Hospital/Weill Cornell Medical Center
- TriHealth Heart Institute
- Mission Research Institute
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Lutonix Drug Coated Balloon
Standard Uncoated Angioplasty Balloon
Arm Description
Formerly called the Moxy Drug Coated Balloon, the Lutonix Drug Coated Balloon (Lutonix DCB) is a paclitaxel coated balloon catheter
PTA Catheter
Outcomes
Primary Outcome Measures
Number of Participants With Unanticipated Device- or Drug-Related Serious Adverse Events at 60 Months Post Index Procedure.
Secondary Outcome Measures
Number of Subjects With Freedom From Death, Index-Limb Amputation, and Target Vessel Revascularization (TVR) at 30 Days Post Index Procedure
Number of subjects with Freedom from all-cause death, index limb amputation above the ankle and Target Vessel Revascularization (TVR) (VIVA Safety Endpoint)
Number of Participants With All-Cause Perioperative (<30 Day) Death, Index Limb Amputation, Index Limb Re-intervention, and Index Limb Related Death at 1,6, 12, 24, 36, 48, and 60 Months Post Index Procedure
Percentage of Participants With Primary Patency of the Target Lesion at 6, 12, and 24 Months Post Index Procedure
Primary Patency is defined as the absence of target lesion restenosis (defined by DUS peak systolic velocity ratio (PSVR) ≥2.5) and freedom from target lesion revascularization (TLR).
Number of Acute Device Success at Time of Index Procedure
Device Success was defined as the achievement of successful delivery and deployment of the study device(s) as intended at the intended target lesion, without balloon rupture or inflation/deflation abnormalities and a successful withdrawal of the study system.
Number of Participants With Technical and Procedural Success
Technical Success is defined as successful access and deployment of the device and visual estimate of ≤30% diameter residual stenosis during the index procedure without deployment of a bailout stent.
Procedural Success is defined as attainment of ≤30% residual stenosis in the treatment area by independent core lab analysis without serious adverse events during the index procedure.
Number of Participants With Freedom From Target Lesion Revascularization (TLR) at 6, 12, and 24 Months Post Index Procedure
Number of Participants With Alternative Primary Patency at 6, 12, and 24 Months Post Index Procedure
Percentage of subjects with Alternative Primary Patency based on alternative definitions of duplex ultrasound (DUS) peak systolic velocity ratio (PSVR) <2.0 and <3.0 at 6, 12, and 24 months post index procedure. DUS PSVR was calculated by dividing the maximum peak systolic velocity (PSV) from the stenosis by the PSV from the nearest segment of normal artery above the site of increase.
Improvement in Rutherford Classification Scores at 6, 12, and 24 Months Post Index Procedure Compared to Baseline
The endpoint summarizes the change in index-limb Rutherford Classification of participants from baseline through 24 months. Data is presented as shift from baseline Rutherford Classification data using the following categories: 1) Improvement, 2) Same, and 3) Worsened.
Change in Resting Ankle Brachial Index (ABI) at 6, 12, and 24 Months Compared to Baseline
Mean change from baseline values. The Ankle Brachial Index (ABI) is defined as a ratio of ankle to brachial (upper arm) artery systolic blood pressure and aims at determining how well the blood is flowing in the legs.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01790243
Brief Title
LEVANT 2 Safety Registry
Official Title
A Prospective, Multicenter, Registry of the Lutonix Drug Coated Balloon for Treatment of Femoropopliteal Arteries (LEVANT 2 Safety Registry)
Study Type
Interventional
2. Study Status
Record Verification Date
May 2020
Overall Recruitment Status
Completed
Study Start Date
July 20, 2011 (Actual)
Primary Completion Date
November 27, 2015 (Actual)
Study Completion Date
November 1, 2018 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
C. R. Bard
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The primary objective of the LEVANT 2 Extended Follow-up Post-Approval Study (PAS 1) is to evaluate the long-term performance of the Lutonix Drug Coated Balloon (DCB) versus Percutaneous Transluminal Balloon Angioplasty (PTA) in the treatment of stenosis or occlusion of the femoropopliteal arteries.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peripheral Artery Disease, Femoropopliteal Artery Occlusion, Femoropopliteal Stenosis
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
1189 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Lutonix Drug Coated Balloon
Arm Type
Experimental
Arm Description
Formerly called the Moxy Drug Coated Balloon, the Lutonix Drug Coated Balloon (Lutonix DCB) is a paclitaxel coated balloon catheter
Arm Title
Standard Uncoated Angioplasty Balloon
Arm Type
Active Comparator
Arm Description
PTA Catheter
Intervention Type
Device
Intervention Name(s)
Lutonix Drug Coated Balloon
Intervention Description
Use of the Lutonix Drug Coated Balloon (DCB) for the treatment of stenosis or occlusion of the femoropopliteal arteries.
Intervention Type
Device
Intervention Name(s)
Standard PTA Balloon
Intervention Description
Use of Standard PTA Balloon in the treatment of stenosis or occlusion of the femoropopliteal arteries.
Primary Outcome Measure Information:
Title
Number of Participants With Unanticipated Device- or Drug-Related Serious Adverse Events at 60 Months Post Index Procedure.
Time Frame
From index procedure to 60 months Post Index Procedure
Secondary Outcome Measure Information:
Title
Number of Subjects With Freedom From Death, Index-Limb Amputation, and Target Vessel Revascularization (TVR) at 30 Days Post Index Procedure
Description
Number of subjects with Freedom from all-cause death, index limb amputation above the ankle and Target Vessel Revascularization (TVR) (VIVA Safety Endpoint)
Time Frame
30 days post index procedure
Title
Number of Participants With All-Cause Perioperative (<30 Day) Death, Index Limb Amputation, Index Limb Re-intervention, and Index Limb Related Death at 1,6, 12, 24, 36, 48, and 60 Months Post Index Procedure
Time Frame
1, 6, 12, 24, 36, 48, and 60 months post index procedure (PPI)
Title
Percentage of Participants With Primary Patency of the Target Lesion at 6, 12, and 24 Months Post Index Procedure
Description
Primary Patency is defined as the absence of target lesion restenosis (defined by DUS peak systolic velocity ratio (PSVR) ≥2.5) and freedom from target lesion revascularization (TLR).
Time Frame
6, 12, and 24 months post index procedure
Title
Number of Acute Device Success at Time of Index Procedure
Description
Device Success was defined as the achievement of successful delivery and deployment of the study device(s) as intended at the intended target lesion, without balloon rupture or inflation/deflation abnormalities and a successful withdrawal of the study system.
Time Frame
At time of index procedure
Title
Number of Participants With Technical and Procedural Success
Description
Technical Success is defined as successful access and deployment of the device and visual estimate of ≤30% diameter residual stenosis during the index procedure without deployment of a bailout stent.
Procedural Success is defined as attainment of ≤30% residual stenosis in the treatment area by independent core lab analysis without serious adverse events during the index procedure.
Time Frame
At time of index procedure
Title
Number of Participants With Freedom From Target Lesion Revascularization (TLR) at 6, 12, and 24 Months Post Index Procedure
Time Frame
6, 12, and 24 months post index procedure
Title
Number of Participants With Alternative Primary Patency at 6, 12, and 24 Months Post Index Procedure
Description
Percentage of subjects with Alternative Primary Patency based on alternative definitions of duplex ultrasound (DUS) peak systolic velocity ratio (PSVR) <2.0 and <3.0 at 6, 12, and 24 months post index procedure. DUS PSVR was calculated by dividing the maximum peak systolic velocity (PSV) from the stenosis by the PSV from the nearest segment of normal artery above the site of increase.
Time Frame
6, 12, and 24 months post index procedure
Title
Improvement in Rutherford Classification Scores at 6, 12, and 24 Months Post Index Procedure Compared to Baseline
Description
The endpoint summarizes the change in index-limb Rutherford Classification of participants from baseline through 24 months. Data is presented as shift from baseline Rutherford Classification data using the following categories: 1) Improvement, 2) Same, and 3) Worsened.
Time Frame
6, 12, and 24 months post index procedure
Title
Change in Resting Ankle Brachial Index (ABI) at 6, 12, and 24 Months Compared to Baseline
Description
Mean change from baseline values. The Ankle Brachial Index (ABI) is defined as a ratio of ankle to brachial (upper arm) artery systolic blood pressure and aims at determining how well the blood is flowing in the legs.
Time Frame
6, 12, and 24 months from baseline
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Clinical Inclusion Criteria:
Male or non-pregnant female ≥18 years of age;
Rutherford Clinical Category 2-4;
Patient is willing to provide informed consent, is geographically stable and comply with the required follow up visits, testing schedule and medication regimen;
Angiographic Lesion Inclusion Criteria:
Length ≤15 cm;
Up to two focal lesions or segments within the designated 15 cm length of vessel may be treated (e.g. two discrete segments, separated by several cm, but both falling within a composite length of <15 cm);
≥70% stenosis by visual estimate;
Lesion location starts ≥1 cm below the common femoral bifurcation and terminates distally ≤2 cm below the tibial plateau AND ≥1 cm above the origin of the TP trunk;
De novo lesion(s) or non-stented restenotic lesion(s) >90 days from prior angioplasty procedure;
Lesion is located at least 3 cm from any stent, if target vessel was previously stented;
Target vessel diameter between ≥4 and ≤6 mm and able to be treated with available device size matrix;
Successful, uncomplicated (without use of a crossing device) antegrade wire crossing of lesion;
A patent inflow artery free from significant lesion (≥50% stenosis) as confirmed by angiography (treatment of target lesion acceptable after successful treatment of inflow artery lesions); NOTE: Successful inflow artery treatment is defined as attainment of residual diameter stenosis ≤30% without death or major vascular complication.
At least one patent native outflow artery to the ankle, free from significant (≥50%) stenosis as confirmed by angiography that has not previously been revascularized (treatment of outflow disease is NOT permitted during the index procedure);
Contralateral limb lesion(s) cannot be treated within 2 weeks before and/or planned 30 days after the protocol treatment in order to avoid confounding complications;
No other prior vascular interventions within 2 weeks before and/or planned 30 days after the protocol treatment.
Exclusion Criteria:
Patients will be excluded if ANY of the following conditions apply:
Pregnant or planning on becoming pregnant or men intending to father children;
Life expectancy of <5 years;
Patient is currently participating in an investigational drug or other device study or previously enrolled in this study; NOTE: Enrollment in another clinical trial during the follow up period is not allowed.
History of hemorrhagic stroke within 3 months;
Previous or planned surgical or interventional procedure within 2 weeks before or within 30 days after the index procedure;
History of MI, thrombolysis or angina within 2 weeks of enrollment;
Rutherford Class 0, 1, 5 or 6;
Renal failure or chronic kidney disease with MDRD GFR ≤30 ml/min per 1.73 m2 (or serum creatinine ≥2.5 mg/L within 30 days of index procedure or treated with dialysis);
Prior vascular surgery of the index limb, with the exception of remote common femoral patch angioplasty separated by at least 2 cm from the target lesion;
Inability to take required study medications or allergy to contrast that cannot be adequately managed with pre- and post-procedure medication;
Anticipated use of IIb/IIIa inhibitor prior to randomization;
Ipsilateral retrograde access;
Composite lesion length is >15 cm or there is no normal proximal arterial segment in which duplex flow velocity can be measured;
Significant inflow disease. Successful treatment of inflow disease allowed prior to target lesion treatment;
Known inadequate distal outflow (>50 % stenosis of distal popliteal and/or all three tibial vessels), or planned future treatment of vascular disease distal to the target lesion;
Sudden symptom onset, acute vessel occlusion, or acute or sub-acute thrombus in target vessel;
Severe calcification that renders the lesion un-dilatable;
Use of adjunctive treatment modalities (i.e. laser, atherectomy, cryoplasty, scoring/cutting balloon, etc.).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kenneth Rosenfield, MD
Organizational Affiliation
Massachusetts General Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mission Cardiovascular Research Institute
City
Fremont
State/Province
California
ZIP/Postal Code
94538
Country
United States
Facility Name
Metro Health Hospital
City
Wyoming
State/Province
Michigan
ZIP/Postal Code
49519
Country
United States
Facility Name
Jackson Heart Clinic/St. Dominic's Hospital
City
Jackson
State/Province
Mississippi
ZIP/Postal Code
39216
Country
United States
Facility Name
Mercy Hospital
City
Springfield
State/Province
Missouri
ZIP/Postal Code
65804
Country
United States
Facility Name
Holy Name Medical Center
City
Teaneck
State/Province
New Jersey
ZIP/Postal Code
07666
Country
United States
Facility Name
New York Presbyterian Hospital/Weill Cornell Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
TriHealth Heart Institute
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45220
Country
United States
Facility Name
Mission Research Institute
City
New Braunfels
State/Province
Texas
ZIP/Postal Code
78130
Country
United States
12. IPD Sharing Statement
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LEVANT 2 Safety Registry
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