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Complete Lesion Assessment With ffR and IVUS TechnologY (CLARITY I)

Primary Purpose

Peripheral Artery Disease, Critical Limb Ischemia

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Orbital Atherectomy System
Balloon Angioplasty
Sponsored by
Abbott Medical Devices
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peripheral Artery Disease focused on measuring Peripheral Artery Disease, Critical Limb Ischemia, Orbital Atherectomy, Balloon Angioplasty, Intravascular Ultrasound (IVUS), Fractional Flow Reserve (FFR)

Eligibility Criteria

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

General Inclusion Criteria:

  1. Subject's age ≥ 18 years.
  2. Subject is an acceptable candidate for percutaneous intervention with the Sponsor's OAS and BA in accordance with their labeled indications and instructions for use.
  3. Subject is willing and able to sign an approved informed consent form (ICF).
  4. Subject is willing and able to attend follow-up and wound care visits.

General Exclusion Criteria:

  1. Subject is pregnant or planning to become pregnant within the study period.
  2. Subject is currently participating in an investigational drug or other device study that can clinically interfere with the endpoints of this trial.
  3. Subject has a known sensitivity to contrast media and the sensitivity cannot be adequately pre-medicated.
  4. Uncontrolled allergy to nitinol, stainless steel, or other stent materials.
  5. Subject has known allergy to atherectomy lubricant components such as soybean oil, egg yolk phospholipids, glycerin or sodium hydroxide.
  6. Subject has a history of bleeding diathesis or coagulopathy or will refuse blood transfusions.
  7. Subject has been diagnosed with chronic renal failure or has a creatinine level > 2.5, unless on dialysis, prior to the index treatment.
  8. Subject has evidence of intracranial or gastrointestinal bleeding within 90 days.
  9. Subject has a history of trauma, fracture, major surgery (includes major amputation), or biopsy of a parenchymal organ within past 14 days, or patient has not healed from a previous medical intervention occurring more than 14 days.
  10. Subject has a history of stroke or myocardial infarction (MI) within 90 days prior to enrollment in the study.
  11. Subject has a planned major surgery (includes major amputation) scheduled within 60 days after treatment of the index limb.
  12. Subject has a planned interventional treatment to address stenosis of the contralateral limb scheduled within 60 days after the index treatment.
  13. Subject has a planned interventional treatment to address inflow stenosis of the ipsilateral limb scheduled within 60 days after the index treatment.
  14. Inflow or bilateral PAD requiring treatment prior to enrollment was not successfully treated, defined as > 50% residual stenosis and/or occurrence of procedural angiographic complications, excluding dissection types A and B.
  15. Subject has previously had their other limb treated as part of the study.

Angiographic Inclusion Criteria:

  1. Target lesion(s) located in the anterior tibial (AT), posterior tibial (PT), tibial peroneal trunk (TPT) or peroneal (PR) arteries.
  2. Target lesion has ≥ 50 % stenosis by angiography.
  3. Subject has a corresponding wound being fed by the target vessel.

Angiographic Exclusion Criteria:

  1. Target limb does not have any visual flow to the foot confirmed via distal selective angiography.
  2. Thrombus is present or suspected in the target treatment vessel.
  3. Target lesion is within a bypass graft or near a previously placed stent.
  4. The guide wire cannot be passed across the target lesion.
  5. Anterograde access of the lesion is not possible.
  6. Subject has angiographic evidence of significant dissection at or near the treatment site.
  7. Interventional treatment is intended for in-stent restenosis at the peripheral vascular site.
  8. Subject's wound(s) involve multiple angiosomes.

Sites / Locations

  • Arkansas Heart Clinic
  • Northside Hospital
  • Midwest Cardiovascular Research Foundation
  • St. John Hospital and Medical Center
  • Holy Name Medical Center
  • Rex Hospital
  • Mission Research Institute
  • Sentara Vascular Specialists

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Orbital Atherectomy System

Balloon Angioplasty

Arm Description

Orbital Atherectomy (OA) is performed prior to adjunctive Balloon Angioplasty (BA)

Balloon Angioplasty (BA) alone

Outcomes

Primary Outcome Measures

Percentage of Calcium Removal Out of Lumen Gain as Assessed by IVUS
The post-treatment percentage of calcium removal out of lumen gain at the maximum calcium ablation site. A positive value equates to reduction in calcium out of the lumen gain.
Change in Minimum Lumen Area Percent Stenosis as Assessed by IVUS
The pre- (Pre-Tx) and post-treatment (Post-Tx) minimum lumen area percent stenosis. A positive value equates to a decrease in lumen area percent stenosis.
Change in Plaque Area as Assessed by IVUS
The pre- (Pre-Tx) and post-treatment (Post-Tx) plaque area. A positive value equates to a decrease in plaque area.
Change in Dense Calcium Area as Assessed by IVUS
The pre- (Pre-Tx) and post-treatment (Post-Tx) dense calcium area. A positive value equates to a decrease in dense calcium area.
Change in Necrotic Core Area as Assessed by IVUS
The pre- (Pre-Tx) and post-treatment (Post-Tx) necrotic core area. A positive value equates to a decrease necrotic core area.
Change in Fibrous Plaque Area as Assessed by IVUS
The pre- (Pre-Tx) and post-treatment (Post-Tx) fibrous plaque area. A positive value equates to a decrease in fibrous plaque area.
Change in Fibrofatty Plaque Area as Assessed by IVUS
The pre- (Pre-Tx) and post-treatment (Post-Tx) fibrofatty plaque area. A positive value equates to a decrease in fibrofatty plaque area.

Secondary Outcome Measures

Fractional Flow Reserve
Fractional flow reserve (FFR) will be measured to assess hemodynamic function following each device procedure. During FFR, adenosine will be given through the femoral artery sheath or access catheter in two doses: 600 mcg and 1200 mcg. A higher FFR is presumed to correlate to better flow which may improve wound healing.

Full Information

First Posted
March 11, 2013
Last Updated
July 14, 2023
Sponsor
Abbott Medical Devices
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1. Study Identification

Unique Protocol Identification Number
NCT01941030
Brief Title
Complete Lesion Assessment With ffR and IVUS TechnologY
Acronym
CLARITY I
Official Title
Complete Lesion Assessment With ffR and IVUS TechnologY (CLARITY I)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Completed
Study Start Date
March 2013 (undefined)
Primary Completion Date
June 2015 (Actual)
Study Completion Date
June 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Abbott Medical Devices

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
CLARITY I is a pilot study to identify the clinically appropriate endpoint(s) of a larger, statistically powered pivotal trial for treatment of patients with Critical Limb Ischemia (CLI).
Detailed Description
This prospective, randomized, multi-center, post-market study of approximately 50 subjects randomized 1:1 to Orbital Atherectomy (OA) performed with Cardiovascular Systems, Inc.'s Orbital Atherectomy System (OAS) followed by adjunctive balloon angioplasty (BA) vs. BA alone for treatment of tibial vessel disease, defined as ≥ 50 % stenosis of the anterior tibial (AT), posterior tibial (PT), tibial peroneal trunk (TPT), or peroneal (PR) arteries by angiography. All subjects will have a corresponding wound being fed by the target vessel which will be assessed during the study. Subjects will be followed to one year.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peripheral Artery Disease, Critical Limb Ischemia
Keywords
Peripheral Artery Disease, Critical Limb Ischemia, Orbital Atherectomy, Balloon Angioplasty, Intravascular Ultrasound (IVUS), Fractional Flow Reserve (FFR)

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
51 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Orbital Atherectomy System
Arm Type
Experimental
Arm Description
Orbital Atherectomy (OA) is performed prior to adjunctive Balloon Angioplasty (BA)
Arm Title
Balloon Angioplasty
Arm Type
Active Comparator
Arm Description
Balloon Angioplasty (BA) alone
Intervention Type
Device
Intervention Name(s)
Orbital Atherectomy System
Intervention Description
Orbital atherectomy (OA) is performed prior to adjunctive balloon angioplasty (BA)
Intervention Type
Device
Intervention Name(s)
Balloon Angioplasty
Intervention Description
Type of balloon selected is driven by preference of the operator.
Primary Outcome Measure Information:
Title
Percentage of Calcium Removal Out of Lumen Gain as Assessed by IVUS
Description
The post-treatment percentage of calcium removal out of lumen gain at the maximum calcium ablation site. A positive value equates to reduction in calcium out of the lumen gain.
Time Frame
Post-balloon angioplasty
Title
Change in Minimum Lumen Area Percent Stenosis as Assessed by IVUS
Description
The pre- (Pre-Tx) and post-treatment (Post-Tx) minimum lumen area percent stenosis. A positive value equates to a decrease in lumen area percent stenosis.
Time Frame
Pre-intervention, and post-balloon angioplasty
Title
Change in Plaque Area as Assessed by IVUS
Description
The pre- (Pre-Tx) and post-treatment (Post-Tx) plaque area. A positive value equates to a decrease in plaque area.
Time Frame
Pre-intervention, and post-balloon angioplasty
Title
Change in Dense Calcium Area as Assessed by IVUS
Description
The pre- (Pre-Tx) and post-treatment (Post-Tx) dense calcium area. A positive value equates to a decrease in dense calcium area.
Time Frame
Pre-intervention, and post-balloon angioplasty
Title
Change in Necrotic Core Area as Assessed by IVUS
Description
The pre- (Pre-Tx) and post-treatment (Post-Tx) necrotic core area. A positive value equates to a decrease necrotic core area.
Time Frame
Pre-intervention, and post-balloon angioplasty
Title
Change in Fibrous Plaque Area as Assessed by IVUS
Description
The pre- (Pre-Tx) and post-treatment (Post-Tx) fibrous plaque area. A positive value equates to a decrease in fibrous plaque area.
Time Frame
Pre-intervention, and post-balloon angioplasty
Title
Change in Fibrofatty Plaque Area as Assessed by IVUS
Description
The pre- (Pre-Tx) and post-treatment (Post-Tx) fibrofatty plaque area. A positive value equates to a decrease in fibrofatty plaque area.
Time Frame
Pre-intervention, and post-balloon angioplasty
Secondary Outcome Measure Information:
Title
Fractional Flow Reserve
Description
Fractional flow reserve (FFR) will be measured to assess hemodynamic function following each device procedure. During FFR, adenosine will be given through the femoral artery sheath or access catheter in two doses: 600 mcg and 1200 mcg. A higher FFR is presumed to correlate to better flow which may improve wound healing.
Time Frame
Post-orbital atherectomy (OA arm only) and post-balloon angioplasty (both arms)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
General Inclusion Criteria: Subject's age ≥ 18 years. Subject is an acceptable candidate for percutaneous intervention with the Sponsor's OAS and BA in accordance with their labeled indications and instructions for use. Subject is willing and able to sign an approved informed consent form (ICF). Subject is willing and able to attend follow-up and wound care visits. General Exclusion Criteria: Subject is pregnant or planning to become pregnant within the study period. Subject is currently participating in an investigational drug or other device study that can clinically interfere with the endpoints of this trial. Subject has a known sensitivity to contrast media and the sensitivity cannot be adequately pre-medicated. Uncontrolled allergy to nitinol, stainless steel, or other stent materials. Subject has known allergy to atherectomy lubricant components such as soybean oil, egg yolk phospholipids, glycerin or sodium hydroxide. Subject has a history of bleeding diathesis or coagulopathy or will refuse blood transfusions. Subject has been diagnosed with chronic renal failure or has a creatinine level > 2.5, unless on dialysis, prior to the index treatment. Subject has evidence of intracranial or gastrointestinal bleeding within 90 days. Subject has a history of trauma, fracture, major surgery (includes major amputation), or biopsy of a parenchymal organ within past 14 days, or patient has not healed from a previous medical intervention occurring more than 14 days. Subject has a history of stroke or myocardial infarction (MI) within 90 days prior to enrollment in the study. Subject has a planned major surgery (includes major amputation) scheduled within 60 days after treatment of the index limb. Subject has a planned interventional treatment to address stenosis of the contralateral limb scheduled within 60 days after the index treatment. Subject has a planned interventional treatment to address inflow stenosis of the ipsilateral limb scheduled within 60 days after the index treatment. Inflow or bilateral PAD requiring treatment prior to enrollment was not successfully treated, defined as > 50% residual stenosis and/or occurrence of procedural angiographic complications, excluding dissection types A and B. Subject has previously had their other limb treated as part of the study. Angiographic Inclusion Criteria: Target lesion(s) located in the anterior tibial (AT), posterior tibial (PT), tibial peroneal trunk (TPT) or peroneal (PR) arteries. Target lesion has ≥ 50 % stenosis by angiography. Subject has a corresponding wound being fed by the target vessel. Angiographic Exclusion Criteria: Target limb does not have any visual flow to the foot confirmed via distal selective angiography. Thrombus is present or suspected in the target treatment vessel. Target lesion is within a bypass graft or near a previously placed stent. The guide wire cannot be passed across the target lesion. Anterograde access of the lesion is not possible. Subject has angiographic evidence of significant dissection at or near the treatment site. Interventional treatment is intended for in-stent restenosis at the peripheral vascular site. Subject's wound(s) involve multiple angiosomes.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Raymond Dattilo, M.D.
Organizational Affiliation
St. Francis Heart and Vascular Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Arkansas Heart Clinic
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72211
Country
United States
Facility Name
Northside Hospital
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30342
Country
United States
Facility Name
Midwest Cardiovascular Research Foundation
City
Davenport
State/Province
Iowa
ZIP/Postal Code
52803
Country
United States
Facility Name
St. John Hospital and Medical Center
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48236
Country
United States
Facility Name
Holy Name Medical Center
City
Teaneck
State/Province
New Jersey
ZIP/Postal Code
07666
Country
United States
Facility Name
Rex Hospital
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27607
Country
United States
Facility Name
Mission Research Institute
City
New Braunfels
State/Province
Texas
ZIP/Postal Code
78130
Country
United States
Facility Name
Sentara Vascular Specialists
City
Norfolk
State/Province
Virginia
ZIP/Postal Code
23507
Country
United States

12. IPD Sharing Statement

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Complete Lesion Assessment With ffR and IVUS TechnologY

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