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Trial of Pantheris System, an Atherectomy Device That Provides Imaging While Removing Plaque in Lower Extremity Arteries (COMBINE-II)

Primary Purpose

Peripheral Arterial Disease

Status
Withdrawn
Phase
Not Applicable
Locations
New Zealand
Study Type
Interventional
Intervention
Pantheris Atherectomy System
Sponsored by
Avinger, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peripheral Arterial Disease focused on measuring Peripheral Arterial Disease, Atherectomy, Optical Coherence Tomography

Eligibility Criteria

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

Inclusion Criteria:

  1. Age ≥ 18 years old.
  2. Patient is a candidate for percutaneous intervention for peripheral vascular disease in the legs.
  3. Patient is willing and able to give informed consent
  4. Documented symptomatic atherosclerotic peripheral vascular disease Rutherford Classification 2-5.
  5. Reference vessel lumen proximal to target lesion >3.0 mm in diameter by visual estimation.
  6. Subject has de novo target lesion(s) with stenosis >70% by visual estimation distal to the profunda femoral artery. No more than 2 lesions may be treated with the Pantheris device.
  7. Target lesion length <10 cm if target lesion >70% and <99% stenosed. If target lesion a chronic total occlusion (99-100% stenosed), target lesion length <4 cm.
  8. Patient is capable of meeting requirements and be present at the follow-up clinic visits at 30 days.
  9. At least one patent tibial run-off vessel at baseline. -

Exclusion Criteria:

  1. Subject is pregnant or breast feeding.
  2. Rutherford Class 0 to 1 (asymptomatic and mild claudication).
  3. Rutherford Class 6 (critical limb ischemia).
  4. Severe calcification of the target lesion.
  5. Target lesion with any type of stent or graft.
  6. Target lesion in the iliac artery.
  7. Target lesion stenosis <70%.
  8. Subjects with significant (>70%) occlusive lesions proximal to the target lesion not successfully treated during the index procedure (upstream disease) and prior to treatment of the target lesion.
  9. Endovascular or surgical procedure performed on the index limb less than or equal to 30 days prior to the index procedure.
  10. Planned endovascular or surgical procedure 30 days after the index procedure.
  11. Lesion in the contralateral limb requiring intervention during the index procedure or within 30 days of the index procedure.
  12. Subjects with active infections whether they are being currently treated or not.
  13. Hemodialysis or GFR <30 mL/min or creatinine level >2.5mg/dL.
  14. Evidence or history of intracranial or gastrointestinal bleeding, intracranial aneurysm, myocardial infarction or stroke within the past 2 months.
  15. Evidence or history of aneurysmal target vessel within the past 2 months.
  16. History of severe trauma, fracture, major surgery or biopsy of a parenchymal organ within the past 14 days.
  17. Known allergy to contrast agents or medications used to perform endovascular intervention that cannot be adequately pre-treated.
  18. Subjects in whom anti-platelet, anticoagulant, or thrombolytic therapy is contraindicated.
  19. History of heparin-induced thrombocytopenia (HIT).
  20. Uncorrectable bleeding diathesis, platelet dysfunction, thrombocytopenia with platelet count less than 125,000/mm2 , known coagulopathy, or INR >1.5.
  21. Any thrombolytic therapy within 2 weeks of the index procedure.
  22. Any clinical and/or angiographic complication attributed to the use of another device prior to the insertion of the Pantheris into the subject.
  23. Subjects or their legal guardians who have not or will not sign the Informed Consent.
  24. Subjects who are unwilling or unable to comply with the follow-up study requirements.
  25. Participation in any study of an investigational device, medication, biologic or other agent within 30 days prior to enrollment that is either a cardiovascular study or could, in the judgment of the investigator, affect the results of the study.

Sites / Locations

  • Auckland City Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Primary Cohort

Arm Description

Main cohort; treatment Arm with Pantheris Atherectomy System

Outcomes

Primary Outcome Measures

Primary Safety Endpoint
The primary safety endpoint is defined as freedom from major adverse events (MAE) through 30 day follow-up: Clinically driven target lesion revascularization (TLR) Myocardial infarction (MI) Cardiovascular related deaths Unplanned, major index limb amputation Device Related Events: Clinically Significant Perforations Clinically Significant Dissections Clinically Significant Embolus Pseudoaneurysm
Primary Effectiveness Endpoint
The primary efficacy endpoint of technical success is defined as the percent of target lesions that has a residual diameter stenosis <50% post the Pantheris device alone as assessed by an independent review at the time of treatment using quantitative angiography or visual estimate.

Secondary Outcome Measures

Secondary Safety Endpoint
Freedom from procedural emboli, defined as a new occlusion of any visualized runoff vessel which cannot be reversed with an intravascular vasodilator.
Secondary Effectiveness Endpoint
Procedural success defined as the percent of target lesions that have residual diameter stenosis < 30% post-Pantheris and any other adjunctive therapy.
Secondary Effectiveness Endpoint
Ankle-Brachial Index at 30 days
Secondary Effectiveness Endpoint
Rutherford Classification at 30 days.

Full Information

First Posted
April 28, 2014
Last Updated
December 15, 2015
Sponsor
Avinger, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02126540
Brief Title
Trial of Pantheris System, an Atherectomy Device That Provides Imaging While Removing Plaque in Lower Extremity Arteries
Acronym
COMBINE-II
Official Title
A Non-randomized, Multi-center Feasibility Trial of the Avinger Pantheris System, an Atherectomy Device That Provides Directional Visualization and Imaging While Removing Plaque in Diseased Lower Extremity Arteries
Study Type
Interventional

2. Study Status

Record Verification Date
December 2015
Overall Recruitment Status
Withdrawn
Study Start Date
September 2015 (undefined)
Primary Completion Date
January 2016 (Anticipated)
Study Completion Date
July 2016 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Avinger, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To evaluate the safety and effectiveness of the Pantheris System to perform atherectomy while using directional visualization and imaging as an adjunct to fluoroscopy to aid removal of plaque from diseased lower extremity arteries.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peripheral Arterial Disease
Keywords
Peripheral Arterial Disease, Atherectomy, Optical Coherence Tomography

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Primary Cohort
Arm Type
Experimental
Arm Description
Main cohort; treatment Arm with Pantheris Atherectomy System
Intervention Type
Device
Intervention Name(s)
Pantheris Atherectomy System
Other Intervention Name(s)
Pantheris
Intervention Description
Treatment device in primary cohort arm; OCT image guided directional atherectomy
Primary Outcome Measure Information:
Title
Primary Safety Endpoint
Description
The primary safety endpoint is defined as freedom from major adverse events (MAE) through 30 day follow-up: Clinically driven target lesion revascularization (TLR) Myocardial infarction (MI) Cardiovascular related deaths Unplanned, major index limb amputation Device Related Events: Clinically Significant Perforations Clinically Significant Dissections Clinically Significant Embolus Pseudoaneurysm
Time Frame
Day 0 through Day 30
Title
Primary Effectiveness Endpoint
Description
The primary efficacy endpoint of technical success is defined as the percent of target lesions that has a residual diameter stenosis <50% post the Pantheris device alone as assessed by an independent review at the time of treatment using quantitative angiography or visual estimate.
Time Frame
Day 0
Secondary Outcome Measure Information:
Title
Secondary Safety Endpoint
Description
Freedom from procedural emboli, defined as a new occlusion of any visualized runoff vessel which cannot be reversed with an intravascular vasodilator.
Time Frame
Day 0
Title
Secondary Effectiveness Endpoint
Description
Procedural success defined as the percent of target lesions that have residual diameter stenosis < 30% post-Pantheris and any other adjunctive therapy.
Time Frame
Day 0
Title
Secondary Effectiveness Endpoint
Description
Ankle-Brachial Index at 30 days
Time Frame
Day 30
Title
Secondary Effectiveness Endpoint
Description
Rutherford Classification at 30 days.
Time Frame
Day 30

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 years old. Patient is a candidate for percutaneous intervention for peripheral vascular disease in the legs. Patient is willing and able to give informed consent Documented symptomatic atherosclerotic peripheral vascular disease Rutherford Classification 2-5. Reference vessel lumen proximal to target lesion >3.0 mm in diameter by visual estimation. Subject has de novo target lesion(s) with stenosis >70% by visual estimation distal to the profunda femoral artery. No more than 2 lesions may be treated with the Pantheris device. Target lesion length <10 cm if target lesion >70% and <99% stenosed. If target lesion a chronic total occlusion (99-100% stenosed), target lesion length <4 cm. Patient is capable of meeting requirements and be present at the follow-up clinic visits at 30 days. At least one patent tibial run-off vessel at baseline. - Exclusion Criteria: Subject is pregnant or breast feeding. Rutherford Class 0 to 1 (asymptomatic and mild claudication). Rutherford Class 6 (critical limb ischemia). Severe calcification of the target lesion. Target lesion with any type of stent or graft. Target lesion in the iliac artery. Target lesion stenosis <70%. Subjects with significant (>70%) occlusive lesions proximal to the target lesion not successfully treated during the index procedure (upstream disease) and prior to treatment of the target lesion. Endovascular or surgical procedure performed on the index limb less than or equal to 30 days prior to the index procedure. Planned endovascular or surgical procedure 30 days after the index procedure. Lesion in the contralateral limb requiring intervention during the index procedure or within 30 days of the index procedure. Subjects with active infections whether they are being currently treated or not. Hemodialysis or GFR <30 mL/min or creatinine level >2.5mg/dL. Evidence or history of intracranial or gastrointestinal bleeding, intracranial aneurysm, myocardial infarction or stroke within the past 2 months. Evidence or history of aneurysmal target vessel within the past 2 months. History of severe trauma, fracture, major surgery or biopsy of a parenchymal organ within the past 14 days. Known allergy to contrast agents or medications used to perform endovascular intervention that cannot be adequately pre-treated. Subjects in whom anti-platelet, anticoagulant, or thrombolytic therapy is contraindicated. History of heparin-induced thrombocytopenia (HIT). Uncorrectable bleeding diathesis, platelet dysfunction, thrombocytopenia with platelet count less than 125,000/mm2 , known coagulopathy, or INR >1.5. Any thrombolytic therapy within 2 weeks of the index procedure. Any clinical and/or angiographic complication attributed to the use of another device prior to the insertion of the Pantheris into the subject. Subjects or their legal guardians who have not or will not sign the Informed Consent. Subjects who are unwilling or unable to comply with the follow-up study requirements. Participation in any study of an investigational device, medication, biologic or other agent within 30 days prior to enrollment that is either a cardiovascular study or could, in the judgment of the investigator, affect the results of the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Andreq Holden, MD
Organizational Affiliation
Auckland City Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Auckland City Hospital
City
Auckland
ZIP/Postal Code
1023
Country
New Zealand

12. IPD Sharing Statement

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Trial of Pantheris System, an Atherectomy Device That Provides Imaging While Removing Plaque in Lower Extremity Arteries

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