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First-in-man Evaluation of a Novel, Microcrystalline Paclitaxel Coated Balloon for Treatment of Femoropopliteal Artery Disease (PAX-r) (PAX)

Primary Purpose

Peripheral Artery Disease, Femoropopliteal Artery Disease

Status
Completed
Phase
Not Applicable
Locations
Poland
Study Type
Interventional
Intervention
Local drug delivery via microcrystalline paclitaxel balloon coating (PAK,Balton, Poland)
Plain balloon angioplasty, uncoated balloon (Neptun, Balton, Poland)
Sponsored by
Balton Sp.zo.o.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peripheral Artery Disease focused on measuring paclitaxel coated balloon, restenosis, Femoropopliteal artery disease

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age > 18 y.o.
  • Claudication in Rutherford Class 1-5,
  • Lesion in the femoropopliteal artery defined as >50% and < 99% diameter stenosis with length of up to 10 cm in vessel diameter of 3-7 mm
  • Chronic total occlusions of length less than 100 mm
  • Ability to cross the lesions with a guidewire.

Exclusion Criteria:

  • Critical acute or chronic limb ischemia
  • Acute coronary syndrome
  • Chronic kidney disease stage III-V
  • Restenotic lesion
  • Femoropopliteal graft
  • Known allergy to clopidogrel or aspirin
  • History of stroke within past 6 months
  • Age > 80 y.o.
  • Life expectancy < 2 years

Sites / Locations

  • Lesser-Poland Cardiovascular Center of American Heart of Poland

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Plain Balloon Angioplasty

microcrystalline Paclitaxel Coated Balloon (PAK)

Arm Description

Plain Balloon Angioplasty

plain balloon angioplasty followed by mcPCB dilation

Outcomes

Primary Outcome Measures

Angiographic late lumen loss

Secondary Outcome Measures

Safety - Device related adverse events
Critical limb ischemia
Device Success
Successful delivery and deployment of the first inserted study device (in overlapping setting a successful delivery and deployment of the first and second study device) at the intended target lesion and successful withdrawal of the study device with attainment of final residual stenosis of less than 30% of the target lesion by quantitative vessel angiography (QVA).
Target Lesion Revascularization
Target vessel revascularization
Primary patency of treated segment
Treated limb amputation

Full Information

First Posted
May 20, 2014
Last Updated
August 6, 2018
Sponsor
Balton Sp.zo.o.
Collaborators
American Heart of Poland
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1. Study Identification

Unique Protocol Identification Number
NCT02145065
Brief Title
First-in-man Evaluation of a Novel, Microcrystalline Paclitaxel Coated Balloon for Treatment of Femoropopliteal Artery Disease (PAX-r)
Acronym
PAX
Official Title
Prospective, Pivotal, First - in Man Clinical Trial of the Safety and Efficacy of a Novel Microcrystalline Paclitaxel Coated Balloon for Treatment of Femoropopliteal Artery Disease
Study Type
Interventional

2. Study Status

Record Verification Date
August 2018
Overall Recruitment Status
Completed
Study Start Date
September 2014 (undefined)
Primary Completion Date
September 2017 (Actual)
Study Completion Date
October 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Balton Sp.zo.o.
Collaborators
American Heart of Poland

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this pivotal, first in man study will be to evaluate safety and efficacy of the novel, microcrystalline paclitaxel coated balloon (mcPCB, PAK, Balton) in the treatment of femoropopliteal artery disease.
Detailed Description
Although clinically effective, the manufacturing process of first generation PCB coatings contributed to inconsistent drug concentrations, particulate formations on the balloon surface and their shedding during the interventional procedures. As a consequence developments of new PCB coatings have been proposed to address consistency, uniformity, small particle drug coverage, which may potentially contribute to improved vessel healing profile and improved clinical outcomes. Nevertheless, data on the safety and efficacy of this novel coating developments in the clinical setting remain limited. Previously in the experimental model, the investigators reported that delivery of paclitaxel via a novel mcPCB resulted in low long-term tissue retention of paclitaxel, however displayed reduced neointimal proliferation and favorable healing profile. Therefore in current clinical trial the investigators will address the feasibility and safety of the mcPCB (PAK, Balton) in the treatment of femoropopliteal restenotic disease in a prospective, randomized manner when compared to plain balloon angioplasty (PBA). The efficacy analysis will be observational and evaluated post-hoc, with no prespecified criteria.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peripheral Artery Disease, Femoropopliteal Artery Disease
Keywords
paclitaxel coated balloon, restenosis, Femoropopliteal artery disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
66 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Plain Balloon Angioplasty
Arm Type
Active Comparator
Arm Description
Plain Balloon Angioplasty
Arm Title
microcrystalline Paclitaxel Coated Balloon (PAK)
Arm Type
Experimental
Arm Description
plain balloon angioplasty followed by mcPCB dilation
Intervention Type
Drug
Intervention Name(s)
Local drug delivery via microcrystalline paclitaxel balloon coating (PAK,Balton, Poland)
Intervention Type
Device
Intervention Name(s)
Plain balloon angioplasty, uncoated balloon (Neptun, Balton, Poland)
Primary Outcome Measure Information:
Title
Angiographic late lumen loss
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Safety - Device related adverse events
Time Frame
30 days, 6 months
Title
Critical limb ischemia
Time Frame
30 days, 6 months
Title
Device Success
Description
Successful delivery and deployment of the first inserted study device (in overlapping setting a successful delivery and deployment of the first and second study device) at the intended target lesion and successful withdrawal of the study device with attainment of final residual stenosis of less than 30% of the target lesion by quantitative vessel angiography (QVA).
Time Frame
at procedure
Title
Target Lesion Revascularization
Time Frame
6, 12, 24 months
Title
Target vessel revascularization
Time Frame
6, 12, 24 months
Title
Primary patency of treated segment
Time Frame
6, 12, 24 months
Title
Treated limb amputation
Time Frame
30 days, 6 months
Other Pre-specified Outcome Measures:
Title
Change in ankle-brachial index
Time Frame
pre-procedure, 3,6 and 12 months
Title
Change in Walking Impairment Questionnaire (WIQ)
Time Frame
pre procedure, 3, 6 and 12 months
Title
Flow velocity in doppler ultrasonography
Time Frame
3, 6 and 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age > 18 y.o. Claudication in Rutherford Class 1-5, Lesion in the femoropopliteal artery defined as >50% and < 99% diameter stenosis with length of up to 10 cm in vessel diameter of 3-7 mm Chronic total occlusions of length less than 100 mm Ability to cross the lesions with a guidewire. Exclusion Criteria: Critical acute or chronic limb ischemia Acute coronary syndrome Chronic kidney disease stage III-V Restenotic lesion Femoropopliteal graft Known allergy to clopidogrel or aspirin History of stroke within past 6 months Age > 80 y.o. Life expectancy < 2 years
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Przemysław Nowakowski, M.D., PhD
Organizational Affiliation
American Heart of Poland, Katowice, Poland
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Piotr P Buszman, M.D., PhD
Organizational Affiliation
American Heart of Poland, Katowice, Poland
Official's Role
Principal Investigator
Facility Information:
Facility Name
Lesser-Poland Cardiovascular Center of American Heart of Poland
City
Chrzanów
ZIP/Postal Code
32-500
Country
Poland

12. IPD Sharing Statement

Citations:
PubMed Identifier
23703720
Citation
Buszman PP, Milewski K, Zurakowski A, Pajak J, Jelonek M, Gasior P, Peppas A, Tellez A, Granada JF, Buszman PE. Experimental evaluation of pharmacokinetic profile and biological effect of a novel paclitaxel microcrystalline balloon coating in the iliofemoral territory of swine. Catheter Cardiovasc Interv. 2014 Feb;83(2):325-33. doi: 10.1002/ccd.24982. Epub 2013 Oct 23.
Results Reference
background
PubMed Identifier
18272892
Citation
Tepe G, Zeller T, Albrecht T, Heller S, Schwarzwalder U, Beregi JP, Claussen CD, Oldenburg A, Scheller B, Speck U. Local delivery of paclitaxel to inhibit restenosis during angioplasty of the leg. N Engl J Med. 2008 Feb 14;358(7):689-99. doi: 10.1056/NEJMoa0706356.
Results Reference
background
PubMed Identifier
18779447
Citation
Werk M, Langner S, Reinkensmeier B, Boettcher HF, Tepe G, Dietz U, Hosten N, Hamm B, Speck U, Ricke J. Inhibition of restenosis in femoropopliteal arteries: paclitaxel-coated versus uncoated balloon: femoral paclitaxel randomized pilot trial. Circulation. 2008 Sep 23;118(13):1358-65. doi: 10.1161/CIRCULATIONAHA.107.735985. Epub 2008 Sep 8. Erratum In: Circulation. 2008 Oct 14;118(16):e670.
Results Reference
background
PubMed Identifier
17101615
Citation
Scheller B, Hehrlein C, Bocksch W, Rutsch W, Haghi D, Dietz U, Bohm M, Speck U. Treatment of coronary in-stent restenosis with a paclitaxel-coated balloon catheter. N Engl J Med. 2006 Nov 16;355(20):2113-24. doi: 10.1056/NEJMoa061254. Epub 2006 Nov 13.
Results Reference
background
PubMed Identifier
24456716
Citation
Scheinert D, Duda S, Zeller T, Krankenberg H, Ricke J, Bosiers M, Tepe G, Naisbitt S, Rosenfield K. The LEVANT I (Lutonix paclitaxel-coated balloon for the prevention of femoropopliteal restenosis) trial for femoropopliteal revascularization: first-in-human randomized trial of low-dose drug-coated balloon versus uncoated balloon angioplasty. JACC Cardiovasc Interv. 2014 Jan;7(1):10-9. doi: 10.1016/j.jcin.2013.05.022.
Results Reference
background
PubMed Identifier
33686879
Citation
Nowakowski P, Uchto W, Hrycek E, Kachel M, Ludyga T, Polczyk F, Zurakowski A, Kazmierczak P, Granada JF, Nowakowska I, Kiesz RS, Milewski KP, Buszman PE, Buszman PP. Microcrystalline paclitaxel-coated balloon for revascularization of femoropopliteal artery disease: Three-year outcomes of the randomized BIOPAC trial. Vasc Med. 2021 Aug;26(4):401-408. doi: 10.1177/1358863X20988360. Epub 2021 Mar 9.
Results Reference
derived

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First-in-man Evaluation of a Novel, Microcrystalline Paclitaxel Coated Balloon for Treatment of Femoropopliteal Artery Disease (PAX-r)

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