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The OPC for Optimal Delivery of Paclitaxel for the Prevention of Endovascular Restenosis - Above and Below the Knee (COPPER-A)

Primary Purpose

Peripheral Arterial Disease, Cardiovascular Disease, Peripheral Vascular Disease

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Paclitaxel administration using the OPC
Sponsored by
Horizons International Peripheral Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peripheral Arterial Disease focused on measuring PAD, COPPER-A, Peripheral Arterial Disease, OPC, Occlusion Perfusion Catheter, Paclitaxel, Pressana, Precision Delivery System

Eligibility Criteria

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

General Inclusion Criteria:

  • Willing and able to provide informed consent and comply with all study requirements;
  • Candidate for peripheral vascular femoropopliteal or infrapopliteal percutaneous intervention;
  • Must be ≥ 18 years of age;
  • Rutherford category 2, 3, 4, or 5;
  • Willing and able to tolerate dual anti-platelet therapy (DAPT) for a minimum of one (1) month;
  • Lab work within acceptable limits according to standard of care;
  • INR < 2.0 if on warfarin or not on warfarin;
  • Minimum sheath size used for the interventional procedure

    • 7x8 OPC Catheter - 7FR.
    • 3x15 OPC, 3x15 PRESSANA(TM), or 3x8 PRESSANA(TM) - 6FR.

General Exclusion Criteria:

  • Life expectancy < three (3) years;
  • Planned amputation prior to procedure;
  • Pregnancy or nursing (a pregnancy test is required for all women of childbearing capabilities ≤ 7 days prior to the index procedure);
  • Previous intervention of the target lesion with a drug eluting balloon or drug delivery catheter;
  • Any treatment in the target vessel with drug eluting balloon;
  • Acute limb ischemia
  • Known allergy to paclitaxel;
  • Known hypersensitivity to other drugs manufactured in Cremophor® EL (polyoxyethylated castor oil; e.g. Drugs containing polyoxyethylated castor oil are drugs such as miconazole, cyclosporine injection, nelfinavir mesylate, saperconazole, tacrolimus, and xenaderm ointment);
  • Known allergy to anticoagulants;
  • Known TRUE acetylsalicylic acid (ASA) allergy;
  • Use of glycoprotein (GP) IIb/IIIa inhibitors during the procedure visit within 30 days following the index procedure;
  • Target lesion treated with a cryoplasty balloon at the time of the index procedure;
  • Hemorrhagic stroke within six (6) months;
  • Renal failure or chronic kidney disease with GFR ≤30 mL/min or 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;
  • Current enrollment in another investigational device or drug study;
  • After obtaining informed consent, at any point up to introduction of the OPC, the investigator determines the study subject is not appropriate for the study.

Angiographic Inclusion Criteria:

  • Reference vessel diameter (RVD) ≥ 4 mm and ≤ 7 mm for femoropopliteal arteries or ≥ 2 mm and ≤ 4 mm for infrapopliteal arteries;
  • Either single or multiple lesions in the SFA and/or popliteal artery or single or multiple lesions in the infrapopliteal arteries (AT, PT, peroneal);
  • For single lesion treatment, minimum lesion length ≥ 20 mm;
  • Minimum of one patent infrapopliteal vessel;
  • Pre-intervention percent DS ≥ 70%.

Angiographic Exclusion Criteria:

  • Flow limiting dissection necessitating stent placement prior to OPC use;
  • Post PTA residual stenosis ≥ 30% as visualized by treating physician;
  • Perforation requiring a covered stent;
  • For femoropopliteal target lesion or occlusion location extends distally beyond the P2 region of the popliteal artery or infrapopliteal lesion or occlusion location is at or proximal to the origin of the trifurcation vessel or below the ankle (top of the talus bone);
  • Target lesion within a fractured stent;
  • Target lesion within a stent and restenosed two (2) or more times;
  • Significant (≥ 50% DS) inflow lesion or occlusion left untreated in the ipsilateral Iliac, SFA, or popliteal artery proximal to the target lesion;
  • A lesion treated distal to the target lesion results in compromising inline flow distal to the target lesion;
  • Visible thrombus in the target artery or proximal to the target artery.

Sites / Locations

  • Cardiology Associates
  • First Coast Cardiovascular Institute
  • Coastal Vascular and Interventional
  • Vascular Institute of the Midwest
  • Cardiovascular Institute of the South
  • Michigan Outpatient Vascular Institute
  • St. John Hospital
  • Mid-Michigan Heart & Vascular Center
  • Hattiesburg Clinic
  • Novant Health
  • Medical University of South Carolina
  • University Surgical Associates
  • Kore Cardiovascular Research
  • Huntsville Memorial Hospital
  • North Dallas Research Associates
  • Cardiovascular Associates of East Texas
  • Tyler Cardiovascular Consultants

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

OPC Treatment

Arm Description

Paclitaxel administration using the OPC for the prevention of restenosis in infrainguinal de novo and restenotic femoropopliteal lesions. Subjects will be treated with the endovascular intervention selected by the treating physician in reference vessels ranging from 4mm to 7mm in diameter. Following the achievement of optimal interventional results (less than thirty (30) percent residual stenosis without stenting) the OPC will be placed at the interventional treatment area and paclitaxel will be delivered to the treated segment. Data will be collected to assess acute safety, long-term safety and durability to demonstrate the safety and efficacy of paclitaxel delivered with the ACT, Inc. OPC device.

Outcomes

Primary Outcome Measures

Primary Patency
Femoropopliteal Lesions: Measured by duplex Doppler ultrasound (DUS) - demonstrated by Peak Systolic Velocity Ratio (PSVR) ≤ 2.5 and clinically free from Target Lesion Revascularization.
Primary Patency
Infrapopliteal Lesions: Measured by duplex Doppler ultrasound (DUS) - demonstrated by freedom from target lesion occlusion and clinically free from Target Lesion Revascularization.
Freedom from major adverse events (MAEs)
MAEs are defined as target limb related death, major amputation in the target limb (amputation above the metatarsals), or target lesion revascularization (TLR) within one (1) month.

Secondary Outcome Measures

Primary Patency
Femoropopliteal Lesions: Measured by duplex Doppler ultrasound (DUS) - demonstrated by Peak Systolic Velocity Ratio (PSVR) ≤ 2.5 and clinically free from Target Lesion Revascularization.
Primary Patency
Infrapopliteal Lesions: Measured by duplex Doppler ultrasound (DUS) - demonstrated by freedom from target lesion occlusion and clinically free from Target Lesion Revascularization.
Improvement in Rutherford category
Primary Assisted Patency
Patency of the target lesion following endovascular re-intervention of the target lesion due to symptomatic restenosis.
Secondary Patency
Measured by patency of the target lesion after treatment of a (re)occlusion of the index lesion during the follow-up period.
Freedom from target lesion revascularization (TLR)
Freedom from target vessel revascularization (TVR)
Improvement in Walking Impairment Questionnaire scores
Device Success
Defined as the ability to deliver paclitaxel to the interventional treatment length as intended.
Freedom from major adverse events (MAEs)
Anticipated adverse events

Full Information

First Posted
June 1, 2015
Last Updated
November 7, 2019
Sponsor
Horizons International Peripheral Group
Collaborators
Advanced Catheter Therapies, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02464501
Brief Title
The OPC for Optimal Delivery of Paclitaxel for the Prevention of Endovascular Restenosis - Above and Below the Knee
Acronym
COPPER-A
Official Title
The COPPER-A Trial: The Occlusion Perfusion Catheter for Optimal Delivery of Paclitaxel for the Prevention of Endovascular Restenosis - Above and Below the Knee
Study Type
Interventional

2. Study Status

Record Verification Date
November 2019
Overall Recruitment Status
Completed
Study Start Date
May 20, 2015 (Actual)
Primary Completion Date
September 2019 (Actual)
Study Completion Date
November 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Horizons International Peripheral Group
Collaborators
Advanced Catheter Therapies, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to assess the safety and efficacy of paclitaxel administration using the occlusion perfusion catheter (OPC) for the prevention of restenosis in infrainguinal de novo, restenotic femoropopliteal and infrapopliteal stenoses and occlusions, and in-stent restenosis.
Detailed Description
The purpose of this study is to assess the safety and efficacy of paclitaxel administration using the occlusion perfusion catheter (OPC) for the prevention of restenosis in infrainguinal de novo, restenotic femoropopliteal and infrapopliteal stenoses and occlusions, and in-stent restenosis. Subjects will be treated with the endovascular intervention selected by the treating physician in SFA reference vessels ranging from 4mm to 7mm in diameter and infrapopliteal vessels ranging from 2mm to 4mm. Following the achievement of optimal interventional results (less than thirty (30) percent residual stenosis without stenting) the OPC will be placed at the interventional treatment area and paclitaxel will be delivered to the treated segment. Data will be collected to assess acute safety, long-term safety and durability to demonstrate the safety and efficacy of paclitaxel delivered with the ACT, Inc. OPC device.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peripheral Arterial Disease, Cardiovascular Disease, Peripheral Vascular Disease
Keywords
PAD, COPPER-A, Peripheral Arterial Disease, OPC, Occlusion Perfusion Catheter, Paclitaxel, Pressana, Precision Delivery System

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
OPC Treatment
Arm Type
Experimental
Arm Description
Paclitaxel administration using the OPC for the prevention of restenosis in infrainguinal de novo and restenotic femoropopliteal lesions. Subjects will be treated with the endovascular intervention selected by the treating physician in reference vessels ranging from 4mm to 7mm in diameter. Following the achievement of optimal interventional results (less than thirty (30) percent residual stenosis without stenting) the OPC will be placed at the interventional treatment area and paclitaxel will be delivered to the treated segment. Data will be collected to assess acute safety, long-term safety and durability to demonstrate the safety and efficacy of paclitaxel delivered with the ACT, Inc. OPC device.
Intervention Type
Other
Intervention Name(s)
Paclitaxel administration using the OPC
Primary Outcome Measure Information:
Title
Primary Patency
Description
Femoropopliteal Lesions: Measured by duplex Doppler ultrasound (DUS) - demonstrated by Peak Systolic Velocity Ratio (PSVR) ≤ 2.5 and clinically free from Target Lesion Revascularization.
Time Frame
12 months
Title
Primary Patency
Description
Infrapopliteal Lesions: Measured by duplex Doppler ultrasound (DUS) - demonstrated by freedom from target lesion occlusion and clinically free from Target Lesion Revascularization.
Time Frame
6 months
Title
Freedom from major adverse events (MAEs)
Description
MAEs are defined as target limb related death, major amputation in the target limb (amputation above the metatarsals), or target lesion revascularization (TLR) within one (1) month.
Time Frame
1 month
Secondary Outcome Measure Information:
Title
Primary Patency
Description
Femoropopliteal Lesions: Measured by duplex Doppler ultrasound (DUS) - demonstrated by Peak Systolic Velocity Ratio (PSVR) ≤ 2.5 and clinically free from Target Lesion Revascularization.
Time Frame
6 months
Title
Primary Patency
Description
Infrapopliteal Lesions: Measured by duplex Doppler ultrasound (DUS) - demonstrated by freedom from target lesion occlusion and clinically free from Target Lesion Revascularization.
Time Frame
12 months
Title
Improvement in Rutherford category
Time Frame
3, 6, and 12 months
Title
Primary Assisted Patency
Description
Patency of the target lesion following endovascular re-intervention of the target lesion due to symptomatic restenosis.
Time Frame
1, 3, 6, and 12 months
Title
Secondary Patency
Description
Measured by patency of the target lesion after treatment of a (re)occlusion of the index lesion during the follow-up period.
Time Frame
1, 3, 6, and 12 months
Title
Freedom from target lesion revascularization (TLR)
Time Frame
1, 3, 6, and 12 months
Title
Freedom from target vessel revascularization (TVR)
Time Frame
1, 3, 6, and 12 months
Title
Improvement in Walking Impairment Questionnaire scores
Time Frame
6 and 12 months
Title
Device Success
Description
Defined as the ability to deliver paclitaxel to the interventional treatment length as intended.
Time Frame
Day 1 - Index Procedure
Title
Freedom from major adverse events (MAEs)
Time Frame
1, 3, 6, and 12 months
Title
Anticipated adverse events
Time Frame
1, 3, 6, and 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
General Inclusion Criteria: Willing and able to provide informed consent and comply with all study requirements; Candidate for peripheral vascular femoropopliteal or infrapopliteal percutaneous intervention; Must be ≥ 18 years of age; Rutherford category 2, 3, 4, or 5; Willing and able to tolerate dual anti-platelet therapy (DAPT) for a minimum of one (1) month; Lab work within acceptable limits according to standard of care; INR < 2.0 if on warfarin or not on warfarin; Minimum sheath size used for the interventional procedure 7x8 OPC Catheter - 7FR. 3x15 OPC, 3x15 PRESSANA(TM), or 3x8 PRESSANA(TM) - 6FR. General Exclusion Criteria: Life expectancy < three (3) years; Planned amputation prior to procedure; Pregnancy or nursing (a pregnancy test is required for all women of childbearing capabilities ≤ 7 days prior to the index procedure); Previous intervention of the target lesion with a drug eluting balloon or drug delivery catheter; Any treatment in the target vessel with drug eluting balloon; Acute limb ischemia Known allergy to paclitaxel; Known hypersensitivity to other drugs manufactured in Cremophor® EL (polyoxyethylated castor oil; e.g. Drugs containing polyoxyethylated castor oil are drugs such as miconazole, cyclosporine injection, nelfinavir mesylate, saperconazole, tacrolimus, and xenaderm ointment); Known allergy to anticoagulants; Known TRUE acetylsalicylic acid (ASA) allergy; Use of glycoprotein (GP) IIb/IIIa inhibitors during the procedure visit within 30 days following the index procedure; Target lesion treated with a cryoplasty balloon at the time of the index procedure; Hemorrhagic stroke within six (6) months; Renal failure or chronic kidney disease with GFR ≤30 mL/min or 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; Current enrollment in another investigational device or drug study; After obtaining informed consent, at any point up to introduction of the OPC, the investigator determines the study subject is not appropriate for the study. Angiographic Inclusion Criteria: Reference vessel diameter (RVD) ≥ 4 mm and ≤ 7 mm for femoropopliteal arteries or ≥ 2 mm and ≤ 4 mm for infrapopliteal arteries; Either single or multiple lesions in the SFA and/or popliteal artery or single or multiple lesions in the infrapopliteal arteries (AT, PT, peroneal); For single lesion treatment, minimum lesion length ≥ 20 mm; Minimum of one patent infrapopliteal vessel; Pre-intervention percent DS ≥ 70%. Angiographic Exclusion Criteria: Flow limiting dissection necessitating stent placement prior to OPC use; Post PTA residual stenosis ≥ 30% as visualized by treating physician; Perforation requiring a covered stent; For femoropopliteal target lesion or occlusion location extends distally beyond the P2 region of the popliteal artery or infrapopliteal lesion or occlusion location is at or proximal to the origin of the trifurcation vessel or below the ankle (top of the talus bone); Target lesion within a fractured stent; Target lesion within a stent and restenosed two (2) or more times; Significant (≥ 50% DS) inflow lesion or occlusion left untreated in the ipsilateral Iliac, SFA, or popliteal artery proximal to the target lesion; A lesion treated distal to the target lesion results in compromising inline flow distal to the target lesion; Visible thrombus in the target artery or proximal to the target artery.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Frank Bunch, MD, FACC
Organizational Affiliation
Cardiology Associates
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cardiology Associates
City
Fairhope
State/Province
Alabama
ZIP/Postal Code
36532
Country
United States
Facility Name
First Coast Cardiovascular Institute
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32256
Country
United States
Facility Name
Coastal Vascular and Interventional
City
Pensacola
State/Province
Florida
ZIP/Postal Code
32504
Country
United States
Facility Name
Vascular Institute of the Midwest
City
Davenport
State/Province
Iowa
ZIP/Postal Code
52807
Country
United States
Facility Name
Cardiovascular Institute of the South
City
Houma
State/Province
Louisiana
ZIP/Postal Code
70361
Country
United States
Facility Name
Michigan Outpatient Vascular Institute
City
Dearborn
State/Province
Michigan
ZIP/Postal Code
48124
Country
United States
Facility Name
St. John Hospital
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48236
Country
United States
Facility Name
Mid-Michigan Heart & Vascular Center
City
Saginaw
State/Province
Michigan
ZIP/Postal Code
48604
Country
United States
Facility Name
Hattiesburg Clinic
City
Hattiesburg
State/Province
Mississippi
ZIP/Postal Code
39401
Country
United States
Facility Name
Novant Health
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28204
Country
United States
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Facility Name
University Surgical Associates
City
Chattanooga
State/Province
Tennessee
ZIP/Postal Code
37403
Country
United States
Facility Name
Kore Cardiovascular Research
City
Jackson
State/Province
Tennessee
ZIP/Postal Code
38305
Country
United States
Facility Name
Huntsville Memorial Hospital
City
Huntsville
State/Province
Texas
ZIP/Postal Code
77340
Country
United States
Facility Name
North Dallas Research Associates
City
McKinney
State/Province
Texas
ZIP/Postal Code
75069
Country
United States
Facility Name
Cardiovascular Associates of East Texas
City
Tyler
State/Province
Texas
ZIP/Postal Code
75701
Country
United States
Facility Name
Tyler Cardiovascular Consultants
City
Tyler
State/Province
Texas
ZIP/Postal Code
75701
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

The OPC for Optimal Delivery of Paclitaxel for the Prevention of Endovascular Restenosis - Above and Below the Knee

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