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The ABSORB Bioresorbable Scaffold Below the Knee (BTK) Study

Primary Purpose

Ischemia, Peripheral Arterial Disease (PTA, Arterial Occlusive Diseases

Status
Terminated
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Absorb Bioresorbable Vascular Scaffold
Sponsored by
The University of New South Wales
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ischemia focused on measuring angioplasty, stents, polymers, absorbable implants

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Stenotic (> 50%) or occlusive atherosclerotic disease of the distal popliteal or infrapopliteal arteries
  • A maximum of two focal target lesions in one or more distal popliteal or infrapopliteal vessels
  • Length of lesion is maximally 55 mm, allowing maximally 2 stents to be implanted
  • Reference vessel diameter should be 2.5 mm-4 mm
  • Symptomatic critical limb ischemia (Rutherford 3, 4, 5)
  • Subject is able to take at least one type of thienopyridine (e.g. clopidogrel) and acetylsalicylic acid
  • The patient must be > 18 years of age
  • Life-expectancy of more than 12 months
  • The patient has no child bearing potential or negative serum pregnancy test within 7 days of the index procedure
  • The patient must be willing and able to return to the appropriate follow-up times for the duration of the study
  • The patient must provide written patient informed consent that is approved by the ethics committee

Exclusion Criteria:

  • Patient refusing treatment
  • The reference segment diameter is not suitable for available stent design.
  • Unsuccessfully treated (>30% residual stenosis) proximal inflow limiting arterial stenosis
  • Untreatable lesion located at the distal outflow arteries
  • More than two infrapopliteal lesions in the same limb
  • Previously implanted stent(s) or PTA at the same lesion site
  • Lesion location requiring kissing stent procedure
  • Lesion lies within or adjacent to an aneurysm
  • Inflow-limiting arterial lesions left untreated
  • The patient has a known allergy to heparin, Aspirin or other anticoagulant/anti-platelet therapies or a bleeding diatheses or is unable, or unwilling, to tolerate such therapies.
  • The patient takes Phenprocoumon (Marcumar).
  • The patient has a history of prior life-threatening contrast media reaction.
  • The patient is currently enrolled in another investigational device or drug trial.
  • The patient is currently breast-feeding, pregnant or intends to become pregnant.
  • The patient is mentally ill or retarded.
  • Subject has received a heart transplant or any other organ transplant or is on a waiting list for any organ transplant
  • Subject is receiving or scheduled to receive anticancer therapy for malignancy within 30 days prior to or after the procedure
  • Subject is receiving immunosuppression therapy, or has known serious immunosuppressive disease (e.g., human immunodeficiency virus), or has severe autoimmune disease that requires chronic immunosuppressive therapy (e.g., systemic lupus erythematosus, etc.) The patient should also not receive inhibitors of CYP3A (such as Itraconazole, and Erythromycin), or inducers of CYP3A (Cytochrome P450 3A4) (such as Rifampin) within 90 days following the procedure.
  • Subject is receiving or is scheduled to receive chronic anticoagulation therapy (e.g., heparin, coumadin)
  • Use of alternative therapy (e.g. atherectomy, cutting balloon, laser, radiation therapy) as part of the index procedure

Sites / Locations

  • Prince of Wales Hospital
  • Epworth Hospital
  • Reinier de Graf Hospital
  • Auckland City Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Bioresorbable Vascular Scaffold

Arm Description

Absorb Bioresorbable Vascular Scaffold

Outcomes

Primary Outcome Measures

Angiographic patency
Freedom from angiographic binary in-scaffold restenosis (>50% stenosis)

Secondary Outcome Measures

Technical success
Technical success defined as the ability to cross and dilate the lesion to achieve residual angiographic stenosis no greater than 30% and residual stenosis less than 50% by duplex ultrasound (US) imaging.
Haemodynamic primary, assisted primary and secondary patency
Haemodynamic primary, assisted primary and secondary patency as assessed by ultrasound
Haemodynamic primary, assisted primary and secondary patency
Haemodynamic primary, assisted primary and secondary patency as assessed by ultrasound
Haemodynamic primary, assisted primary and secondary patency
Haemodynamic primary, assisted primary and secondary patency as assessed by ultrasound
Haemodynamic primary, assisted primary and secondary patency
Haemodynamic primary, assisted primary and secondary patency as assessed by ultrasound
Haemodynamic primary, assisted primary and secondary patency
Haemodynamic primary, assisted primary and secondary patency as assessed by ultrasound
Limb salvage rate (LSR)
Limb salvage defined as 1 minus major amputation rate (major amputation is defined as at or above ankle, as opposed to minor amputation being at or below metatarsus preserving functionality of foot)
Target lesion revascularization (TLR)
Target lesion revascularization (TLR) is defined as a repeat intervention to maintain or re-establish patency within the region of the treated arterial vessel plus 5 mm proximal and distal to the treated lesion edge
Rutherford Category
Clinical success defined as an improvement of Rutherford classification of one class or more as compared to the pre-procedure Rutherford classification
Adverse clinical events
Clinical events defined as fatal, life-threatening, or judged to be severe by the investigator; resulted in persistent or significant disability; necessitated surgical or percutaneous intervention; or required prolonged hospitalization

Full Information

First Posted
June 3, 2016
Last Updated
April 15, 2019
Sponsor
The University of New South Wales
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1. Study Identification

Unique Protocol Identification Number
NCT02793349
Brief Title
The ABSORB Bioresorbable Scaffold Below the Knee (BTK) Study
Official Title
ABSORB BTK Study: A Prospective, Multi-center, Controlled Clinical Evaluation of the Use of a Bioresorbable Drug Eluting Stent (Absorb, Abbott Vascular) in the Arterial Vasculature Below the Knee
Study Type
Interventional

2. Study Status

Record Verification Date
April 2019
Overall Recruitment Status
Terminated
Why Stopped
Company have withdrawn the product
Study Start Date
June 2015 (undefined)
Primary Completion Date
June 2017 (Actual)
Study Completion Date
June 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
The University of New South Wales

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
ABSORB BTK Study: A prospective, multicenter, controlled clinical evaluation of the use of a bioresorbable drug eluting stent in the arterial vasculature below the knee
Detailed Description
The aim of this study is to evaluate the performance of a bioresorbable vascular scaffold (BVS) coated with the drug Everolimus. This will be used to treat short length blockages of up to 55mm (5.5cm) in arteries below the knee. This will be performed to treat patients who have severe leg pain or have developed skin ulcers or gangrene which are not healing due to insufficent blood supply. The ABSORB Everolimus Eluting Bioresorbable Vascular Scaffold works on similar principles of drug eluting stents which have been used for a considerable time in treating blocked arteries. However this product consists of a scaffold coated with a drug so rather than leaving a metallic stent in the blood vessel, this product primarily delivers the drug, gives mechanical support to the blood vessel and once it is no longer needed the scaffold absorbs into the body leaving no permanent metallic implant. This same device has been used safely and effectively in the arteries which supply the heart both in clinical trials and current practice and has also been evaluated in the leg arteries in a single-centre pilot study. This study aims to evaluate it's use in a larger number of patients in multiple centres and compare that to a historical control group of metal drug eluting stents. The study will evaluate both ultrasound and angiographic derived patency in those arteries out to a 36 month follow-up time point. This data will be collected in patients who fulfill the inclusion criteria and who are then treated and followed over time.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ischemia, Peripheral Arterial Disease (PTA, Arterial Occlusive Diseases
Keywords
angioplasty, stents, polymers, absorbable implants

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Bioresorbable Vascular Scaffold
Arm Type
Experimental
Arm Description
Absorb Bioresorbable Vascular Scaffold
Intervention Type
Device
Intervention Name(s)
Absorb Bioresorbable Vascular Scaffold
Other Intervention Name(s)
BVS
Intervention Description
Absorb Bioresorbable Vascular Scaffold
Primary Outcome Measure Information:
Title
Angiographic patency
Description
Freedom from angiographic binary in-scaffold restenosis (>50% stenosis)
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Technical success
Description
Technical success defined as the ability to cross and dilate the lesion to achieve residual angiographic stenosis no greater than 30% and residual stenosis less than 50% by duplex ultrasound (US) imaging.
Time Frame
Procedure
Title
Haemodynamic primary, assisted primary and secondary patency
Description
Haemodynamic primary, assisted primary and secondary patency as assessed by ultrasound
Time Frame
1 month
Title
Haemodynamic primary, assisted primary and secondary patency
Description
Haemodynamic primary, assisted primary and secondary patency as assessed by ultrasound
Time Frame
6 months
Title
Haemodynamic primary, assisted primary and secondary patency
Description
Haemodynamic primary, assisted primary and secondary patency as assessed by ultrasound
Time Frame
12 months
Title
Haemodynamic primary, assisted primary and secondary patency
Description
Haemodynamic primary, assisted primary and secondary patency as assessed by ultrasound
Time Frame
24 months
Title
Haemodynamic primary, assisted primary and secondary patency
Description
Haemodynamic primary, assisted primary and secondary patency as assessed by ultrasound
Time Frame
36 months
Title
Limb salvage rate (LSR)
Description
Limb salvage defined as 1 minus major amputation rate (major amputation is defined as at or above ankle, as opposed to minor amputation being at or below metatarsus preserving functionality of foot)
Time Frame
12 months
Title
Target lesion revascularization (TLR)
Description
Target lesion revascularization (TLR) is defined as a repeat intervention to maintain or re-establish patency within the region of the treated arterial vessel plus 5 mm proximal and distal to the treated lesion edge
Time Frame
12 months
Title
Rutherford Category
Description
Clinical success defined as an improvement of Rutherford classification of one class or more as compared to the pre-procedure Rutherford classification
Time Frame
12 months
Title
Adverse clinical events
Description
Clinical events defined as fatal, life-threatening, or judged to be severe by the investigator; resulted in persistent or significant disability; necessitated surgical or percutaneous intervention; or required prolonged hospitalization
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Stenotic (> 50%) or occlusive atherosclerotic disease of the distal popliteal or infrapopliteal arteries A maximum of two focal target lesions in one or more distal popliteal or infrapopliteal vessels Length of lesion is maximally 55 mm, allowing maximally 2 stents to be implanted Reference vessel diameter should be 2.5 mm-4 mm Symptomatic critical limb ischemia (Rutherford 3, 4, 5) Subject is able to take at least one type of thienopyridine (e.g. clopidogrel) and acetylsalicylic acid The patient must be > 18 years of age Life-expectancy of more than 12 months The patient has no child bearing potential or negative serum pregnancy test within 7 days of the index procedure The patient must be willing and able to return to the appropriate follow-up times for the duration of the study The patient must provide written patient informed consent that is approved by the ethics committee Exclusion Criteria: Patient refusing treatment The reference segment diameter is not suitable for available stent design. Unsuccessfully treated (>30% residual stenosis) proximal inflow limiting arterial stenosis Untreatable lesion located at the distal outflow arteries More than two infrapopliteal lesions in the same limb Previously implanted stent(s) or PTA at the same lesion site Lesion location requiring kissing stent procedure Lesion lies within or adjacent to an aneurysm Inflow-limiting arterial lesions left untreated The patient has a known allergy to heparin, Aspirin or other anticoagulant/anti-platelet therapies or a bleeding diatheses or is unable, or unwilling, to tolerate such therapies. The patient takes Phenprocoumon (Marcumar). The patient has a history of prior life-threatening contrast media reaction. The patient is currently enrolled in another investigational device or drug trial. The patient is currently breast-feeding, pregnant or intends to become pregnant. The patient is mentally ill or retarded. Subject has received a heart transplant or any other organ transplant or is on a waiting list for any organ transplant Subject is receiving or scheduled to receive anticancer therapy for malignancy within 30 days prior to or after the procedure Subject is receiving immunosuppression therapy, or has known serious immunosuppressive disease (e.g., human immunodeficiency virus), or has severe autoimmune disease that requires chronic immunosuppressive therapy (e.g., systemic lupus erythematosus, etc.) The patient should also not receive inhibitors of CYP3A (such as Itraconazole, and Erythromycin), or inducers of CYP3A (Cytochrome P450 3A4) (such as Rifampin) within 90 days following the procedure. Subject is receiving or is scheduled to receive chronic anticoagulation therapy (e.g., heparin, coumadin) Use of alternative therapy (e.g. atherectomy, cutting balloon, laser, radiation therapy) as part of the index procedure
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ramon L Varcoe, MS,FRACS,PhD
Organizational Affiliation
Prince of Wales Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Prince of Wales Hospital
City
Sydney
State/Province
New South Wales
ZIP/Postal Code
2031
Country
Australia
Facility Name
Epworth Hospital
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3121
Country
Australia
Facility Name
Reinier de Graf Hospital
City
Delft
ZIP/Postal Code
2625AD
Country
Netherlands
Facility Name
Auckland City Hospital
City
Auckland
Country
New Zealand

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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The ABSORB Bioresorbable Scaffold Below the Knee (BTK) Study

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