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Safety and Feasibility of the Shockwave Lithoplasty® System for the Treatment of Peripheral Vascular Stenosis (BTK)

Primary Purpose

Peripheral Arterial Disease

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Shockwave Lithoplasty® System
Sponsored by
Shockwave Medical, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peripheral Arterial Disease

Eligibility Criteria

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

Inclusion Criteria:

  1. Subject is able and willing to comply with all assessments in the study.
  2. Subject or subject's legal representative have been informed of the nature of the study, agrees to participate and has signed the approved consent form.
  3. Age of subject is >18.
  4. Rutherford Clinical Category 1 - 5.

Angiographic Inclusion Criteria:

  1. Single or multiple target lesion(s) is/are located in a de novo artery distal to the trifurcation vessels and extends to and ends above the ankle
  2. Target vessel reference diameter is between 2.5mm and 3.5mm by visual estimate
  3. Target lesion with diameter stenosis ≥50% by investigator via visual estimate
  4. If inflow disease >50% proximal to the trifurcation vessels is present, and it can be treated with POBA, stent or Lithoplasty and without complications.
  5. Target lesion is ≤150mm in length
  6. Subject has at least one patent tibial vessel (>50%) with run-off to the foot.
  7. No evidence of aneurysm or acute thrombus in target vessel.
  8. Any presence of calcification within the target lesion as assessed by imaging (radiograph, CT or angiography).

Exclusion Criteria:

  1. Rutherford Clinical Category 6.
  2. Target lesion is within only lower extremity vessel with < 50% stenosis.
  3. Gangrene of the lower extremity.
  4. Planned major amputation of the target leg.
  5. Previously implanted stent in the treatment lesion
  6. Target lesion length exceeds 150mm.
  7. Patient has chronic total occlusion of target lesion.
  8. Patient has significant stenosis (>50% stenosis) or occlusion of inflow tract (e.g., iliac or common femoral) not successfully treated with POBA, stent or Lithoplasty and without complications.
  9. Patient in whom antiplatelet, anticoagulant, or thrombolytic therapy is contraindicated.
  10. Patient has known allergy to contrast agents or medications used to perform endovascular intervention that cannot be adequately pre-treated.
  11. Patient has known allergy to urethane, nylon, or silicone.
  12. Patient is pregnant or nursing.
  13. Patient is participating in another research study involving an investigational agent (pharmaceutical, biologic, or medical device) that has not reached the primary endpoint.

Sites / Locations

  • Medizinische Universitaet Graz
  • Hanusch Krankenhaus
  • Department of Angiology - Universitats Herzzentrum Freiburg
  • Auckland City Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Lithoplasty Treatment

Arm Description

Patients in this group will receive treatment with the Shockwave Lithoplasty® System which uses lithotripsy-enhanced, low-pressure balloon dilation of calcified stenotic peripheral arteries.

Outcomes

Primary Outcome Measures

Composite of new-onset Major Adverse Events (MAE)
Death Myocardial infarction Need for emergency surgical revascularization of the target limb. Amputation of target limb.
Efficacy
Acute reduction in percent (%) diameter stenosis of target lesion

Secondary Outcome Measures

Procedural Success
The ability of the Shockwave Lithoplasty® System to achieve a post-shockwave residual diameter stenosis of ≤50%

Full Information

First Posted
September 16, 2016
Last Updated
October 5, 2017
Sponsor
Shockwave Medical, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02911623
Brief Title
Safety and Feasibility of the Shockwave Lithoplasty® System for the Treatment of Peripheral Vascular Stenosis
Acronym
BTK
Official Title
Safety and Feasibility of the Shockwave Lithoplasty® System for the Treatment of Peripheral Vascular Stenosis
Study Type
Interventional

2. Study Status

Record Verification Date
October 2017
Overall Recruitment Status
Completed
Study Start Date
June 2016 (Actual)
Primary Completion Date
May 2017 (Actual)
Study Completion Date
July 2017 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
To observe early safety and performance of the Shockwave Medical Lithoplasty® System (specifically, Lithoplasty® Catheters: 2.5 x 60mm, 2.75 x 60mm, 3.0 x 60mm, 3.25 x 60mm, and 3.5 x 60mm) in subjects to demonstrate that the Shockwave device can safely and effectively deliver localized pulsatile mechanical energy for balloon dilation of calcified, stenotic, infrapopliteal arteries.
Detailed Description
Shockwave Medical, Inc. intends to conduct a prospective, single-arm, multi-center, clinical study designed to evaluate the early safety and performance of the Shockwave Lithoplasty® System in subjects with moderate to heavily calcified peripheral arteries with 2.5mm to 3.5mm reference vessel diameter at the target site. The Shockwave Lithoplasty® System is indicated for lithotripsy-enhanced, low-pressure balloon dilation of calcified, stenotic peripheral arteries in patients who are candidates for percutaneous therapy. Up to twenty subjects will be enrolled and treated with Lithoplasty® System.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peripheral Arterial Disease

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Lithoplasty Treatment
Arm Type
Experimental
Arm Description
Patients in this group will receive treatment with the Shockwave Lithoplasty® System which uses lithotripsy-enhanced, low-pressure balloon dilation of calcified stenotic peripheral arteries.
Intervention Type
Device
Intervention Name(s)
Shockwave Lithoplasty® System
Intervention Description
The Shockwave Lithoplasty® System is a proprietary lithotripsy-enhanced balloon catheter that is designed to be delivered through the peripheral arterial system of the lower extremities to the site of calcified stenosis. Activating the lithotripsy within the device will generate pulsatile mechanical energy within the target treatment site, disrupt calcium within the lesion and allow subsequent dilation of a peripheral artery stenosis using low balloon pressure. The system consists of a balloon catheter with multiple integrated lithotripsy electrodes, and a generator.
Primary Outcome Measure Information:
Title
Composite of new-onset Major Adverse Events (MAE)
Description
Death Myocardial infarction Need for emergency surgical revascularization of the target limb. Amputation of target limb.
Time Frame
Procedure through 30 days post procedure
Title
Efficacy
Description
Acute reduction in percent (%) diameter stenosis of target lesion
Time Frame
Peri-Procedural
Secondary Outcome Measure Information:
Title
Procedural Success
Description
The ability of the Shockwave Lithoplasty® System to achieve a post-shockwave residual diameter stenosis of ≤50%
Time Frame
Peri-Procedural

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject is able and willing to comply with all assessments in the study. Subject or subject's legal representative have been informed of the nature of the study, agrees to participate and has signed the approved consent form. Age of subject is >18. Rutherford Clinical Category 1 - 5. Angiographic Inclusion Criteria: Single or multiple target lesion(s) is/are located in a de novo artery distal to the trifurcation vessels and extends to and ends above the ankle Target vessel reference diameter is between 2.5mm and 3.5mm by visual estimate Target lesion with diameter stenosis ≥50% by investigator via visual estimate If inflow disease >50% proximal to the trifurcation vessels is present, and it can be treated with POBA, stent or Lithoplasty and without complications. Target lesion is ≤150mm in length Subject has at least one patent tibial vessel (>50%) with run-off to the foot. No evidence of aneurysm or acute thrombus in target vessel. Any presence of calcification within the target lesion as assessed by imaging (radiograph, CT or angiography). Exclusion Criteria: Rutherford Clinical Category 6. Target lesion is within only lower extremity vessel with < 50% stenosis. Gangrene of the lower extremity. Planned major amputation of the target leg. Previously implanted stent in the treatment lesion Target lesion length exceeds 150mm. Patient has chronic total occlusion of target lesion. Patient has significant stenosis (>50% stenosis) or occlusion of inflow tract (e.g., iliac or common femoral) not successfully treated with POBA, stent or Lithoplasty and without complications. Patient in whom antiplatelet, anticoagulant, or thrombolytic therapy is contraindicated. Patient has known allergy to contrast agents or medications used to perform endovascular intervention that cannot be adequately pre-treated. Patient has known allergy to urethane, nylon, or silicone. Patient is pregnant or nursing. Patient is participating in another research study involving an investigational agent (pharmaceutical, biologic, or medical device) that has not reached the primary endpoint.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marianne Brodmann, MD
Organizational Affiliation
Universitätsklinikum LKH Graz
Official's Role
Principal Investigator
Facility Information:
Facility Name
Medizinische Universitaet Graz
City
Graz
ZIP/Postal Code
8036
Country
Austria
Facility Name
Hanusch Krankenhaus
City
Vienna
Country
Austria
Facility Name
Department of Angiology - Universitats Herzzentrum Freiburg
City
Bad Krozingen
State/Province
Baden-Württemberg
ZIP/Postal Code
79189
Country
Germany
Facility Name
Auckland City Hospital
City
Auckland
Country
New Zealand

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
29911480
Citation
Brodmann M, Holden A, Zeller T. Safety and Feasibility of Intravascular Lithotripsy for Treatment of Below-the-Knee Arterial Stenoses. J Endovasc Ther. 2018 Aug;25(4):499-503. doi: 10.1177/1526602818783989. Epub 2018 Jun 18.
Results Reference
derived

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Safety and Feasibility of the Shockwave Lithoplasty® System for the Treatment of Peripheral Vascular Stenosis

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