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Tack Optimized Balloon Angioplasty Study of the Tack Endovascular System® in Below the Knee Arteries (TOBA II BTK)

Primary Purpose

Peripheral Arterial Disease

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Tack Endovascular System
Sponsored by
Philips Clinical & Medical Affairs Global
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peripheral Arterial Disease focused on measuring Angioplasty, Below the Knee, PAD, Critical Limb Ischemia, Lesion, Claudication

Eligibility Criteria

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

Inclusion Criteria:

  • Males or non-pregnant females ≥ 18 years of age at the time of consent
  • Female subjects of childbearing potential must have a negative pregnancy test prior to treatment and must use some form of contraception (abstinence is acceptable) through the duration of the study
  • Subject has been informed of and understands the nature of the study and provides signed informed consent to participate in the study. If the subject possesses the ability to understand and provide informed consent but due to physical inability, the subject cannot sign the informed consent form (ICF), an impartial witness may sign on behalf of the subject
  • Willing to comply with all required follow-up visits
  • Rutherford Classification 4 or 5.
  • WIfI Wound grade of 0, 1 or modified 2.
  • WIfI Foot Infection grade of 0 or 1.
  • Estimated life expectancy ≥1 year

Exclusion Criteria:

  • Is pregnant or refuses to use contraception through the duration of the study
  • Previous bypass graft in the target limb
  • Acute limb ischemia, defined as symptom onset occurring less than 14 days prior to the index procedure
  • Prior or planned above-ankle amputation or complete transmetatarsal amputation to the target limb (this does not apply to ray amputation of ≤2 digits, simple digital amputations or ulcer debridements)
  • WIfI Foot Infection grade 2 or 3
  • Any systemic infection or immunocompromised state. Patients with an ascending infection/deep foot infection or abscess/white blood count (WBC)≥12,000/or febrile state
  • Endovascular or surgical procedure (not including diagnostic procedures, planned simple digital amputation or wound debridement) to the target limb less than 30 days prior to or planned for less than 30 days after the index procedure
  • Existing stent implant in the target vessel
  • Any other endovascular or surgical procedure (not including diagnostic procedures, planned simple digital amputation or wound debridement) less than 14 days prior to the index procedure or planned procedure less than 30 days after the index procedure
  • Known coagulopathy, hypercoagulable state, bleeding diathesis, other blood disorder, or a platelet count less than 80,000/microliter or greater than 500,000/microliter
  • WIfI Wound grade of 2 or 3.
  • Any subject in which antiplatelet, anticoagulant, or thrombolytic therapy is contraindicated
  • Myocardial infarction, coronary thrombolysis or angina less than 30 days prior to the Index Procedure
  • History of stroke or transient ischemic attack (TIA) less than 90 days prior to the Index Procedure
  • Currently on dialysis
  • Known hypersensitivity or contraindication to nickel-titanium alloy (Nitinol)
  • Participating in another ongoing investigational clinical trial in which the subject has not completed the primary endpoint(s)
  • Has other comorbidities that, in the opinion of the investigator, would preclude them from receiving this treatment and/or participating in study-required follow-up assessments
  • Known hypersensitivity or allergy to contrast agents that cannot be medically managed
  • Subject already enrolled into this study
  • Restenotic target lesion previously treated by means other than plain balloon angioplasty and/or less than 1 year prior to index procedure.

Sites / Locations

  • Yuma Regional Medical Center
  • Mission Cardiovascular Research Institute
  • Denver VA Medical Center
  • Yale New Haven Hospital
  • MedStar Washington Hospital Center
  • First Coast Cardiovascular Institute
  • Piedmont Heart Institute
  • Amita Health Cardiovascular Associates
  • Advocate Christ Medical Center
  • Midwest Cardiovascular Research Foundation
  • Cardiovascular Institute of the South
  • Ascension St. John Hospital
  • Michigan Vascular Center
  • St. Louis Heart & Vascular
  • Deborah Heart and Lung Center
  • Holy Name Medical Center
  • New Mexico Heart Institute, PA
  • Novant Health Heart and Vascular Institute
  • Rex Hospital
  • WakeMed Hospital
  • Lindner Research Center
  • University Hospitals, Cleveland Medical Center
  • Ohio Health Research Institute
  • Einstein Healthcare Network
  • University of Pittsburgh Medical Center
  • The Miriam Hospital
  • Palmetto Health USC Medical Group
  • Kore Cardiovascular Research
  • Centennial Medical Center
  • University of Texas Medical Branch at Galveston
  • Baylor College of Medicine
  • North Dallas Research Associates
  • Mission Research Institute
  • The Heart Hospital Baylor Plano
  • Cardiovascular Associates of East Texas
  • Sentara Vascular Specialists
  • Lake Washington Vascular, PLLC
  • Division of Angiology, Medical University Graz
  • St. Anne's University Hospital Brno
  • Karolinen-Hospital
  • Franziskus-Hospital Berlin-Radiology
  • Westküstenklinikum Heide
  • Universitätsklinikum Leipzig
  • Evangelisches Krankenhaus Mülheim an der Ruhr
  • Krankenhaus Buchholz
  • MEDINOS Kliniken des Landkreises Sonneberg GmbH
  • Heart & Vascular Center - Semmelweis University
  • Bács-Kiskun County Hospital
  • Auckland Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Tack Implant

Arm Description

Implantation of a Tack using the Intact Vascular Tack Endovascular System for the repair of post angioplasty dissections below the knee.

Outcomes

Primary Outcome Measures

Efficacy - Number of Participants With Freedom From MALE at 6 Months and POD at 30 Days
Freedom from major adverse limb events (MALE) at 6 months defined as above-ankle target limb amputation or major re-intervention to the target lesion(s) (i.e. new bypass graft, jump/interposition graft revision, or thrombectomy / thrombolysis) and perioperative death (POD) at 30 days.
Safety - Number of Participants With MALE Plus POD at 30 Days
Major adverse limb events (MALE) at 30 days defined as above-ankle target limb amputation or major re-intervention to the target lesion(s) (i.e. new bypass graft, jump/interposition graft revision, or thrombectomy / thrombolysis) and perioperative death at 30 days

Secondary Outcome Measures

Patency - Number of Target Lesion(s) Tacked Segment(s) Patent at 6 Months
Target lesion(s) tacked segment(s) patency at 6 months defined as the presence of blood flow using duplex ultrasound. If angiography is available within the 6 month follow-up visit window, it should be used in place of the duplex ultrasound. Evidence of no blood flow within the Tacked segment indicates restenosis/loss of patency.
Target Limb Salvage - Number of Participants With Freedom From Above-Ankle Target Limb Amputation at 6 Months
Target Limb Salvage defined as freedom from any above-ankle target limb amputation at 6 months.

Full Information

First Posted
October 20, 2016
Last Updated
January 24, 2022
Sponsor
Philips Clinical & Medical Affairs Global
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1. Study Identification

Unique Protocol Identification Number
NCT02942966
Brief Title
Tack Optimized Balloon Angioplasty Study of the Tack Endovascular System® in Below the Knee Arteries
Acronym
TOBA II BTK
Official Title
Tack Optimized Balloon Angioplasty Study for the Below The Knee Arteries Using the Tack Endovascular System®
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Completed
Study Start Date
February 8, 2017 (Actual)
Primary Completion Date
July 11, 2019 (Actual)
Study Completion Date
January 10, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Philips Clinical & Medical Affairs Global

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a prospective, multi-center, single-arm, non-blinded study designed to investigate the safety and efficacy of the Tack Endovascular System in the Mid/Distal Popliteal, Tibial, and Peroneal Arteries ranging in diameter from 1.5mm to 4.5mm for the treatment of post percutaneous transluminal balloon angioplasty (PTA) dissection(s) requiring repair.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peripheral Arterial Disease
Keywords
Angioplasty, Below the Knee, PAD, Critical Limb Ischemia, Lesion, Claudication

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Tack Implant
Arm Type
Experimental
Arm Description
Implantation of a Tack using the Intact Vascular Tack Endovascular System for the repair of post angioplasty dissections below the knee.
Intervention Type
Device
Intervention Name(s)
Tack Endovascular System
Other Intervention Name(s)
Post-PTA Dissection Repair Implant, Tack Implant, Tack Dissection Repair Device
Intervention Description
Repair of post-PTA dissections using the Intact Vascular Tack Endovascular System.
Primary Outcome Measure Information:
Title
Efficacy - Number of Participants With Freedom From MALE at 6 Months and POD at 30 Days
Description
Freedom from major adverse limb events (MALE) at 6 months defined as above-ankle target limb amputation or major re-intervention to the target lesion(s) (i.e. new bypass graft, jump/interposition graft revision, or thrombectomy / thrombolysis) and perioperative death (POD) at 30 days.
Time Frame
6 months
Title
Safety - Number of Participants With MALE Plus POD at 30 Days
Description
Major adverse limb events (MALE) at 30 days defined as above-ankle target limb amputation or major re-intervention to the target lesion(s) (i.e. new bypass graft, jump/interposition graft revision, or thrombectomy / thrombolysis) and perioperative death at 30 days
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Patency - Number of Target Lesion(s) Tacked Segment(s) Patent at 6 Months
Description
Target lesion(s) tacked segment(s) patency at 6 months defined as the presence of blood flow using duplex ultrasound. If angiography is available within the 6 month follow-up visit window, it should be used in place of the duplex ultrasound. Evidence of no blood flow within the Tacked segment indicates restenosis/loss of patency.
Time Frame
6 months
Title
Target Limb Salvage - Number of Participants With Freedom From Above-Ankle Target Limb Amputation at 6 Months
Description
Target Limb Salvage defined as freedom from any above-ankle target limb amputation at 6 months.
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males or non-pregnant females ≥ 18 years of age at the time of consent Female subjects of childbearing potential must have a negative pregnancy test prior to treatment and must use some form of contraception (abstinence is acceptable) through the duration of the study Subject has been informed of and understands the nature of the study and provides signed informed consent to participate in the study. If the subject possesses the ability to understand and provide informed consent but due to physical inability, the subject cannot sign the informed consent form (ICF), an impartial witness may sign on behalf of the subject Willing to comply with all required follow-up visits Rutherford Classification 4 or 5. WIfI Wound grade of 0, 1 or modified 2. WIfI Foot Infection grade of 0 or 1. Estimated life expectancy ≥1 year Exclusion Criteria: Is pregnant or refuses to use contraception through the duration of the study Previous bypass graft in the target limb Acute limb ischemia, defined as symptom onset occurring less than 14 days prior to the index procedure Prior or planned above-ankle amputation or complete transmetatarsal amputation to the target limb (this does not apply to ray amputation of ≤2 digits, simple digital amputations or ulcer debridements) WIfI Foot Infection grade 2 or 3 Any systemic infection or immunocompromised state. Patients with an ascending infection/deep foot infection or abscess/white blood count (WBC)≥12,000/or febrile state Endovascular or surgical procedure (not including diagnostic procedures, planned simple digital amputation or wound debridement) to the target limb less than 30 days prior to or planned for less than 30 days after the index procedure Existing stent implant in the target vessel Any other endovascular or surgical procedure (not including diagnostic procedures, planned simple digital amputation or wound debridement) less than 14 days prior to the index procedure or planned procedure less than 30 days after the index procedure Known coagulopathy, hypercoagulable state, bleeding diathesis, other blood disorder, or a platelet count less than 80,000/microliter or greater than 500,000/microliter WIfI Wound grade of 2 or 3. Any subject in which antiplatelet, anticoagulant, or thrombolytic therapy is contraindicated Myocardial infarction, coronary thrombolysis or angina less than 30 days prior to the Index Procedure History of stroke or transient ischemic attack (TIA) less than 90 days prior to the Index Procedure Currently on dialysis Known hypersensitivity or contraindication to nickel-titanium alloy (Nitinol) Participating in another ongoing investigational clinical trial in which the subject has not completed the primary endpoint(s) Has other comorbidities that, in the opinion of the investigator, would preclude them from receiving this treatment and/or participating in study-required follow-up assessments Known hypersensitivity or allergy to contrast agents that cannot be medically managed Subject already enrolled into this study Restenotic target lesion previously treated by means other than plain balloon angioplasty and/or less than 1 year prior to index procedure.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Patrick J. Geraghty, MD
Organizational Affiliation
Washington University School of Medicine in St. Louis
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
George Adams, MD
Organizational Affiliation
Rex Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Yuma Regional Medical Center
City
Yuma
State/Province
Arizona
ZIP/Postal Code
85364
Country
United States
Facility Name
Mission Cardiovascular Research Institute
City
Fremont
State/Province
California
ZIP/Postal Code
94538
Country
United States
Facility Name
Denver VA Medical Center
City
Denver
State/Province
Colorado
ZIP/Postal Code
80220
Country
United States
Facility Name
Yale New Haven Hospital
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06510
Country
United States
Facility Name
MedStar Washington Hospital Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20010
Country
United States
Facility Name
First Coast Cardiovascular Institute
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32256
Country
United States
Facility Name
Piedmont Heart Institute
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30309
Country
United States
Facility Name
Amita Health Cardiovascular Associates
City
Elk Grove Village
State/Province
Illinois
ZIP/Postal Code
60007
Country
United States
Facility Name
Advocate Christ Medical Center
City
Oak Lawn
State/Province
Illinois
ZIP/Postal Code
60453
Country
United States
Facility Name
Midwest Cardiovascular Research Foundation
City
Davenport
State/Province
Iowa
ZIP/Postal Code
52803
Country
United States
Facility Name
Cardiovascular Institute of the South
City
Houma
State/Province
Louisiana
ZIP/Postal Code
70360
Country
United States
Facility Name
Ascension St. John Hospital
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48215
Country
United States
Facility Name
Michigan Vascular Center
City
Flint
State/Province
Michigan
ZIP/Postal Code
48507
Country
United States
Facility Name
St. Louis Heart & Vascular
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63136
Country
United States
Facility Name
Deborah Heart and Lung Center
City
Browns Mills
State/Province
New Jersey
ZIP/Postal Code
08015
Country
United States
Facility Name
Holy Name Medical Center
City
Teaneck
State/Province
New Jersey
ZIP/Postal Code
07666
Country
United States
Facility Name
New Mexico Heart Institute, PA
City
Albuquerque
State/Province
New Mexico
ZIP/Postal Code
87102
Country
United States
Facility Name
Novant Health Heart and Vascular Institute
City
Matthews
State/Province
North Carolina
ZIP/Postal Code
28204
Country
United States
Facility Name
Rex Hospital
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27607
Country
United States
Facility Name
WakeMed Hospital
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27609
Country
United States
Facility Name
Lindner Research Center
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45219
Country
United States
Facility Name
University Hospitals, Cleveland Medical Center
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Facility Name
Ohio Health Research Institute
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43214
Country
United States
Facility Name
Einstein Healthcare Network
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19141
Country
United States
Facility Name
University of Pittsburgh Medical Center
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Facility Name
The Miriam Hospital
City
Providence
State/Province
Rhode Island
ZIP/Postal Code
02906
Country
United States
Facility Name
Palmetto Health USC Medical Group
City
Columbia
State/Province
South Carolina
ZIP/Postal Code
29203
Country
United States
Facility Name
Kore Cardiovascular Research
City
Jackson
State/Province
Tennessee
ZIP/Postal Code
38305
Country
United States
Facility Name
Centennial Medical Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Facility Name
University of Texas Medical Branch at Galveston
City
Galveston
State/Province
Texas
ZIP/Postal Code
77555
Country
United States
Facility Name
Baylor College of Medicine
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
North Dallas Research Associates
City
McKinney
State/Province
Texas
ZIP/Postal Code
75069
Country
United States
Facility Name
Mission Research Institute
City
New Braunfels
State/Province
Texas
ZIP/Postal Code
78130
Country
United States
Facility Name
The Heart Hospital Baylor Plano
City
Plano
State/Province
Texas
ZIP/Postal Code
75093
Country
United States
Facility Name
Cardiovascular Associates of East Texas
City
Tyler
State/Province
Texas
ZIP/Postal Code
75701
Country
United States
Facility Name
Sentara Vascular Specialists
City
Norfolk
State/Province
Virginia
ZIP/Postal Code
23507
Country
United States
Facility Name
Lake Washington Vascular, PLLC
City
Bellevue
State/Province
Washington
ZIP/Postal Code
98004
Country
United States
Facility Name
Division of Angiology, Medical University Graz
City
Graz
ZIP/Postal Code
8036
Country
Austria
Facility Name
St. Anne's University Hospital Brno
City
Brno
Country
Czechia
Facility Name
Karolinen-Hospital
City
Arnsberg
ZIP/Postal Code
59759
Country
Germany
Facility Name
Franziskus-Hospital Berlin-Radiology
City
Berlin
ZIP/Postal Code
10787
Country
Germany
Facility Name
Westküstenklinikum Heide
City
Heide
ZIP/Postal Code
25746
Country
Germany
Facility Name
Universitätsklinikum Leipzig
City
Leipzig
ZIP/Postal Code
04103
Country
Germany
Facility Name
Evangelisches Krankenhaus Mülheim an der Ruhr
City
Mülheim an der Ruhr
Country
Germany
Facility Name
Krankenhaus Buchholz
City
Nordheide
ZIP/Postal Code
21244
Country
Germany
Facility Name
MEDINOS Kliniken des Landkreises Sonneberg GmbH
City
Sonneberg
ZIP/Postal Code
96515
Country
Germany
Facility Name
Heart & Vascular Center - Semmelweis University
City
Budapest
ZIP/Postal Code
1122
Country
Hungary
Facility Name
Bács-Kiskun County Hospital
City
Kecskemét
Country
Hungary
Facility Name
Auckland Hospital
City
Auckland
ZIP/Postal Code
1023
Country
New Zealand

12. IPD Sharing Statement

Citations:
PubMed Identifier
19897335
Citation
Conte MS, Geraghty PJ, Bradbury AW, Hevelone ND, Lipsitz SR, Moneta GL, Nehler MR, Powell RJ, Sidawy AN. Suggested objective performance goals and clinical trial design for evaluating catheter-based treatment of critical limb ischemia. J Vasc Surg. 2009 Dec;50(6):1462-73.e1-3. doi: 10.1016/j.jvs.2009.09.044. Epub 2009 Nov 7.
Results Reference
background
PubMed Identifier
24126108
Citation
Mills JL Sr, Conte MS, Armstrong DG, Pomposelli FB, Schanzer A, Sidawy AN, Andros G; Society for Vascular Surgery Lower Extremity Guidelines Committee. The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: risk stratification based on wound, ischemia, and foot infection (WIfI). J Vasc Surg. 2014 Jan;59(1):220-34.e1-2. doi: 10.1016/j.jvs.2013.08.003. Epub 2013 Oct 12.
Results Reference
background
PubMed Identifier
35352604
Citation
Adams GL, Lichtenberg M, Wissgott C, Schmidt A, Tarra T, Matricardi S, Geraghty PJ. Twenty-Four Month Results of Tack-Optimized Balloon Angioplasty Using the Tack Endovascular System in Below-the-Knee Arteries. J Endovasc Ther. 2023 Jun;30(3):393-400. doi: 10.1177/15266028221083462. Epub 2022 Mar 30.
Results Reference
derived
PubMed Identifier
35156451
Citation
Geraghty PJ, Adams GL, Schmidt A, Lichtenberg M, Wissgott C, Armstrong EJ, Hertting K; TOBA II BTK investigators. Twelve-Month Results of Tack-Optimized Balloon Angioplasty Using the Tack Endovascular System in Below-the-Knee Arteries (TOBA II BTK). J Endovasc Ther. 2020 Aug;27(4):626-636. doi: 10.1177/1526602820944402.
Results Reference
derived

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Tack Optimized Balloon Angioplasty Study of the Tack Endovascular System® in Below the Knee Arteries

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