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Directional Versus Orbital Atherectomy Plaque Modification and Luminal Area Assessment of the Femoro-popliteal Artery Via Intravascular Ultrasound

Primary Purpose

Peripheral Artery Disease

Status
Active
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Percutaneous Revascularization of the Femoropopliteal Arteries using a DAS
Percutaneous Revascularization of the Femoropopliteal Arteries using a OAS device
Sponsored by
NYU Langone Health
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peripheral Artery Disease

Eligibility Criteria

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

Inclusion Criteria:

  • Subject's age ≥ 18 years;
  • Subject (or Legal Guardian if applicable) is willing and able to provide consent before any study-specific test or procedure is performed, signs the consent form, and agrees to attend all required follow-up visits.
  • Chronic, symptomatic lower limb ischemia defined as Rutherford categories 1-4
  • Target lesion(s) located in a superficial femoral or popliteal arteries
  • Degree of stenosis ≥70% via Qualitative Comparative Analysis (QCA)
  • Total Lesion Length ≥ 80 mm and ≤ 150 mm
  • Reference Vessel ≥ 3.0 mm and <6.5mm
  • Patent infrapopliteal artery, i.e., single vessel runoff or better with at least one of three vessels patent (<50% stenosis) to the ankle or foot with no planned intervention.
  • Subject is an acceptable candidate for percutaneous intervention using the OAS or DAS in accordance with their labeled indications and instructions for use

Exclusion Criteria:

  • Subjects who have an:
  • Previously stented target lesion/vessel.
  • Subjects who have undergone prior surgery of the SFA/PA in the target limb to treat atherosclerotic disease.
  • Presence of aneurysm in the target vessel.
  • Interventional treatment is intended for in-stent restenosis at the peripheral vascular site.
  • Target vessel with moderate or severe angulation (e.g., > 30°) or tortuosity at the treatment segment, that precludes safe advancement of the atherectomy device.
  • Pre-planned interventional treatment includes planned laser, brachytherapy or atherectomy procedure other than OAS or DAS.
  • Known hypersensitivity or contraindication to contrast dye that, in the opinion of the investigator, cannot be adequately pre-medicated.
  • Known hypersensitivity/allergy to antiplatelet, anticoagulant, thrombolytic medications
  • Platelet count <80,000 mm3 or >600,000 mm3 or history of bleeding diathesis.
  • Patient has any known coagulation disorder, including hypercoagulability
  • Receiving dialysis or immunosuppressant therapy.
  • Patient has evidence of intracranial or gastrointestinal bleeding within last 3 months.
  • Patient has history of severe trauma, fracture, major surgery or biopsy of a parenchymal organ within past 14 days,
  • Female patient who is pregnant or nursing a child,
  • Current participation in another investigational drug or device clinical study that has not completed the primary endpoint at the time of randomization/enrollment or that clinically interferes with the current study endpoints.

Sites / Locations

  • New York University School of Medicine

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

CSI's DIAMONDBACK 360® Peripheral Orbital Atherectomy (OAS)

Medtronic's Hawkone Directional Atherectomy system (DAS)

Arm Description

OAS (using CSI device) followed by Inpact Admiral drug coated balloon (DCB)

DAS (using the Hawkone device) followed by DCB

Outcomes

Primary Outcome Measures

Change in Minimal Luminal Area
To be measured via Intravasular Ultrasound (IVUS) before and after atherectomy
Change in Percentage Diameter Stenosis (%DS)
Angiographic measurements of diameter stenosis following atherectomy

Secondary Outcome Measures

Change in Percentage Plaque Volume
To be measured and analyzed via Intravascular Ultrasound (IVUS)

Full Information

First Posted
March 26, 2018
Last Updated
June 7, 2023
Sponsor
NYU Langone Health
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1. Study Identification

Unique Protocol Identification Number
NCT03495453
Brief Title
Directional Versus Orbital Atherectomy Plaque Modification and Luminal Area Assessment of the Femoro-popliteal Artery Via Intravascular Ultrasound
Official Title
Directional Versus Orbital Atherectomy Plaque Modification and Luminal Area Assessment of the Femoro-popliteal Artery Via Intravascular Ultrasound
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
March 23, 2018 (Actual)
Primary Completion Date
September 7, 2023 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
NYU Langone Health

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
No

5. Study Description

Brief Summary
This single center prospective, randomized study will be conducted to investigate plaque removal and luminal gain using CSI's DIAMONDBACK 360® Peripheral Orbital Atherectomy System (OAS) (St.Paul, MN) versus Medtronic's Hawkone Directional Atherectomy system (DAS) (Minneapolis, MN) assessed by angiography and Intravascular Ultrasound (IVUS) in patients diagnosed with symptomatic obstructive femoro-popliteal disease will be analyzed. Both devices have received clearance by the Food and Drug Administration (FDA) for use by the label indication.Subjects will be randomized in a 1:1 fashion to receive treatment with either OAS (using CSI device) followed by Inpact Admiral drug coated balloon (DCB) or DAS (using the Hawkone device) followed by DCB. Subjects in both arms will undergo IVUS before and after atherectomy, as well as at the conclusion of the procedure. Clinical data will be collected at baseline, immediately prior to the procedure, during and immediately after the procedures, and within 30 days, 6 and 12 months office visits after the procedure. Data may also be collected at office or hospital visits that are not scheduled but occur up to 12 months after the procedure, if they pertain to treatment related to the obstructive SFA disease. Data to be collected for this study includes demographics, medical history, procedural parameters and follow-up. The study will be conducted at one study center, 90 subjects will be enrolled in the trial with plan to accrue 60 subjects - 30 patients enrolled in the OAS arm and 30 patients enrolled in the DAS arm. The duration of the study is expected to be approximately 2 years from the date of first enrollment (1 year for enrollment of 60 subjects and a year for follow-up).

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
94 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CSI's DIAMONDBACK 360® Peripheral Orbital Atherectomy (OAS)
Arm Type
Active Comparator
Arm Description
OAS (using CSI device) followed by Inpact Admiral drug coated balloon (DCB)
Arm Title
Medtronic's Hawkone Directional Atherectomy system (DAS)
Arm Type
Active Comparator
Arm Description
DAS (using the Hawkone device) followed by DCB
Intervention Type
Device
Intervention Name(s)
Percutaneous Revascularization of the Femoropopliteal Arteries using a DAS
Intervention Description
Diamondback 360 Peripheral Orbital Atherectomy System (OAS) is a small catheter with a diamond crown. The doctor inserts it at the groin and advances into the leg.The OAS works by spinning around inside the artery to "sand down" the buildup of material along the artery walls while leaving the healthy vessel behind.
Intervention Type
Device
Intervention Name(s)
Percutaneous Revascularization of the Femoropopliteal Arteries using a OAS device
Intervention Description
HawkOne Directional Atherectomy System (DAS) also is the small catheter with cutting device. Doctor slowly and smoothly advances it across the blockage in your artery and shaves the plaque from the vessel wall and collects it in the reservoir.
Primary Outcome Measure Information:
Title
Change in Minimal Luminal Area
Description
To be measured via Intravasular Ultrasound (IVUS) before and after atherectomy
Time Frame
Day 0, Immediately before procedure, immediately after procedure
Title
Change in Percentage Diameter Stenosis (%DS)
Description
Angiographic measurements of diameter stenosis following atherectomy
Time Frame
Day 0, Immediately before and after procedure
Secondary Outcome Measure Information:
Title
Change in Percentage Plaque Volume
Description
To be measured and analyzed via Intravascular Ultrasound (IVUS)
Time Frame
Day 0, Immediately before procedure, immediately after procedure

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject's age ≥ 18 years; Subject (or Legal Guardian if applicable) is willing and able to provide consent before any study-specific test or procedure is performed, signs the consent form, and agrees to attend all required follow-up visits. Chronic, symptomatic lower limb ischemia defined as Rutherford categories 1-4 Target lesion(s) located in a superficial femoral or popliteal arteries Degree of stenosis ≥70% via Qualitative Comparative Analysis (QCA) Total Lesion Length ≥ 80 mm and ≤ 150 mm Reference Vessel ≥ 3.0 mm and <6.5mm Patent infrapopliteal artery, i.e., single vessel runoff or better with at least one of three vessels patent (<50% stenosis) to the ankle or foot with no planned intervention. Subject is an acceptable candidate for percutaneous intervention using the OAS or DAS in accordance with their labeled indications and instructions for use Exclusion Criteria: Subjects who have an: Previously stented target lesion/vessel. Subjects who have undergone prior surgery of the SFA/PA in the target limb to treat atherosclerotic disease. Presence of aneurysm in the target vessel. Interventional treatment is intended for in-stent restenosis at the peripheral vascular site. Target vessel with moderate or severe angulation (e.g., > 30°) or tortuosity at the treatment segment, that precludes safe advancement of the atherectomy device. Pre-planned interventional treatment includes planned laser, brachytherapy or atherectomy procedure other than OAS or DAS. Known hypersensitivity or contraindication to contrast dye that, in the opinion of the investigator, cannot be adequately pre-medicated. Known hypersensitivity/allergy to antiplatelet, anticoagulant, thrombolytic medications Platelet count <80,000 mm3 or >600,000 mm3 or history of bleeding diathesis. Patient has any known coagulation disorder, including hypercoagulability Receiving dialysis or immunosuppressant therapy. Patient has evidence of intracranial or gastrointestinal bleeding within last 3 months. Patient has history of severe trauma, fracture, major surgery or biopsy of a parenchymal organ within past 14 days, Female patient who is pregnant or nursing a child, Current participation in another investigational drug or device clinical study that has not completed the primary endpoint at the time of randomization/enrollment or that clinically interferes with the current study endpoints.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Anvar Babaev, MD, PhD
Organizational Affiliation
NYU Langone Health
Official's Role
Principal Investigator
Facility Information:
Facility Name
New York University School of Medicine
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Directional Versus Orbital Atherectomy Plaque Modification and Luminal Area Assessment of the Femoro-popliteal Artery Via Intravascular Ultrasound

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