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Safety and Efficacy of Atherectomy on VasculaR Functions (SAVioR)

Primary Purpose

Peripheral Arterial Disease, Claudication, Intermittent

Status
Unknown status
Phase
Not Applicable
Locations
Germany
Study Type
Interventional
Intervention
Atherectomy
POBA and DCB
Sponsored by
University Hospital, Essen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Peripheral Arterial Disease

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Peripheral artery disease, lesions in the SFA and popliteal artery.
  • Clinical diagnosis of chronic, symptomatic lower limb ischemia as defined by Rutherford 2, 3, or 4
  • Planed peripheral intervention TASC A-D
  • Subject must be between 18 and 85 years old
  • Female of childbearing potential must have a negative pregnancy test within 10 days prior to index procedure and utilize reliable birth control until completion of the 12-month angiographic evaluation
  • Vessel diameter ≥3.0 mm and ≤7.0 mm
  • Willing to comply with the specified follow-up evaluation
  • Written informed consent prior to any study procedures

Exclusion Criteria:

  • Thrombolysis within 72 hours prior to the index procedure
  • Aneurysm in the femoral artery or popliteal artery
  • Concomitant hepatic insufficiency, deep venous thrombus, coagulation disorder or receiving immunosuppressant therapy
  • Unstable angina pectoris at the time of the enrollment
  • Recent myocardial infarction or stroke < 30 days prior to the index procedure
  • Life expectancy less than 12 months
  • Septicemia at the time of enrollment
  • Known or suspected active infection at the time of the index procedure, excluding an infection of a lower extremity wound of the target limb
  • Known or suspected allergies or contraindications to aspirin, clopidogrel or heparin Presence of other hemodynamically significant outflow lesions in the target limb requiring a planned surgical intervention or endovascular procedure within 30 days after the index procedure

Sites / Locations

  • University Hospital EssenRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Atherectomy

Standard care

Arm Description

Atherectomy and drug-coated balloon (DCB)

Standard care with predilation (POBA) and DCB

Outcomes

Primary Outcome Measures

Treatment-Emerged Adverse Events
Incidence of Treatment-Emerged Adverse Events as assessed by angiography and adverse event assessment
Primary patency
determined through doppler ultrasound

Secondary Outcome Measures

Bail-out stent rate
success of atherectomy in the SFA including the bail-out stenting rates
FMD local
Local endothelial function and vasomotion testing as determinded by FMD of the femoral artery
Vessel stiffness
Vascular stiffness determined through pulse wave velocity (PWV)
target lesion revascularization
freedom from Target Lesion Revascularization (FTLR) is defined as the Need for percutaneous or interventional revascularization
ABI (Ankle Brachial Index)
Ankle Brachial Index assessed by Doppler
Systemic endothelial function
Change of endothelial function, assessed by the change in the vasodilation after reactive hyperaemia of the brachial artery (flow-mediated dilation = FMD)
Change in Plaque burden
Change in plaque burden is measured by plaque volume change using intravascular ultrasound (IVUS)
Change in plaque characteristic
Change in plaque characteristic is quantified using virtual histology using intravascular ultrasound (IVUS)

Full Information

First Posted
April 17, 2019
Last Updated
January 20, 2021
Sponsor
University Hospital, Essen
Collaborators
Straub Medical AG
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1. Study Identification

Unique Protocol Identification Number
NCT04092972
Brief Title
Safety and Efficacy of Atherectomy on VasculaR Functions
Acronym
SAVioR
Official Title
Safety and Efficacy of Interventional Treatment Through Atherectomy to Improve Vascular Functions and Patency in Symptomatic Peripheral Artery Disease - Pilot Study
Study Type
Interventional

2. Study Status

Record Verification Date
January 2021
Overall Recruitment Status
Unknown status
Study Start Date
January 1, 2019 (Actual)
Primary Completion Date
July 28, 2021 (Anticipated)
Study Completion Date
August 31, 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University Hospital, Essen
Collaborators
Straub Medical AG

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Interventional strategies aim to restore tissue perfusion. However, despite the simple reopening of a narrowed artery they affect endothelial function, perpetuating dysfunctional vascular homeostasis. PTA and atherectomy might alter the endothelial function but the mechanisms are incompletely understood. The primary goal of atherectomy is vessel preparation and improving compliance, which could aid in preserving vessel functions. Aim of this study is to determine safety, efficacy, patency and vessel functions in the femoropopliteal artery following atherectomy and DCB.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Non-Randomized
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Atherectomy
Arm Type
Experimental
Arm Description
Atherectomy and drug-coated balloon (DCB)
Arm Title
Standard care
Arm Type
Active Comparator
Arm Description
Standard care with predilation (POBA) and DCB
Intervention Type
Other
Intervention Name(s)
Atherectomy
Intervention Description
Straub Rotarex S atherectomy and drug-coated balloon DCB. Predilation of the lesion with a predefined ballon (180 sec, Passeo-18). Thus, no direct DCB will be conducted. All DCB lengths (40mm to 200 mm) and Diameters (3mm to 7mm) are eligible for the Trial as long as used in the superficial femoral artery (SFA).
Intervention Type
Other
Intervention Name(s)
POBA and DCB
Intervention Description
Standard predilation (POBA) and DCB. Predilation of the lesion with a predefined ballon (180 sec, Passeo-18). Thus, no direct DCB will be conducted. All DCB lengths (40mm to 200 mm) and Diameters (3mm to 7mm) are eligible for the Trial as long as used in the superficial femoral artery (SFA).
Primary Outcome Measure Information:
Title
Treatment-Emerged Adverse Events
Description
Incidence of Treatment-Emerged Adverse Events as assessed by angiography and adverse event assessment
Time Frame
6 months Follow Up
Title
Primary patency
Description
determined through doppler ultrasound
Time Frame
6 months Follow Up
Secondary Outcome Measure Information:
Title
Bail-out stent rate
Description
success of atherectomy in the SFA including the bail-out stenting rates
Time Frame
6 months Follow Up
Title
FMD local
Description
Local endothelial function and vasomotion testing as determinded by FMD of the femoral artery
Time Frame
6 months Follow Up
Title
Vessel stiffness
Description
Vascular stiffness determined through pulse wave velocity (PWV)
Time Frame
6 months Follow Up
Title
target lesion revascularization
Description
freedom from Target Lesion Revascularization (FTLR) is defined as the Need for percutaneous or interventional revascularization
Time Frame
6 months Follow Up
Title
ABI (Ankle Brachial Index)
Description
Ankle Brachial Index assessed by Doppler
Time Frame
6 months Follow Up
Title
Systemic endothelial function
Description
Change of endothelial function, assessed by the change in the vasodilation after reactive hyperaemia of the brachial artery (flow-mediated dilation = FMD)
Time Frame
6 months Follow Up
Title
Change in Plaque burden
Description
Change in plaque burden is measured by plaque volume change using intravascular ultrasound (IVUS)
Time Frame
during baseline visit
Title
Change in plaque characteristic
Description
Change in plaque characteristic is quantified using virtual histology using intravascular ultrasound (IVUS)
Time Frame
during baseline visit

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Peripheral artery disease, lesions in the SFA and popliteal artery. Clinical diagnosis of chronic, symptomatic lower limb ischemia as defined by Rutherford 2, 3, or 4 Planed peripheral intervention TASC A-D Subject must be between 18 and 85 years old Female of childbearing potential must have a negative pregnancy test within 10 days prior to index procedure and utilize reliable birth control until completion of the 12-month angiographic evaluation Vessel diameter ≥3.0 mm and ≤7.0 mm Willing to comply with the specified follow-up evaluation Written informed consent prior to any study procedures Exclusion Criteria: Thrombolysis within 72 hours prior to the index procedure Aneurysm in the femoral artery or popliteal artery Concomitant hepatic insufficiency, deep venous thrombus, coagulation disorder or receiving immunosuppressant therapy Unstable angina pectoris at the time of the enrollment Recent myocardial infarction or stroke < 30 days prior to the index procedure Life expectancy less than 12 months Septicemia at the time of enrollment Known or suspected active infection at the time of the index procedure, excluding an infection of a lower extremity wound of the target limb Known or suspected allergies or contraindications to aspirin, clopidogrel or heparin Presence of other hemodynamically significant outflow lesions in the target limb requiring a planned surgical intervention or endovascular procedure within 30 days after the index procedure
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Christos Rammos
Phone
020172384808
Email
Christos.Rammos@uk-essen.de
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Christos Rammos
Organizational Affiliation
Universität Duisburg-Essen
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Hospital Essen
City
Essen
State/Province
NRW
ZIP/Postal Code
45122
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Fadi Al-Rashid, Dr.med.
Phone
00492017230
Email
fadi.al-rashid@uk-essen.de
First Name & Middle Initial & Last Name & Degree
Christos Rammos, MD, PHD

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
36193630
Citation
Rammos C, Manzke A, Lortz J, Messiha D, Petrikhovich O, Janosi RA, Steinmetz M, Rassaf T. Mechanical atherothrombectomy improves endothelial function through plaque burden reduction in PAD. Vasa. 2022 Nov;51(6):377-385. doi: 10.1024/0301-1526/a001034. Epub 2022 Oct 4.
Results Reference
derived

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Safety and Efficacy of Atherectomy on VasculaR Functions

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