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The GORE VBX FORWARD Clinical Study: A Comparison of the GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis to Bare Metal Stenting for Patients With Complex Iliac Occlusive Disease

Primary Purpose

Aortoiliac Occlusive Disease, Peripheral Arterial Disease

Status
Not yet recruiting
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Stenting of the Common and/or External Iliac Arteries with the GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis
Stenting of the Common and/or External Iliac Arteries with Bare Metal Stent
Sponsored by
W.L.Gore & Associates
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Aortoiliac Occlusive Disease

Eligibility Criteria

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

Inclusion Criteria: Age ≥ 18 years at time of informed consent signature Informed Consent Form (ICF) is signed by the subject Subject can comply with protocol requirements, including follow-up Patient has symptomatic claudication, rest pain, or minor tissue loss (Rutherford Category 2-5) Patient has de novo or restenotic lesion(s) found in the common and/or external iliac artery(ies) Patient has: Unilateral or bilateral single or multiple lesions (>50% stenosis or chronic total occlusion) each between 4 and 11 cm in length Patient has a target vessel diameter visually estimated to be approximately between 5 mm and 13 mm Patient has a sufficient (<50% stenotic) common femoral artery and at least one sufficient (<50% stenotic) femoral artery (deep or superficial). Patient has at least one sufficient (<50% stenotic) infrapopliteal run-off vessel. Exclusion Criteria: Life expectancy <1 year Patient is pregnant at time of informed consent. Patient has a known allergy to stent or stent graft components (including nitinol, stainless steel, or heparin). Patient has severe chronic renal insufficiency (serum creatinine level > 2.5mg/dL) and not undergoing hemodialysis. Patient has evidence of a systemic infection. Patient has a known intolerance to antithrombotic medications that prevent compliance with study or control device Instructions for Use. Patient has had vascular catheterization of the lower extremities within 30 days of randomization (excluding diagnostic angiograms for the study procedure). Patient has previous stenting in the iliac arteries. Patient has previous surgical bypass in the target limb. Patient is currently participating in another investigative clinical study unless received written approval by the sponsor. Patient has a lesion requiring drug-coated balloon angioplasty, atherectomy, lithotripsy, or any ablative device to facilitate stent delivery. Patient has an abdominal aortic artery lesion or aneurysm. Patient has a lesion that requires stent placement within 2 cm of the inguinal ligament. Patient has isolated common iliac artery stenosis that can be treated with a single device (i.e., common iliac artery stenosis that does not require kissing stents or extend into the external iliac artery). Patient has outflow disease that requires concomitant interventions (i.e. common femoral endarterectomy or femoral / tibial revascularization).

Sites / Locations

  • North Suburban Medical Center
  • University of Pennsylvania
  • The University of Texas Southwestern Medical Center
  • Texas Tech University Health Science Center
  • Krankenhaus der Barmherzigen Brüder
  • Rijnstate Hospital
  • Auckland City Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

VBX Device Group

BMS Control Group

Arm Description

Subject in this group will receive treatment with the GORE VIABAHN® VBX Balloon Expandable Endoprosthesis (VBX)

Subjects in this group will receive treatment with a commercially available bare metal stent (BMS) that is approved for treatment of the disease

Outcomes

Primary Outcome Measures

Primary Patency
Blood flow through the target lesion (no evidence of binary restenosis >50% or occlusion) without a Target Lesion Revascularization (TLR).

Secondary Outcome Measures

Technical success
Deployment of device with < 30% residual stenosis on final angiography.
Acute procedural success
Binary assessment based on technical success and freedom from device or procedure-related serious adverse events (SAE) requiring intervention.
Clinical success
Improvement from baseline of at least 1 Rutherford Category and freedom from device or procedure-related SAE requiring intervention.
Hemodynamic Status
Change in Ankle-brachial index (ABI)/toe-brachial index (TBI) as compared to baseline
Change in EQ-5D-5L
Change in EQ-5D-5L responses as compared to baseline. The EQ-5D-5L Questionnaire measures quality of life (QoL) over 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension is measured over five levels from no problems to extreme problems. Scored on a 0 to 100 scale with 0 as the worst possible health and 100 is the best possible health.
Change in WIQ
Change in Walking Impairment Questionnaire (WIQ) responses as compared to baseline. The WIQ is a validated QoL measurement of walking abilities over 3 dimensions: distance, speed, and stair-climbing. Scored on a 0 to 100 scale with 0 as no degree of difficulty and 100 is the highest degree of difficulty.
Primary patency
Blood flow through the target lesion (no evidence of binary restenosis >50% or occlusion) without a Target Lesion Revascularization (TLR).
Freedom from binary restenosis
Freedom from binary restenosis. binary restenosis defined as evidence of >50% restenosis or occlusion of the target lesion(s) based on core lab adjudicated duplex ultrasound or angiography
Primary assisted patency
Blood flow maintained (no evidence of occlusion) through the target lesion with or without a Target Lesion Revascularization (TLR).
Secondary patency
Blood flow through the target lesion with or without a Target Lesion Revascularization (TLR).
Freedom from target lesion revascularization
Freedom from target lesion revascularization (TLR). TLR defined as endovascular or surgical intervention performed on the target lesion(s).
Cumulative reintervention rate
Rate of first and recurrent Target Lesion Revascularization (TLR).
Freedom from clinically driven target lesion revascularization
Freedom from clinically driven target lesion revascularization. Endovascular or surgical intervention performed on the target lesion(s) in response to recurrent symptoms (increase ≥ 1 Rutherford Category).
Amputation-free survival
Binary assessment based on freedom from major amputation (target limb, amputation above the metatarsals) and all-cause mortality
Survival
Freedom from all-cause mortality
Change in Rutherford Category
Change in Rutherford Category as compared to baseline. Scaled from 0 to 6, with 0 as asymptotic and 6 as major tissue loss, extending above the transmetatarsal (TM) level, functional foot no longer salvageable.

Full Information

First Posted
March 14, 2023
Last Updated
June 7, 2023
Sponsor
W.L.Gore & Associates
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1. Study Identification

Unique Protocol Identification Number
NCT05811364
Brief Title
The GORE VBX FORWARD Clinical Study: A Comparison of the GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis to Bare Metal Stenting for Patients With Complex Iliac Occlusive Disease
Official Title
The GORE VBX FORWARD Clinical Study: A Comparison of the GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis to Bare Metal Stenting for Patients With Complex Iliac Occlusive Disease
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
July 31, 2023 (Anticipated)
Primary Completion Date
April 30, 2027 (Anticipated)
Study Completion Date
April 30, 2031 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
W.L.Gore & Associates

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
The objective of this prospective, multicenter, randomized, controlled clinical trial is to demonstrate the superiority of the VBX Device for primary patency when compared to bare metal stenting in complex iliac occlusive disease.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Subject randomized to a VBX device group and BMS control group
Masking
ParticipantOutcomes Assessor
Masking Description
Every effort will be made to blind subjects to the treatment device up to the 1 year follow up visit. The independent Core Lab and Clinical Events Committee (CEC) members will also be blinded.
Allocation
Randomized
Enrollment
244 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
VBX Device Group
Arm Type
Active Comparator
Arm Description
Subject in this group will receive treatment with the GORE VIABAHN® VBX Balloon Expandable Endoprosthesis (VBX)
Arm Title
BMS Control Group
Arm Type
Active Comparator
Arm Description
Subjects in this group will receive treatment with a commercially available bare metal stent (BMS) that is approved for treatment of the disease
Intervention Type
Device
Intervention Name(s)
Stenting of the Common and/or External Iliac Arteries with the GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis
Intervention Description
Treatment of target lesions in the common and/or external iliac arteries by stenting with the GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis.
Intervention Type
Device
Intervention Name(s)
Stenting of the Common and/or External Iliac Arteries with Bare Metal Stent
Intervention Description
Treatment of target lesions in the common and/or external iliac arteries by stenting with a commercially available bare metal stent that is approved for treatment of the disease.
Primary Outcome Measure Information:
Title
Primary Patency
Description
Blood flow through the target lesion (no evidence of binary restenosis >50% or occlusion) without a Target Lesion Revascularization (TLR).
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Technical success
Description
Deployment of device with < 30% residual stenosis on final angiography.
Time Frame
at the procedure
Title
Acute procedural success
Description
Binary assessment based on technical success and freedom from device or procedure-related serious adverse events (SAE) requiring intervention.
Time Frame
at the procedure
Title
Clinical success
Description
Improvement from baseline of at least 1 Rutherford Category and freedom from device or procedure-related SAE requiring intervention.
Time Frame
Through 1 month
Title
Hemodynamic Status
Description
Change in Ankle-brachial index (ABI)/toe-brachial index (TBI) as compared to baseline
Time Frame
Through 5 years
Title
Change in EQ-5D-5L
Description
Change in EQ-5D-5L responses as compared to baseline. The EQ-5D-5L Questionnaire measures quality of life (QoL) over 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension is measured over five levels from no problems to extreme problems. Scored on a 0 to 100 scale with 0 as the worst possible health and 100 is the best possible health.
Time Frame
Through 5 years
Title
Change in WIQ
Description
Change in Walking Impairment Questionnaire (WIQ) responses as compared to baseline. The WIQ is a validated QoL measurement of walking abilities over 3 dimensions: distance, speed, and stair-climbing. Scored on a 0 to 100 scale with 0 as no degree of difficulty and 100 is the highest degree of difficulty.
Time Frame
Through 5 years
Title
Primary patency
Description
Blood flow through the target lesion (no evidence of binary restenosis >50% or occlusion) without a Target Lesion Revascularization (TLR).
Time Frame
Through 5 years
Title
Freedom from binary restenosis
Description
Freedom from binary restenosis. binary restenosis defined as evidence of >50% restenosis or occlusion of the target lesion(s) based on core lab adjudicated duplex ultrasound or angiography
Time Frame
Through 5 years
Title
Primary assisted patency
Description
Blood flow maintained (no evidence of occlusion) through the target lesion with or without a Target Lesion Revascularization (TLR).
Time Frame
Through 5 years
Title
Secondary patency
Description
Blood flow through the target lesion with or without a Target Lesion Revascularization (TLR).
Time Frame
Through 5 years
Title
Freedom from target lesion revascularization
Description
Freedom from target lesion revascularization (TLR). TLR defined as endovascular or surgical intervention performed on the target lesion(s).
Time Frame
Through 5 years
Title
Cumulative reintervention rate
Description
Rate of first and recurrent Target Lesion Revascularization (TLR).
Time Frame
Through 5 years
Title
Freedom from clinically driven target lesion revascularization
Description
Freedom from clinically driven target lesion revascularization. Endovascular or surgical intervention performed on the target lesion(s) in response to recurrent symptoms (increase ≥ 1 Rutherford Category).
Time Frame
Through 5 years
Title
Amputation-free survival
Description
Binary assessment based on freedom from major amputation (target limb, amputation above the metatarsals) and all-cause mortality
Time Frame
Through 5 years
Title
Survival
Description
Freedom from all-cause mortality
Time Frame
Through 5 years
Title
Change in Rutherford Category
Description
Change in Rutherford Category as compared to baseline. Scaled from 0 to 6, with 0 as asymptotic and 6 as major tissue loss, extending above the transmetatarsal (TM) level, functional foot no longer salvageable.
Time Frame
Through 5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 years at time of informed consent signature Informed Consent Form (ICF) is signed by the subject Subject can comply with protocol requirements, including follow-up Patient has symptomatic claudication, rest pain, or minor tissue loss (Rutherford Category 2-5) Patient has de novo or restenotic lesion(s) found in the common and/or external iliac artery(ies) Patient has: Unilateral or bilateral single or multiple lesions (>50% stenosis or chronic total occlusion) each between 4 and 11 cm in length Patient has a target vessel diameter visually estimated to be approximately between 5 mm and 13 mm Patient has a sufficient (<50% stenotic) common femoral artery and at least one sufficient (<50% stenotic) femoral artery (deep or superficial). Patient has at least one sufficient (<50% stenotic) infrapopliteal run-off vessel. Exclusion Criteria: Life expectancy <1 year Patient is pregnant at time of informed consent. Patient has a known allergy to stent or stent graft components (including nitinol, stainless steel, or heparin). Patient has severe chronic renal insufficiency (serum creatinine level > 2.5mg/dL) and not undergoing hemodialysis. Patient has evidence of a systemic infection. Patient has a known intolerance to antithrombotic medications that prevent compliance with study or control device Instructions for Use. Patient has had vascular catheterization of the lower extremities within 30 days of randomization (excluding diagnostic angiograms for the study procedure). Patient has previous stenting in the iliac arteries. Patient has previous surgical bypass in the target limb. Patient is currently participating in another investigative clinical study unless received written approval by the sponsor. Patient has a lesion requiring drug-coated balloon angioplasty, atherectomy, lithotripsy, or any ablative device to facilitate stent delivery. Patient has an abdominal aortic artery lesion or aneurysm. Patient has a lesion that requires stent placement within 2 cm of the inguinal ligament. Patient has isolated common iliac artery stenosis that can be treated with a single device (i.e., common iliac artery stenosis that does not require kissing stents or extend into the external iliac artery). Patient has outflow disease that requires concomitant interventions (i.e. common femoral endarterectomy or femoral / tibial revascularization).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Makensley Lordeus
Phone
623-234-5989
Email
mlordeus@wlgore.com
Facility Information:
Facility Name
North Suburban Medical Center
City
Denver
State/Province
Colorado
ZIP/Postal Code
80229
Country
United States
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ehrin Armstrong, MD
Facility Name
University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Darren Schneider, MD
Facility Name
The University of Texas Southwestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Melissa Kirkwood, MD
Facility Name
Texas Tech University Health Science Center
City
Lubbock
State/Province
Texas
ZIP/Postal Code
79430
Country
United States
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mac Ansari, MD
Facility Name
Krankenhaus der Barmherzigen Brüder
City
Regensburg
Country
Germany
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Markus Steinbauer, MD
Facility Name
Rijnstate Hospital
City
Arnhem
Country
Netherlands
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Michel Reijnen, MD
Facility Name
Auckland City Hospital
City
Auckland
Country
New Zealand
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Andrew Holden, MD

12. IPD Sharing Statement

Learn more about this trial

The GORE VBX FORWARD Clinical Study: A Comparison of the GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis to Bare Metal Stenting for Patients With Complex Iliac Occlusive Disease

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