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Comparison of the Ranger™ Paclitaxel-Coated PTA Balloon Catheter and Uncoated PTA Balloons in Femoropopliteal Arteries (RANGER-SFA)

Primary Purpose

Peripheral Artery Disease, Claudication, Atherosclerosis

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Ranger DCB
uncoated PTA balloon
Sponsored by
Hemoteq AG
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peripheral Artery Disease focused on measuring drug-coated balloon, drug-eluting balloon, peripheral artery disease, claudication

Eligibility Criteria

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

Inclusion Criteria:

  • Subjects must be age 18 or older
  • Subject is willing and able to provide informed consent
  • Subject is available to attend all required follow-up visits
  • Subject has a clinically significant symptomatic leg ischemia requiring treatment
  • Subject has a Rutherford clinical category of 2-4
  • If the index lesion is restenotic, the prior PTA must have been >30 days prior to treatment in the current study
  • Only one lesion per limb can be treated under this protocol.
  • Successful intraluminal wire crossing of the target lesion
  • Index lesion is a clinically and hemodynamically significant stenotic or restenotic lesion located in the native nonstented superficial femoral artery or proximal popliteal artery
  • Degree of stenosis 70% or more, by visual assessment
  • Lesion length between 20 mm and 150 mm
  • At least one patent infrapopliteal artery to the foot of the index limb

Exclusion Criteria:

  • Subjects who have undergone prior vascular surgery of the femoropopliteal artery in the index limb to treat atherosclerotic disease
  • History of major amputation in the same limb as the target lesion
  • Presence of aneurysm in the target vessel
  • Acute ischemia and/or acute thrombosis in any artery of the lower limbs
  • Acute Myocardial Infarction within 30 days before the index procedure
  • Persistent, intraluminal thrombus of the proposed target lesion post-thrombolytic therapy
  • Known hypersensitivity or contraindication to contrast dye that cannot be adequately pre-medicated
  • Known allergies against Paclitaxel or other components of the used medical devices
  • Intolerance to antiplatelet, anticoagulant, or thrombolytic medications that would be administered during the trial
  • Platelet count <100,000 mm3 or >600,000 mm3
  • Concomitant renal failure with a serum creatinine >2.0 mg/dL
  • Receiving dialysis or immunosuppressant therapy
  • Life expectancy of less than one year
  • Women of child-bearing potential must agree to use a reliable method of contraception from the time of screening through 12 months after the index procedure.
  • Woman who is pregnant or nursing.
  • Previously planned stenting of the index lesion
  • Use of adjunctive therapies (debulking, laser, cryoplasty, re-entry devices)
  • Planned or expected procedures (cardiac, aorta, peripheral) within 30 days after the index procedure
  • Presence of outflow lesions requiring intervention within 30 days of the index procedure
  • Perforated vessel as evidenced by extravasation of contrast media
  • Heavily calcified target lesions resistant to PTA
  • Current participation in another drug or device trial that has not completed the primary endpoint, that may potentially confound the results of this trial, or that would limit the subject's compliance with the follow-up requirements
  • Current participation in any study using drug-coated/drug-eluting technologies
  • Current participation in any study using drug-coated/drug-eluting technologies
  • Target lesion with in-stent restenosis (any stent or stent-graft)

Sites / Locations

  • Medical University, AKH
  • CHU Caen Côte de Nacre
  • Hopital Europeen Georges-Pompidou (HEGP)
  • Clinique Pasteur Toulouse
  • Klinikum Arnsberg
  • Segeberger Kliniken
  • Klinikum Darmstadt GmbH
  • CardioVascular Center
  • Universitätsklinikum Leipzig
  • Park-Krankenhaus
  • Universitätsklinikum

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Ranger(TM) Paclitaxel-coated balloon

uncoated PTA balloon

Arm Description

Index lesion treated with Ranger(TM) Paclitaxel-coated PTA balloon catheter (Ranger DCB)

Index lesion treated with an uncoated standard PTA dilatation balloon catheter selected upon investigator´s discretion

Outcomes

Primary Outcome Measures

in-segment late lumen loss
In-segment late lumen loss (LLL) of the treated segment after PTA using the Ranger™ paclitaxel-coated PTA balloon, in comparison to the LLL after PTA using an uncoated balloon, as observed by angiography at six months post-index procedure.

Secondary Outcome Measures

technical success
The ability to cross and dilate the lesion to achieve residual angiographic stenosis no greater than 30%.
procedural success
Technical success with no MAE noted within 24 hours of the index procedure.
primary patency
Percentage of lesions that reach endpoint without a hemodynamically significant stenosis on duplex ultrasound (DUS) and without target lesion revascularization (TLR) or bypass of the target lesion to maintain or restore patency.
primary patency
Percentage of lesions that reach endpoint without a hemodynamically significant stenosis on DUS and without TLR or bypass of the target lesion to maintain or restore patency.
assisted primary patency
Percentage of lesions without TLR and those with TLR (not due to complete occlusion or bypass) that reach endpoint without restenosis.
assisted primary patency
Percentage of lesions without TLR and those with TLR (not due to complete occlusion or bypass) that reach endpoint without restenosis.
secondary patency
Percentage of lesions with TLR for occlusion that reach endpoint without restenosis.
secondary patency
Percentage of lesions with TLR for occlusion that reach endpoint without restenosis.
binary restenosis rate
Binary restenosis defined as > 50% diameter stenosis via peak systolic velocity ratio (PSVR) > 2.4 via duplex ultrasound and assessed by the core lab.
binary restenosis rate
Binary restenosis defined as > 50% diameter stenosis via peak systolic velocity ratio (PSVR) > 2.4 via duplex ultrasound and assessed by the core lab.
clinical success
Positive change (by +1 or more) of Rutherford category at pre-discharge post-index-procedure as compared to baseline.
clinical success
Positive change (by +1 or more) of Rutherford category at six months (plus or minus 30 days) post-index-procedure as compared to baseline.
clinical success
Positive change (by +1 or more) of Rutherford category at twelve months (plus or minus 30 days) post-index-procedure as compared to baseline.
hemodynamic success
positive change in Ankle-Brachial Index (ABI) at pre-discharge as compared to baseline
hemodynamic success
positive change in ABI at six months (plus or minus 30 days) as compared to baseline
hemodynamic success
positive change in ABI at twelve months (plus or minus 30 days) as compared to baseline
change in quality of life
Change in functional status measured by changes in the Walking Impairment Questionnaire (WiQ) and general health-related quality of life measured by changes in SF-12 and EQ5D scores at six months (plus or minus 30 days) as compared to baseline.
change in quality of life
Change in functional status measured by changes in the Walking Impairment Questionnaire (WiQ) and general health-related quality of life measured by changes in SF-12 and EQ5D scores at twelve months (plus or minus 30 days) as compared to baseline.
change in quality of life
Change in general health-related quality of life measured by changes in SF-12 and EQ5D scores at 24 months (plus or minus 30 days) as compared to baseline.
change in quality of life
Change in general health-related quality of life measured by changes in SF-12 and EQ5D scores at 36 months (plus or minus 30 days) as compared to baseline.

Full Information

First Posted
December 11, 2013
Last Updated
December 20, 2019
Sponsor
Hemoteq AG
Collaborators
CERES GmbH, coreLab Black Forest GmbH
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1. Study Identification

Unique Protocol Identification Number
NCT02013193
Brief Title
Comparison of the Ranger™ Paclitaxel-Coated PTA Balloon Catheter and Uncoated PTA Balloons in Femoropopliteal Arteries
Acronym
RANGER-SFA
Official Title
Prospective, Randomized, Multicentre Clinical Study of the Hemoteq Ranger™ Paclitaxel-Coated PTA Balloon Catheter (Ranger DCB) in Comparison to Uncoated PTA Balloons in Femoropopliteal Lesions
Study Type
Interventional

2. Study Status

Record Verification Date
December 2019
Overall Recruitment Status
Completed
Study Start Date
January 7, 2014 (Actual)
Primary Completion Date
June 16, 2016 (Actual)
Study Completion Date
March 15, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hemoteq AG
Collaborators
CERES GmbH, coreLab Black Forest GmbH

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The primary objective of this study is to prove the superior performance of the Ranger™ paclitaxel-coated PTA balloon catheter for angioplasty for femoropopliteal artery lesions when compared to non-coated balloons at six months post-procedure when comparing Late Lumen Loss (LLL). Study statistical hypothesis: The %-mean loss of luminal diameter as assessed by angiography at six months follow-up after treatment of the femoropopliteal artery with Ranger DCB study devices is lower than the %-mean loss of luminal diameter after treatment with uncoated PTA balloon control devices.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peripheral Artery Disease, Claudication, Atherosclerosis, Arteriosclerosis
Keywords
drug-coated balloon, drug-eluting balloon, peripheral artery disease, claudication

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
105 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ranger(TM) Paclitaxel-coated balloon
Arm Type
Experimental
Arm Description
Index lesion treated with Ranger(TM) Paclitaxel-coated PTA balloon catheter (Ranger DCB)
Arm Title
uncoated PTA balloon
Arm Type
Active Comparator
Arm Description
Index lesion treated with an uncoated standard PTA dilatation balloon catheter selected upon investigator´s discretion
Intervention Type
Device
Intervention Name(s)
Ranger DCB
Intervention Description
After successful pre-dilatation the index lesion is treated with one or two Ranger DCB devices that completely cover the lesion. If two devices are deployed, overlap shall be minimal.
Intervention Type
Device
Intervention Name(s)
uncoated PTA balloon
Intervention Description
The index lesion is treated with one or more uncoated standard PTA balloons that completely cover the lesion.
Primary Outcome Measure Information:
Title
in-segment late lumen loss
Description
In-segment late lumen loss (LLL) of the treated segment after PTA using the Ranger™ paclitaxel-coated PTA balloon, in comparison to the LLL after PTA using an uncoated balloon, as observed by angiography at six months post-index procedure.
Time Frame
six months
Secondary Outcome Measure Information:
Title
technical success
Description
The ability to cross and dilate the lesion to achieve residual angiographic stenosis no greater than 30%.
Time Frame
during index procedure, less 1 hour
Title
procedural success
Description
Technical success with no MAE noted within 24 hours of the index procedure.
Time Frame
within 24 hours of index procedure
Title
primary patency
Description
Percentage of lesions that reach endpoint without a hemodynamically significant stenosis on duplex ultrasound (DUS) and without target lesion revascularization (TLR) or bypass of the target lesion to maintain or restore patency.
Time Frame
six months
Title
primary patency
Description
Percentage of lesions that reach endpoint without a hemodynamically significant stenosis on DUS and without TLR or bypass of the target lesion to maintain or restore patency.
Time Frame
twelve months
Title
assisted primary patency
Description
Percentage of lesions without TLR and those with TLR (not due to complete occlusion or bypass) that reach endpoint without restenosis.
Time Frame
six months
Title
assisted primary patency
Description
Percentage of lesions without TLR and those with TLR (not due to complete occlusion or bypass) that reach endpoint without restenosis.
Time Frame
twelve months
Title
secondary patency
Description
Percentage of lesions with TLR for occlusion that reach endpoint without restenosis.
Time Frame
six months
Title
secondary patency
Description
Percentage of lesions with TLR for occlusion that reach endpoint without restenosis.
Time Frame
twelve months
Title
binary restenosis rate
Description
Binary restenosis defined as > 50% diameter stenosis via peak systolic velocity ratio (PSVR) > 2.4 via duplex ultrasound and assessed by the core lab.
Time Frame
six months
Title
binary restenosis rate
Description
Binary restenosis defined as > 50% diameter stenosis via peak systolic velocity ratio (PSVR) > 2.4 via duplex ultrasound and assessed by the core lab.
Time Frame
twelve months
Title
clinical success
Description
Positive change (by +1 or more) of Rutherford category at pre-discharge post-index-procedure as compared to baseline.
Time Frame
pre-discharge, estim. 1-2 days post-index procedure
Title
clinical success
Description
Positive change (by +1 or more) of Rutherford category at six months (plus or minus 30 days) post-index-procedure as compared to baseline.
Time Frame
six months
Title
clinical success
Description
Positive change (by +1 or more) of Rutherford category at twelve months (plus or minus 30 days) post-index-procedure as compared to baseline.
Time Frame
twelve months
Title
hemodynamic success
Description
positive change in Ankle-Brachial Index (ABI) at pre-discharge as compared to baseline
Time Frame
pre-discharge, estim. 1-2 days post-index procedure
Title
hemodynamic success
Description
positive change in ABI at six months (plus or minus 30 days) as compared to baseline
Time Frame
six months
Title
hemodynamic success
Description
positive change in ABI at twelve months (plus or minus 30 days) as compared to baseline
Time Frame
twelve months
Title
change in quality of life
Description
Change in functional status measured by changes in the Walking Impairment Questionnaire (WiQ) and general health-related quality of life measured by changes in SF-12 and EQ5D scores at six months (plus or minus 30 days) as compared to baseline.
Time Frame
six months
Title
change in quality of life
Description
Change in functional status measured by changes in the Walking Impairment Questionnaire (WiQ) and general health-related quality of life measured by changes in SF-12 and EQ5D scores at twelve months (plus or minus 30 days) as compared to baseline.
Time Frame
twelve months
Title
change in quality of life
Description
Change in general health-related quality of life measured by changes in SF-12 and EQ5D scores at 24 months (plus or minus 30 days) as compared to baseline.
Time Frame
24 months
Title
change in quality of life
Description
Change in general health-related quality of life measured by changes in SF-12 and EQ5D scores at 36 months (plus or minus 30 days) as compared to baseline.
Time Frame
36 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects must be age 18 or older Subject is willing and able to provide informed consent Subject is available to attend all required follow-up visits Subject has a clinically significant symptomatic leg ischemia requiring treatment Subject has a Rutherford clinical category of 2-4 If the index lesion is restenotic, the prior PTA must have been >30 days prior to treatment in the current study Only one lesion per limb can be treated under this protocol. Successful intraluminal wire crossing of the target lesion Index lesion is a clinically and hemodynamically significant stenotic or restenotic lesion located in the native nonstented superficial femoral artery or proximal popliteal artery Degree of stenosis 70% or more, by visual assessment Lesion length between 20 mm and 150 mm At least one patent infrapopliteal artery to the foot of the index limb Exclusion Criteria: Subjects who have undergone prior vascular surgery of the femoropopliteal artery in the index limb to treat atherosclerotic disease History of major amputation in the same limb as the target lesion Presence of aneurysm in the target vessel Acute ischemia and/or acute thrombosis in any artery of the lower limbs Acute Myocardial Infarction within 30 days before the index procedure Persistent, intraluminal thrombus of the proposed target lesion post-thrombolytic therapy Known hypersensitivity or contraindication to contrast dye that cannot be adequately pre-medicated Known allergies against Paclitaxel or other components of the used medical devices Intolerance to antiplatelet, anticoagulant, or thrombolytic medications that would be administered during the trial Platelet count <100,000 mm3 or >600,000 mm3 Concomitant renal failure with a serum creatinine >2.0 mg/dL Receiving dialysis or immunosuppressant therapy Life expectancy of less than one year Women of child-bearing potential must agree to use a reliable method of contraception from the time of screening through 12 months after the index procedure. Woman who is pregnant or nursing. Previously planned stenting of the index lesion Use of adjunctive therapies (debulking, laser, cryoplasty, re-entry devices) Planned or expected procedures (cardiac, aorta, peripheral) within 30 days after the index procedure Presence of outflow lesions requiring intervention within 30 days of the index procedure Perforated vessel as evidenced by extravasation of contrast media Heavily calcified target lesions resistant to PTA Current participation in another drug or device trial that has not completed the primary endpoint, that may potentially confound the results of this trial, or that would limit the subject's compliance with the follow-up requirements Current participation in any study using drug-coated/drug-eluting technologies Current participation in any study using drug-coated/drug-eluting technologies Target lesion with in-stent restenosis (any stent or stent-graft)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dierk Scheinert, M.D.
Organizational Affiliation
University Leipzig
Official's Role
Principal Investigator
Facility Information:
Facility Name
Medical University, AKH
City
Vienna
ZIP/Postal Code
1090
Country
Austria
Facility Name
CHU Caen Côte de Nacre
City
Caen
ZIP/Postal Code
14000
Country
France
Facility Name
Hopital Europeen Georges-Pompidou (HEGP)
City
Paris
ZIP/Postal Code
75908
Country
France
Facility Name
Clinique Pasteur Toulouse
City
Toulouse
ZIP/Postal Code
31076
Country
France
Facility Name
Klinikum Arnsberg
City
Arnsberg
ZIP/Postal Code
59759
Country
Germany
Facility Name
Segeberger Kliniken
City
Bad Segeberg
ZIP/Postal Code
23795
Country
Germany
Facility Name
Klinikum Darmstadt GmbH
City
Darmstadt
ZIP/Postal Code
64283
Country
Germany
Facility Name
CardioVascular Center
City
Frankfurt
ZIP/Postal Code
60389
Country
Germany
Facility Name
Universitätsklinikum Leipzig
City
Leipzig
ZIP/Postal Code
04103
Country
Germany
Facility Name
Park-Krankenhaus
City
Leipzig
ZIP/Postal Code
04289
Country
Germany
Facility Name
Universitätsklinikum
City
Marburg
ZIP/Postal Code
35043
Country
Germany

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
28558502
Citation
Bausback Y, Willfort-Ehringer A, Sievert H, Geist V, Lichtenberg M, Del Giudice C, Sauguet A, Diaz-Cartelle J, Marx C, Strobel A, Schult I, Scheinert D; RANGER SFA Investigators. Six-Month Results From the Initial Randomized Study of the Ranger Paclitaxel-Coated Balloon in the Femoropopliteal Segment. J Endovasc Ther. 2017 Aug;24(4):459-467. doi: 10.1177/1526602817710770. Epub 2017 May 31.
Results Reference
derived

Learn more about this trial

Comparison of the Ranger™ Paclitaxel-Coated PTA Balloon Catheter and Uncoated PTA Balloons in Femoropopliteal Arteries

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