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EverFlex Post Approval Study (DURABILITY PAS)

Primary Purpose

Peripheral Arterial Disease, Lower Extremity Arterial Disease

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
EverFlex™ Self-Expanding Peripheral Stent System
Sponsored by
Medtronic Endovascular
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peripheral Arterial Disease

Eligibility Criteria

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

General Inclusion Criteria

  1. Has stenotic, restenotic (from PTA or adjunct therapy, not including stents or stent grafts), or occluded lesion(s) located in the native superficial femoral artery or superficial femoral and proximal popliteal arteries suitable for primary stenting.
  2. Has a Rutherford Clinical Category Score of 2, 3 or 4.
  3. Is willing to comply with all follow-up evaluations at the specified times.
  4. Is ≥ to18 years old.
  5. Provides written informed consent prior to enrollment in the study.

Angiographic Inclusion Criteria Subjects must meet all of the following angiographic inclusion criteria. The implanting physician bases all angiographic inclusion criteria on visual determination at the time of the procedure.

  1. Target lesion(s) located within the native SFA/proximal popliteal: distal point at least 3 cm above the cortical margin of the femur and proximal point at least 1 cm below the origin of the profunda femoralis measured by straight posteroanterior (PA) view for distal lesions, ipsilateral oblique view for proximal lesions.
  2. Evidence of ≥ 50% stenosis or restenosis (from PTA or adjunct therapy, not including stents or stent grafts), or occlusion of target lesion(s).
  3. Target lesion(s) total length is ≥ 4 cm and ≤ 18 cm.
  4. Target vessel diameter is ≥ 4.5 mm and ≤ 7.5 mm.
  5. There is evidence of at least one runoff vessel to the ankle/foot of the limb to be treated that does not also require treatment for significant (> 50% stenosis or occlusion) stenosis during the index procedure.

General Exclusion Criteria

  1. Has undergone previous implantation of stent(s) or stent graft(s) in the target vessel.
  2. Has a contraindication or known allergy to antiplatelet therapy, anticoagulants, thrombolytic drugs, contrast media or any other drug used in study according to the protocol.
  3. Has known hypersensitivity to nickel-titanium.
  4. Has bleeding diathesis, coagulopathy, known hypercoagulable condition, or refuses blood transfusion.
  5. Female currently breastfeeding, pregnant, or of childbearing potential not using adequate contraceptive measures.
  6. Has life expectancy of less than 1 year.
  7. Has planned use of thrombectomy, atherectomy, brachytherapy or laser devices during procedure.
  8. Has previously been enrolled in the DURABILITY PAS study.
  9. Has received endovascular treatment of target lesion by percutaneous transluminal angioplasty or any other means of previous endovascular treatment (e.g. cutting balloon, scoring balloon, cryoplasty, thrombectomy, atherectomy, brachytherapy or laser devices) within six months of the index procedure.
  10. Has any planned surgical intervention or endovascular procedure 14 days before or 30 days after the index procedure.
  11. Is currently participating in an investigational drug or another device study that has not completed the primary endpoint or that clinically interferes with the current study endpoints.
  12. Has any co-morbid condition that precludes endovascular treatment.

Angiographic Exclusion Criteria The subject must not meet any of the following angiographic exclusion criteria. The implanting physician bases all angiographic exclusion criteria on visual determination at the time of the procedure.

  1. Exchangeable guidewire cannot cross the target lesion and/or re-enter true vessel lumen distal to lesion(s).
  2. Presence of significant (> 50% stenosis or occlusion) ipsilateral common femoral stenosis.
  3. Aneurysmal target vessel.
  4. Presence of an acute intraluminal thrombus at the proposed lesion site.
  5. Perforation, dissection or other injury of the access or target vessel requiring additional stenting or surgical intervention prior to start of PTA procedure.
  6. Focal popliteal disease in the absence of femoral disease.

Sites / Locations

  • St. Luke's Medical Center
  • Memorial Medical Center
  • Sutter Memorial Hospital
  • Christiana Care Health Services
  • First Coast Cardiovascular Institute, P.A.
  • Augusta Vascular Center
  • DuPage Medical Group
  • Rockford Cardiovascular Associates
  • Central Iowa Hospital Corporation
  • Cardiovascular Solutions, LLC
  • Sparrow Hospital
  • Mercy Hospital/Metropolitan Cardiology Consultants
  • Deborah Heart and Lung Center
  • Wake Heart Research
  • Oklahoma Heart Institute
  • Lankenau Institute for Medical Research
  • Thomas Jefferson University
  • Allegheny General Hospital
  • Black Hills Cardiovascular Research
  • Sanford Research
  • Premier Surgical Associates
  • The University of Texas Health Science Center at San Antonio
  • Bellin Memorial Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Study cohort

Arm Description

All patients enrolled in this study will be treated with the EverFlex™ Self-Expanding Peripheral Stent System.

Outcomes

Primary Outcome Measures

Primary Outcome - Freedom From Acute Death, Freedom From 36-month Amputation, and Freedom From 36-month Clinically-driven Target Lesion Revascularization
Composite endpoint defined as freedom from acute death, freedom from 36-month amputation, and freedom from 36-month clinically-driven target lesion revascularization compared to a PTA performance goal.

Secondary Outcome Measures

Secondary Outcome - Freedom From Stent Fracture
Determined by x-ray at 1, 2 and 3 years using the following classifications: Class 0 - No strut fractures Class I - Single tine fracture Class II - Multiple tine fractures Class III - Stent fracture(s) with preserved alignment of the components Class IV - Stent fracture(s) with mal-alignment of the components Class V - Stent fracture(s) in a trans-axial spiral configuration AND the following categories: Category A - Restenosis ≤ 50% at site of fracture Category B - Restenosis ≥ 50% at site of fracture Category C - Occlusion at site of fracture Category D - Unable to determine
Secondary Outcome - Freedom From Acute Death, Freedom From Amputation and Freedom From Clinically-driven Target Lesion Revascularization at 1 and 2 Years
Defined as the absence of all-cause mortality occurring within 30-days, absence of any major amputation within 12-/24- months and the absence of any clinically-driven repeat invasive procedure, including angioplasty, stenting, endarterectomy, bypass, or thrombolysis, performed to open or increase the lumen diameter inside or within 10 mm of the previously treated lesion due to the return of clinical symptoms within 12-/24- months of the procedure.
Secondary Outcome - Freedom From 36-month Amputation
Defined as the absence of any major amputation (removal of the target limb or a part of the target limb above the metatarsal line) within 36 months of the procedure.
Secondary Outcome - Freedom From 36-month Clinically-driven Target Lesion Revascularization
Defined as the absence of any clinically-driven repeat invasive procedure, including angioplasty, stenting, endarterectomy, bypass, or thrombolysis, performed to open or increase the lumen diameter inside or within 10 mm of the previously treated lesion due to the return of clinical symptoms within 36 months of the procedure.
Secondary Outcome - Number of Participants Free From Acute Death
Defined as the absence of all-cause mortality occurring within 30 days of the procedure.
Secondary Outcome - Number of Successfully Implanted Stents
Defined as the ability to deploy the stent as intended at the treatment site.
Secondary Outcome - Number of Participants With Improvement in Rutherford Clinical Category at 1 Year
Defined as an improvement in clinical status indicated by a decrease of one or more in Rutherford Clinical Category compared to baseline.
Secondary Outcome - Number of Participants With Improvement in Ankle-Brachial Index at 1 Year
Defined as an increase in the ankle-brachial index (ABI) compared to baseline in subjects with compressible arteries and baseline ABI < 0.9.
Secondary Outcome - Change in Score of Walking Impairment Questionnaire at 1 Year
Defined as an increase in Walking Impairment Questionnaire score in subjects who did not have iliac disease treated at the time of the index procedure compared to baseline Scale Range: Minimum score 0 to maximum score 100 Higher values represent better outcomes
Secondary Outcome - Number of Adverse Events
Number of Adverse Events in the study through 3 Years.

Full Information

First Posted
September 4, 2012
Last Updated
December 6, 2019
Sponsor
Medtronic Endovascular
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1. Study Identification

Unique Protocol Identification Number
NCT01680835
Brief Title
EverFlex Post Approval Study
Acronym
DURABILITY PAS
Official Title
The US StuDy for EvalUating EndovasculaR TreAtments of Lesions in the Superficial Femoral Artery and Proximal Popliteal By usIng the EverfLex NitInol STent System Post Approval Study
Study Type
Interventional

2. Study Status

Record Verification Date
December 2019
Overall Recruitment Status
Completed
Study Start Date
January 14, 2013 (Actual)
Primary Completion Date
October 23, 2018 (Actual)
Study Completion Date
February 4, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Medtronic Endovascular

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This post-approval study is designed to confirm the long-term safety and effectiveness of the EverFlex™ Self-Expanding Stent System for the treatment of atherosclerotic superficial femoral artery (SFA) and proximal popliteal arteries.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peripheral Arterial Disease, Lower Extremity Arterial Disease

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Study cohort
Arm Type
Experimental
Arm Description
All patients enrolled in this study will be treated with the EverFlex™ Self-Expanding Peripheral Stent System.
Intervention Type
Device
Intervention Name(s)
EverFlex™ Self-Expanding Peripheral Stent System
Intervention Description
Using the EverFlex™ Self-Expanding Peripheral Stent System to treat atherosclerotic superficial femoral artery (SFA) and proximal popliteal lesions 4-18 cm long in subjects with Rutherford Clinical Categories 2-4.
Primary Outcome Measure Information:
Title
Primary Outcome - Freedom From Acute Death, Freedom From 36-month Amputation, and Freedom From 36-month Clinically-driven Target Lesion Revascularization
Description
Composite endpoint defined as freedom from acute death, freedom from 36-month amputation, and freedom from 36-month clinically-driven target lesion revascularization compared to a PTA performance goal.
Time Frame
3 Years
Secondary Outcome Measure Information:
Title
Secondary Outcome - Freedom From Stent Fracture
Description
Determined by x-ray at 1, 2 and 3 years using the following classifications: Class 0 - No strut fractures Class I - Single tine fracture Class II - Multiple tine fractures Class III - Stent fracture(s) with preserved alignment of the components Class IV - Stent fracture(s) with mal-alignment of the components Class V - Stent fracture(s) in a trans-axial spiral configuration AND the following categories: Category A - Restenosis ≤ 50% at site of fracture Category B - Restenosis ≥ 50% at site of fracture Category C - Occlusion at site of fracture Category D - Unable to determine
Time Frame
1, 2 and 3 years
Title
Secondary Outcome - Freedom From Acute Death, Freedom From Amputation and Freedom From Clinically-driven Target Lesion Revascularization at 1 and 2 Years
Description
Defined as the absence of all-cause mortality occurring within 30-days, absence of any major amputation within 12-/24- months and the absence of any clinically-driven repeat invasive procedure, including angioplasty, stenting, endarterectomy, bypass, or thrombolysis, performed to open or increase the lumen diameter inside or within 10 mm of the previously treated lesion due to the return of clinical symptoms within 12-/24- months of the procedure.
Time Frame
1 and 2 years
Title
Secondary Outcome - Freedom From 36-month Amputation
Description
Defined as the absence of any major amputation (removal of the target limb or a part of the target limb above the metatarsal line) within 36 months of the procedure.
Time Frame
3 Years
Title
Secondary Outcome - Freedom From 36-month Clinically-driven Target Lesion Revascularization
Description
Defined as the absence of any clinically-driven repeat invasive procedure, including angioplasty, stenting, endarterectomy, bypass, or thrombolysis, performed to open or increase the lumen diameter inside or within 10 mm of the previously treated lesion due to the return of clinical symptoms within 36 months of the procedure.
Time Frame
3 Years
Title
Secondary Outcome - Number of Participants Free From Acute Death
Description
Defined as the absence of all-cause mortality occurring within 30 days of the procedure.
Time Frame
30 days
Title
Secondary Outcome - Number of Successfully Implanted Stents
Description
Defined as the ability to deploy the stent as intended at the treatment site.
Time Frame
At procedure
Title
Secondary Outcome - Number of Participants With Improvement in Rutherford Clinical Category at 1 Year
Description
Defined as an improvement in clinical status indicated by a decrease of one or more in Rutherford Clinical Category compared to baseline.
Time Frame
1 Year
Title
Secondary Outcome - Number of Participants With Improvement in Ankle-Brachial Index at 1 Year
Description
Defined as an increase in the ankle-brachial index (ABI) compared to baseline in subjects with compressible arteries and baseline ABI < 0.9.
Time Frame
1 Year
Title
Secondary Outcome - Change in Score of Walking Impairment Questionnaire at 1 Year
Description
Defined as an increase in Walking Impairment Questionnaire score in subjects who did not have iliac disease treated at the time of the index procedure compared to baseline Scale Range: Minimum score 0 to maximum score 100 Higher values represent better outcomes
Time Frame
1 Year
Title
Secondary Outcome - Number of Adverse Events
Description
Number of Adverse Events in the study through 3 Years.
Time Frame
3 Years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
General Inclusion Criteria Has stenotic, restenotic (from PTA or adjunct therapy, not including stents or stent grafts), or occluded lesion(s) located in the native superficial femoral artery or superficial femoral and proximal popliteal arteries suitable for primary stenting. Has a Rutherford Clinical Category Score of 2, 3 or 4. Is willing to comply with all follow-up evaluations at the specified times. Is ≥ to18 years old. Provides written informed consent prior to enrollment in the study. Angiographic Inclusion Criteria Subjects must meet all of the following angiographic inclusion criteria. The implanting physician bases all angiographic inclusion criteria on visual determination at the time of the procedure. Target lesion(s) located within the native SFA/proximal popliteal: distal point at least 3 cm above the cortical margin of the femur and proximal point at least 1 cm below the origin of the profunda femoralis measured by straight posteroanterior (PA) view for distal lesions, ipsilateral oblique view for proximal lesions. Evidence of ≥ 50% stenosis or restenosis (from PTA or adjunct therapy, not including stents or stent grafts), or occlusion of target lesion(s). Target lesion(s) total length is ≥ 4 cm and ≤ 18 cm. Target vessel diameter is ≥ 4.5 mm and ≤ 7.5 mm. There is evidence of at least one runoff vessel to the ankle/foot of the limb to be treated that does not also require treatment for significant (> 50% stenosis or occlusion) stenosis during the index procedure. General Exclusion Criteria Has undergone previous implantation of stent(s) or stent graft(s) in the target vessel. Has a contraindication or known allergy to antiplatelet therapy, anticoagulants, thrombolytic drugs, contrast media or any other drug used in study according to the protocol. Has known hypersensitivity to nickel-titanium. Has bleeding diathesis, coagulopathy, known hypercoagulable condition, or refuses blood transfusion. Female currently breastfeeding, pregnant, or of childbearing potential not using adequate contraceptive measures. Has life expectancy of less than 1 year. Has planned use of thrombectomy, atherectomy, brachytherapy or laser devices during procedure. Has previously been enrolled in the DURABILITY PAS study. Has received endovascular treatment of target lesion by percutaneous transluminal angioplasty or any other means of previous endovascular treatment (e.g. cutting balloon, scoring balloon, cryoplasty, thrombectomy, atherectomy, brachytherapy or laser devices) within six months of the index procedure. Has any planned surgical intervention or endovascular procedure 14 days before or 30 days after the index procedure. Is currently participating in an investigational drug or another device study that has not completed the primary endpoint or that clinically interferes with the current study endpoints. Has any co-morbid condition that precludes endovascular treatment. Angiographic Exclusion Criteria The subject must not meet any of the following angiographic exclusion criteria. The implanting physician bases all angiographic exclusion criteria on visual determination at the time of the procedure. Exchangeable guidewire cannot cross the target lesion and/or re-enter true vessel lumen distal to lesion(s). Presence of significant (> 50% stenosis or occlusion) ipsilateral common femoral stenosis. Aneurysmal target vessel. Presence of an acute intraluminal thrombus at the proposed lesion site. Perforation, dissection or other injury of the access or target vessel requiring additional stenting or surgical intervention prior to start of PTA procedure. Focal popliteal disease in the absence of femoral disease.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jon S Matsumura, MD
Organizational Affiliation
University of Wisconsin, Madison
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Krishna Rocha-Singh, MD
Organizational Affiliation
Prairie Heart Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
St. Luke's Medical Center
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85006
Country
United States
Facility Name
Memorial Medical Center
City
Modesto
State/Province
California
ZIP/Postal Code
95355
Country
United States
Facility Name
Sutter Memorial Hospital
City
Sacramento
State/Province
California
ZIP/Postal Code
95819
Country
United States
Facility Name
Christiana Care Health Services
City
Newark
State/Province
Delaware
ZIP/Postal Code
19713
Country
United States
Facility Name
First Coast Cardiovascular Institute, P.A.
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32216
Country
United States
Facility Name
Augusta Vascular Center
City
Augusta
State/Province
Georgia
ZIP/Postal Code
30901
Country
United States
Facility Name
DuPage Medical Group
City
Downers Grove
State/Province
Illinois
ZIP/Postal Code
60515
Country
United States
Facility Name
Rockford Cardiovascular Associates
City
Rockford
State/Province
Illinois
ZIP/Postal Code
61107
Country
United States
Facility Name
Central Iowa Hospital Corporation
City
Des Moines
State/Province
Iowa
ZIP/Postal Code
50266
Country
United States
Facility Name
Cardiovascular Solutions, LLC
City
Shreveport
State/Province
Louisiana
ZIP/Postal Code
71103
Country
United States
Facility Name
Sparrow Hospital
City
Lansing
State/Province
Michigan
ZIP/Postal Code
48912
Country
United States
Facility Name
Mercy Hospital/Metropolitan Cardiology Consultants
City
Coon Rapids
State/Province
Minnesota
ZIP/Postal Code
55433
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
Wake Heart Research
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27607
Country
United States
Facility Name
Oklahoma Heart Institute
City
Tulsa
State/Province
Oklahoma
ZIP/Postal Code
74104
Country
United States
Facility Name
Lankenau Institute for Medical Research
City
Bryn Mawr
State/Province
Pennsylvania
ZIP/Postal Code
19010
Country
United States
Facility Name
Thomas Jefferson University
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19147
Country
United States
Facility Name
Allegheny General Hospital
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15212
Country
United States
Facility Name
Black Hills Cardiovascular Research
City
Rapid City
State/Province
South Dakota
ZIP/Postal Code
57701
Country
United States
Facility Name
Sanford Research
City
Sioux Falls
State/Province
South Dakota
ZIP/Postal Code
57117
Country
United States
Facility Name
Premier Surgical Associates
City
Knoxville
State/Province
Tennessee
ZIP/Postal Code
37909
Country
United States
Facility Name
The University of Texas Health Science Center at San Antonio
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
Bellin Memorial Hospital
City
Green Bay
State/Province
Wisconsin
ZIP/Postal Code
54301
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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EverFlex Post Approval Study

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