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HORIZON Prospective Clinical Investigation

Primary Purpose

Peripheral Arterial Disease

Status
Recruiting
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
EXIST 6F NiTi Stent System FLEX
EXIST 6F NiTi Stent System PULL
Sponsored by
Qmedics AG
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peripheral Arterial Disease focused on measuring stenotic lesions, Peripheral Arterial Disease, occluded lesions, Superficial Femoral Artery, nitinol stent, self-expanding stent, Chronic Limb-Threatening Ischemia

Eligibility Criteria

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

Inclusion Criteria:

- Clinical:

  1. Patient age 18 years or older
  2. Subject 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
  3. Symptoms of peripheral arterial disease classified as Rutherford Category 2, 3 or 4 or Fontaine Class IIb or III
  4. The stenotic or occlusive lesion in Superficial Femoral Artery (SFA) and proximal popliteal artery, P1 segment, is considered suitable for stenting
  5. No underlying medical condition is present which would prevent the subject from performing the required testing or from completing the study.
  6. Stable medical condition

    • Anatomical criteria:
  7. Included TASC II, A-B-C measured on pre- angio CT-scan (if CT-scan is standard of care)
  8. Lesions must be one or multiple that can be treated with maximum two stents, maximum one overlapping and maximum length of the stent 25 cm
  9. Patent ipsilateral iliac, popliteal (P2 and P3) and at least one tibial vessel

Exclusion Criteria:

- Clinical criteria:

  1. Subjects pregnant, breastfeeding or planning to become pregnant during the trial participation
  2. Documented life expectancy less than 24 months due to other medical co-morbid condition(s)
  3. Thrombophlebitis or deep vein thrombosis within the past 30 days.
  4. Unable to assume DAPT (Dual Antiplatelet Therapy)
  5. Concomitant renal failure with serum creatinine level > 2.5 mg/dL (or > 220 µmol/L) or GFR < 30 ml/min/1,73 m2
  6. Unresolved neutropenia (white blood cell count < 3,000 / µL) or thrombocytopenia (platelet count < 80,000 / µL) at the time of the index procedure
  7. Unresolved bleeding disorder (INR ≥ 1.2) at the time of the index procedure
  8. Active gastrointestinal bleeding
  9. Anticoagulation therapy for other medical condition

    • Anatomical criteria:
  10. Target lesion(s) received previous treatment within 30 days prior to enrolment (point of enrolment is defined as the time when the trial device enters the body)
  11. Previously stented ipsilateral SFA
  12. Prior peripheral vascular bypass surgery involving the target limb(s)
  13. Target lesion is located within an aneurysm or associated with an aneurysm in the vessel segment either proximal or distal to the target lesion
  14. Target lesion requires the use of cutting balloons, atherectomy or drug coated balloons (DCB) during the intervention

Sites / Locations

  • Policlinico di Monza
  • University Hospital of Catania
  • Erasmus MC
  • University Clinical Hospital of BialystokRecruiting
  • Geneva University Hospitals

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

EXIST 6F NiTi Stent System FLEX

EXIST 6F NiTi Stent System PULL

Arm Description

Stent implantation of lesions in the SFA graded with Fanelli 1 and 2, and lesions in the P1 segment of the proximal popliteal artery.

Stent implantation of lesions in the SFA graded with 3 and 4.

Outcomes

Primary Outcome Measures

Primary patency
The primary patency rate (defined as freedom from more than ≥ 50% restenosis) at 12 months post-procedure as measured by Peak Systolic Velocity ratio (PSVr) assessed with Duplex ultrasound (DUS). A PSVr ≥ 2,5 suggests a reduction in the luminal diameter >50%.
Major Adverse Events
Freedom from procedure- or stent-related Major Adverse Events (MAEs) at 30-days post index-procedure will be reported. MAE is defined as all causes of death and target limb major amputation, defined as amputation of the lower limb at the ankle level or above.

Secondary Outcome Measures

Improvement of Rutherford / Fontaine classification
Clinical success Defined as improvement of Rutherford / Fontaine classification of one class or more as compared to the pre-procedure and an ankle-brachial index improvement (ABI) by ≥ 0.15.
Primary patency
Compare the Exist 6F NiTi stent primary patency with >50% of subjects with peripheral artery disease with literature data.
Rate of stent fracture
Stent fracture rate is evaluated with x-ray. Stent fracture is defined according to classification on x-ray.
Freedom from Target Lesion Revascularization
Defined as the absence of revascularization (by any means) of the target lesion (fTLR).
Walking and mobility
Improvement of walking and mobility is assessed by change in the 36-Item Short Form Survey (SF-36) score from baseline.
Patency rate
Patency rate as measured by Peak Systolic Velocity ratio (PSVr) assessed with Duplex ultrasound (DUS). A PSVr ≥ 2,5 suggests a reduction in the luminal diameter >50%.
Major Adverse Events
Procedure- or stent-related Major Adverse Events (MAEs) post index-procedure will be reported. MAE is defined as all causes of death and target limb major amputation, defined as amputation of the lower limb at the ankle level or above.

Full Information

First Posted
January 31, 2022
Last Updated
January 31, 2022
Sponsor
Qmedics AG
Collaborators
Policlinico di Monza, University Clinical Hospital of Bialystok, University Hospital, Catania, Erasmus Medical Center, University Hospital, Geneva
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1. Study Identification

Unique Protocol Identification Number
NCT05234164
Brief Title
HORIZON Prospective Clinical Investigation
Official Title
HORIZON. Clinical Investigation of the Qmedics EXIST NiTi Stent Type FLEX & PULL in Adults With Peripheral Artery Disease (PAD)
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Recruiting
Study Start Date
February 2022 (Anticipated)
Primary Completion Date
March 2024 (Anticipated)
Study Completion Date
March 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Qmedics AG
Collaborators
Policlinico di Monza, University Clinical Hospital of Bialystok, University Hospital, Catania, Erasmus Medical Center, University Hospital, Geneva

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
The objective of this clinical investigation is to demonstrate and provide long term clinical data on safety and performance of the Exist 6F NiTi stent system type FLEX & PULL in a prospective investigation for the treatment of adult patients with de novo or re-stenotic symptomatic atherosclerotic lesions in Peripheral Artery Disease (PAD) requiring treatment of the Superficial Femoral Artery (SFA) or Proximal Popliteal Artery (P1 segment).
Detailed Description
This is a multicenter, prospective study with clinical and radiographic follow-up for 24 months months post-procedure. Approximately two hundred thirty subjects will be enrolled (115 subjects will receive the FLEX type and 115 subjects the PULL type) in several centers, minimum 10 patients per investigational center. All patients will be evaluated at 30 days and 6-, 12- and 24-months post-index procedure.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peripheral Arterial Disease
Keywords
stenotic lesions, Peripheral Arterial Disease, occluded lesions, Superficial Femoral Artery, nitinol stent, self-expanding stent, Chronic Limb-Threatening Ischemia

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Subjects requiring treatment of the SFA will undergo a calcification review based on the Fanelli classification. Subjects graded with Fanelli 1 or 2, and subjects requiring treatment of the P1 segment of the proximal popliteal artery will be treated with the Exist 6F NiTi Stent type FLEX. Subject graded with Fanelli 3 and 4 will be treated with the Exist 6F NiTi Stent PULL.
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
230 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
EXIST 6F NiTi Stent System FLEX
Arm Type
Experimental
Arm Description
Stent implantation of lesions in the SFA graded with Fanelli 1 and 2, and lesions in the P1 segment of the proximal popliteal artery.
Arm Title
EXIST 6F NiTi Stent System PULL
Arm Type
Experimental
Arm Description
Stent implantation of lesions in the SFA graded with 3 and 4.
Intervention Type
Device
Intervention Name(s)
EXIST 6F NiTi Stent System FLEX
Intervention Description
Subjects requiring treatment of the P1 segment of the proximal popliteal artery will be treated with the Exist 6F NiTi Stent FLEX type. Subjects requiring treatment of the SFA will undergo an additional calcification review based on the Fanelli classification. Subjects graded with Fanelli 1 or 2 will be treated with the Exist 6F NiTi Stent FLEX type.
Intervention Type
Device
Intervention Name(s)
EXIST 6F NiTi Stent System PULL
Intervention Description
Subjects requiring treatment of the SFA will undergo a calcification review based on the Fanelli classification. Subjects graded with Fanelli grade 3 and 4 will be treated with the Exist 6F NiTi Stent PULL type.
Primary Outcome Measure Information:
Title
Primary patency
Description
The primary patency rate (defined as freedom from more than ≥ 50% restenosis) at 12 months post-procedure as measured by Peak Systolic Velocity ratio (PSVr) assessed with Duplex ultrasound (DUS). A PSVr ≥ 2,5 suggests a reduction in the luminal diameter >50%.
Time Frame
12 months
Title
Major Adverse Events
Description
Freedom from procedure- or stent-related Major Adverse Events (MAEs) at 30-days post index-procedure will be reported. MAE is defined as all causes of death and target limb major amputation, defined as amputation of the lower limb at the ankle level or above.
Time Frame
1 month
Secondary Outcome Measure Information:
Title
Improvement of Rutherford / Fontaine classification
Description
Clinical success Defined as improvement of Rutherford / Fontaine classification of one class or more as compared to the pre-procedure and an ankle-brachial index improvement (ABI) by ≥ 0.15.
Time Frame
6- and 12-months
Title
Primary patency
Description
Compare the Exist 6F NiTi stent primary patency with >50% of subjects with peripheral artery disease with literature data.
Time Frame
12-months
Title
Rate of stent fracture
Description
Stent fracture rate is evaluated with x-ray. Stent fracture is defined according to classification on x-ray.
Time Frame
12- and 24-months
Title
Freedom from Target Lesion Revascularization
Description
Defined as the absence of revascularization (by any means) of the target lesion (fTLR).
Time Frame
1 month, 6-, 12- and 24-months
Title
Walking and mobility
Description
Improvement of walking and mobility is assessed by change in the 36-Item Short Form Survey (SF-36) score from baseline.
Time Frame
1 month, 6-, 12- and 24-months
Title
Patency rate
Description
Patency rate as measured by Peak Systolic Velocity ratio (PSVr) assessed with Duplex ultrasound (DUS). A PSVr ≥ 2,5 suggests a reduction in the luminal diameter >50%.
Time Frame
24 months
Title
Major Adverse Events
Description
Procedure- or stent-related Major Adverse Events (MAEs) post index-procedure will be reported. MAE is defined as all causes of death and target limb major amputation, defined as amputation of the lower limb at the ankle level or above.
Time Frame
24 months
Other Pre-specified Outcome Measures:
Title
Self-reported Quality of life
Description
Improvement of quality of life is assessed by change in the 36-Item Short Form Survey (SF-36) score from baseline.
Time Frame
1 month, 6-, 12- and 24-months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: - Clinical: Patient age 18 years or older Subject 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 Symptoms of peripheral arterial disease classified as Rutherford Category 2, 3 or 4 or Fontaine Class IIb or III The stenotic or occlusive lesion in Superficial Femoral Artery (SFA) and proximal popliteal artery, P1 segment, is considered suitable for stenting No underlying medical condition is present which would prevent the subject from performing the required testing or from completing the study. Stable medical condition Anatomical criteria: Included TASC II, A-B-C measured on pre- angio CT-scan (if CT-scan is standard of care) Lesions must be one or multiple that can be treated with maximum two stents, maximum one overlapping and maximum length of the stent 25 cm Patent ipsilateral iliac, popliteal (P2 and P3) and at least one tibial vessel Exclusion Criteria: - Clinical criteria: Subjects pregnant, breastfeeding or planning to become pregnant during the trial participation Documented life expectancy less than 24 months due to other medical co-morbid condition(s) Thrombophlebitis or deep vein thrombosis within the past 30 days. Unable to assume DAPT (Dual Antiplatelet Therapy) Concomitant renal failure with serum creatinine level > 2.5 mg/dL (or > 220 µmol/L) or GFR < 30 ml/min/1,73 m2 Unresolved neutropenia (white blood cell count < 3,000 / µL) or thrombocytopenia (platelet count < 80,000 / µL) at the time of the index procedure Unresolved bleeding disorder (INR ≥ 1.2) at the time of the index procedure Active gastrointestinal bleeding Anticoagulation therapy for other medical condition Anatomical criteria: Target lesion(s) received previous treatment within 30 days prior to enrolment (point of enrolment is defined as the time when the trial device enters the body) Previously stented ipsilateral SFA Prior peripheral vascular bypass surgery involving the target limb(s) Target lesion is located within an aneurysm or associated with an aneurysm in the vessel segment either proximal or distal to the target lesion Target lesion requires the use of cutting balloons, atherectomy or drug coated balloons (DCB) during the intervention
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Oana Brancati, PhD
Phone
+ 41 44 515 82 26
Email
oana.brancati@qmedics.ch
First Name & Middle Initial & Last Name or Official Title & Degree
Anita Patteet, MD
Phone
+ 41 44 515 82 20
Email
anita.patteet@qmedics.ch
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Anita Patteet, MD
Organizational Affiliation
Qmedics AG
Official's Role
Study Director
Facility Information:
Facility Name
Policlinico di Monza
City
Monza
State/Province
Lombardy
ZIP/Postal Code
111-20900
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Enrico Maria Marone, MD
Facility Name
University Hospital of Catania
City
Catania
State/Province
Sicily
ZIP/Postal Code
95123
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Pierfrancesco Veroux, MD
Facility Name
Erasmus MC
City
Rotterdam
ZIP/Postal Code
3015 GD
Country
Netherlands
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Adriaan Moelker, MD, PhD
Facility Name
University Clinical Hospital of Bialystok
City
Białystok
State/Province
Podlaskie Voivodeship
ZIP/Postal Code
15-276
Country
Poland
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jerzy Głowiński, MD
Facility Name
Geneva University Hospitals
City
Geneva
ZIP/Postal Code
1205
Country
Switzerland
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Frédéric Glauser, MD

12. IPD Sharing Statement

Plan to Share IPD
No

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HORIZON Prospective Clinical Investigation

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