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JetStream (JS) Atherectomy in Femoropopliteal In-Stent Restenotic Lesions (JetStreamISR)

Primary Purpose

Restenosis, Peripheral Vascular Disease

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
JetStream Navitus
Sponsored by
Midwest Cardiovascular Research Foundation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Restenosis focused on measuring Restenosis, aspiration, in-stent restenosis, atherectomy, superficial femoral artery, popliteal artery

Eligibility Criteria

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

Inclusion Criteria:

  1. Subject is 18 years of age or older.
  2. Subject presents with clinical evidence of peripheral arterial disease with ISR in the femoropopliteal segment (includes common femoral, superficial femoral and popliteal)
  3. Subject presents with a Rutherford Classification of 1-5 and has symptoms of rest limb pain, ulcerations or claudication.
  4. Target lesion(s) must be viewed angiographically and have ≥50% stenosis.
  5. The atherectomy wire must be placed entirely across all lesions to be treated with no visible evidence of clear or suspected subintimal/substent wire passage.
  6. The main target vessel reference diameter must be at least 5 mm.
  7. One patent distal run-off vessel with brisk flow is required.
  8. Patient is an acceptable candidate for percutaneous intervention using the Jetstream NAVITUS System in accordance with its labeled instructions for use.
  9. Patient has signed approved informed consent.
  10. Patient is willing to comply with the follow-up evaluations at specified times.

Exclusion Criteria:

  1. Subject is unable to understand the study or has a history of non-compliance with medical advice.
  2. Subject is unwilling or unable to sign the Informed Consent Form (ICF).
  3. Subject is currently enrolled in another clinical investigational study that might clinically interfere with the current study endpoints (e.g., limit use of study-recommended medications, etc.).
  4. Subject is pregnant or planning to become pregnant within the study period.
  5. Subject has a known sensitivity to contrast media and the sensitivity cannot be adequately pre-medicated for.
  6. Subject is diagnosed with chronic renal failure or has a creatinine level > 2.5 mg/dl and is not on chronic dialysis.
  7. Subject has a known allergy to heparin, ASA, Plavix.
  8. Subject has a history of bleeding disorders or platelet count < 80,000 cells/ml.
  9. Subject experiences ongoing cardiac problems (e.g., cardiac arrhythmias, congestive heart failure exacerbation, myocardial infarction, etc.) that, per the investigator, would not make the subject an ideal candidate for study procedures.
  10. Subject has a CVA or TIA within 4 weeks prior to JetStream procedure.
  11. Subject has an anticipated life span of less than 6 months.
  12. Subject is suspected of having an active systemic infection.
  13. Subject per the investigator's medical judgment must be excluded from the study.
  14. Limited vascular access that precludes safe advancement of the Jetstream NAVITUS System to the target lesion(s).
  15. Patient has evidence of intracranial or gastrointestinal bleeding within the past 3 months.
  16. Patient has had severe trauma, fracture, major surgery or biopsy of a parenchymal organ within the past 14 days.
  17. Patient has any planned surgical intervention or endovascular procedure within 15 days after the index procedure.
  18. Use of another debulking device during the index procedure prior to the Jetstream NAVITUS System.
  19. Use of another debulking device after the Jetstream NAVITUS system.

    -

Sites / Locations

  • Trinity Bettendorf Medical Center
  • VA Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

JetStream Atherectomy

Arm Description

Jetstream NAVITUS System is a rotating, aspirating, expandable catheter for active removal of atherosclerotic disease and thrombus in peripheral vasculature.

Outcomes

Primary Outcome Measures

Acute Procedural Success
Acute procedural success is defined as less than or equal to 30 percent residual stenosis (via Quantitative Vascular Analysis) at the index lesion post JestStream atherectomy and final adjunctive treatment And with no serious adverse events.

Secondary Outcome Measures

Patency
Patency is defined as Peak Systolic Velocity Ratio (PSVR) of < 2.4 by duplex criteria. PSVR is obtained by dividing velocity (cm/sec) at the lesion site to the velocity immediately proximal to the lesion.
Target Lesion Revascularization
Reintervention on the same index lesion at 6 months

Full Information

First Posted
November 5, 2012
Last Updated
February 20, 2020
Sponsor
Midwest Cardiovascular Research Foundation
Collaborators
MEDRAD, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01722877
Brief Title
JetStream (JS) Atherectomy in Femoropopliteal In-Stent Restenotic Lesions
Acronym
JetStreamISR
Official Title
Safety and Effectiveness of JetStream (JS) Atherectomy in Femoropopliteal In-Stent Restenotic Lesions: A Prospective Registry
Study Type
Interventional

2. Study Status

Record Verification Date
February 2020
Overall Recruitment Status
Completed
Study Start Date
October 2012 (undefined)
Primary Completion Date
August 2014 (Actual)
Study Completion Date
September 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Midwest Cardiovascular Research Foundation
Collaborators
MEDRAD, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Several studies have shown that stenting of the femoropopliteal artery in the lower leg leads to improved overall results compared to balloon angioplasty alone. However, scar tissue development can occur within the stent, a process called restenosis. Treatment of these in-stent restenotic lesions has a high procedural success rate but recurrence of scar tissue is frequently seen. Several methods have been proposed to treat in-stent restenosis in the lower leg arteries but mixed results have been noted. In this study we hypothesize that simultaneous tissue excision and aspiration using the JetStream Navitus device (Medrad) can lead to a high rate of acute procedural success with low intraprocedural complications and an acceptable recurrence rate of restenosis at 6-month follow-up.
Detailed Description
Data not available yet.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Restenosis, Peripheral Vascular Disease
Keywords
Restenosis, aspiration, in-stent restenosis, atherectomy, superficial femoral artery, popliteal artery

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
JetStream Atherectomy
Arm Type
Experimental
Arm Description
Jetstream NAVITUS System is a rotating, aspirating, expandable catheter for active removal of atherosclerotic disease and thrombus in peripheral vasculature.
Intervention Type
Device
Intervention Name(s)
JetStream Navitus
Intervention Description
Study to use Jetstream device for use of in-stent restenosis in femoral popliteal artery.
Primary Outcome Measure Information:
Title
Acute Procedural Success
Description
Acute procedural success is defined as less than or equal to 30 percent residual stenosis (via Quantitative Vascular Analysis) at the index lesion post JestStream atherectomy and final adjunctive treatment And with no serious adverse events.
Time Frame
intraprocedural
Secondary Outcome Measure Information:
Title
Patency
Description
Patency is defined as Peak Systolic Velocity Ratio (PSVR) of < 2.4 by duplex criteria. PSVR is obtained by dividing velocity (cm/sec) at the lesion site to the velocity immediately proximal to the lesion.
Time Frame
6 months
Title
Target Lesion Revascularization
Description
Reintervention on the same index lesion at 6 months
Time Frame
6 months
Other Pre-specified Outcome Measures:
Title
Acute Device Success
Description
Acute device success is defined as less than or equal to 50% residual stenosis at the index lesion using the JetStream device alone and with no adjunctive balloon angioplasty therapy (via Quantitative Vascular Analysis) and with no serious adverse events.
Time Frame
intraprocedural

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject is 18 years of age or older. Subject presents with clinical evidence of peripheral arterial disease with ISR in the femoropopliteal segment (includes common femoral, superficial femoral and popliteal) Subject presents with a Rutherford Classification of 1-5 and has symptoms of rest limb pain, ulcerations or claudication. Target lesion(s) must be viewed angiographically and have ≥50% stenosis. The atherectomy wire must be placed entirely across all lesions to be treated with no visible evidence of clear or suspected subintimal/substent wire passage. The main target vessel reference diameter must be at least 5 mm. One patent distal run-off vessel with brisk flow is required. Patient is an acceptable candidate for percutaneous intervention using the Jetstream NAVITUS System in accordance with its labeled instructions for use. Patient has signed approved informed consent. Patient is willing to comply with the follow-up evaluations at specified times. Exclusion Criteria: Subject is unable to understand the study or has a history of non-compliance with medical advice. Subject is unwilling or unable to sign the Informed Consent Form (ICF). Subject is currently enrolled in another clinical investigational study that might clinically interfere with the current study endpoints (e.g., limit use of study-recommended medications, etc.). Subject is pregnant or planning to become pregnant within the study period. Subject has a known sensitivity to contrast media and the sensitivity cannot be adequately pre-medicated for. Subject is diagnosed with chronic renal failure or has a creatinine level > 2.5 mg/dl and is not on chronic dialysis. Subject has a known allergy to heparin, ASA, Plavix. Subject has a history of bleeding disorders or platelet count < 80,000 cells/ml. Subject experiences ongoing cardiac problems (e.g., cardiac arrhythmias, congestive heart failure exacerbation, myocardial infarction, etc.) that, per the investigator, would not make the subject an ideal candidate for study procedures. Subject has a CVA or TIA within 4 weeks prior to JetStream procedure. Subject has an anticipated life span of less than 6 months. Subject is suspected of having an active systemic infection. Subject per the investigator's medical judgment must be excluded from the study. Limited vascular access that precludes safe advancement of the Jetstream NAVITUS System to the target lesion(s). Patient has evidence of intracranial or gastrointestinal bleeding within the past 3 months. Patient has had severe trauma, fracture, major surgery or biopsy of a parenchymal organ within the past 14 days. Patient has any planned surgical intervention or endovascular procedure within 15 days after the index procedure. Use of another debulking device during the index procedure prior to the Jetstream NAVITUS System. Use of another debulking device after the Jetstream NAVITUS system. -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nicolas W Shammas, MD, MS
Organizational Affiliation
Midwest Cardiovascular Research Foundation
Official's Role
Principal Investigator
Facility Information:
Facility Name
Trinity Bettendorf Medical Center
City
Bettendorf
State/Province
Iowa
ZIP/Postal Code
52722
Country
United States
Facility Name
VA Medical Center
City
Dallas
State/Province
Texas
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Manuscript will be published in JEVT early 2016
Citations:
PubMed Identifier
26921281
Citation
Shammas NW, Shammas GA, Banerjee S, Popma JJ, Mohammad A, Jerin M. JetStream Rotational and Aspiration Atherectomy in Treating In-Stent Restenosis of the Femoropopliteal Arteries: Results of the JETSTREAM-ISR Feasibility Study. J Endovasc Ther. 2016 Apr;23(2):339-46. doi: 10.1177/1526602816634028. Epub 2016 Feb 26.
Results Reference
derived

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JetStream (JS) Atherectomy in Femoropopliteal In-Stent Restenotic Lesions

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