Percutaneous Deep Vein Arterialization Post-Market Study (PROMISE UK)
Primary Purpose
Critical Limb Ischemia
Status
Active
Phase
Not Applicable
Locations
United Kingdom
Study Type
Interventional
Intervention
Percutaneous deep vein arterialization
LimFlow System
Sponsored by
About this trial
This is an interventional treatment trial for Critical Limb Ischemia focused on measuring Desert foot, No-option patients, Venous arterialization
Eligibility Criteria
Inclusion Criteria:
- Subject must be > 21 and < 95 years of age
- Clinical diagnosis of symptomatic critical limb ischemia, defined as Rutherford category 5 or 6
- Assessment that no conventional surgical or endovascular treatment is possible
- Proximally, the target in-flow artery at the cross-over point must be treatable with a 3.5 - 4.0 mm stent after pre-treatment (by visual estimate), and be <50% stenosed
- Subject is willing and has adequate support to comply with protocol requirements, including medication regimen and follow-up visits
Exclusion Criteria:
- Concomitant hepatic insufficiency, deep venous thrombus in target limb, uncorrected coagulation disorders, or current immunodeficiency disorder
- Prior vein stripping surgery and/or vessel harvesting for CABG in the limb intended for study
- Life expectancy less than 12 months
- Patient currently taking coumarin/warfarin which, in the opinion of the attending physician, interferes with the patient's treatment
- Any significant medical condition which, in the attending physician's opinion, may interfere with the patient's optimal treatment
- Patient currently participating in another investigational drug or device study that has not completed the primary endpoint or that clinically interferes with the endpoints of this treatment
- Patient unable to give consent
- Pregnant or breastfeeding women
- Documented myocardial infarction or stroke within previous 90 days
- Patients suffering from renal insufficiency (GFR value less than 30 ml/min/1.73 m²) who are not on hemodialysis
- Patients with vasculitis and/or untreated popliteal aneurysms
- Patients with acute limb ischemia
- Prior peripheral arterial bypass procedure above or below the knee which could inhibit proximal inflow to the stent graft
- Lower extremity venous disease with significant edema in the target limb that may inhibit the procedure and/or jeopardize wound healing, in the investigator's opinion
- Known or suspected systemic or severe infection (e.g., WIfI foot Infection grade of 3)
- Known or suspected allergies or contraindications to stainless steel, nickel, or contrast agent that cannot be adequately pre-treated, or patients who cannot receive anticoagulation or antiplatelet aggregation therapy
- Severe heart failure, which in the opinion of the investigator may compromise subject's ability to safely undergo a percutaneous procedure (e.g., known ejection fraction of < 40%, NYHA Classification III-IV)
Sites / Locations
- North Bristol NHS Trust
- Glenfield Hospital
- Royal Liverpool and Broadgreen University Hospitals NHS Trust
- Guy's and St Thomas' NHS Foundation Trust
- St George's University Hospitals NHS Foundation Trust
- Manchester University NHS Foundation Trust
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Percutaneous deep vein arterialization
Arm Description
Creation of an arterio-venous fistula in the below-the-knee vasculature using the LimFlow System endovascular, minimally invasive approach
Outcomes
Primary Outcome Measures
Amputation-free survival
Freedom from death or major amputation
Secondary Outcome Measures
Wound healing
Complete index wound healing as assessed by wound pictures
Primary and secondary patency as assessed by duplex ultrasound
Stent graft patency as assessed by duplex ultrasound
Limb salvage
Freedom from major amputation
Technical success (procedure completion)
Procedure completion and immediate morphological success with successful placement of the arterial and venous catheters in the desired location in the limb, and ability to place the stent graft, as assessed angiographically
Procedural success (technical success without death, major amputation, or re-intervention)
Combination of technical success without death, major amputation, or re-intervention
Quality of Life
Quality of Life, as assessed by the EuroQol EQ-5D questionnaire (https://euroqol.org/)
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03807661
Brief Title
Percutaneous Deep Vein Arterialization Post-Market Study
Acronym
PROMISE UK
Official Title
Percutaneous Deep Vein Arterialization Post-Market Study
Study Type
Interventional
2. Study Status
Record Verification Date
November 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
December 11, 2019 (Actual)
Primary Completion Date
October 26, 2023 (Anticipated)
Study Completion Date
October 26, 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
LimFlow SA
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The objective of this post-market study is to evaluate the safety and effectiveness of the LimFlow System in creating a below-the-knee arterio-venous fistula for venous arterialization in subjects with critical limb ischemia.
Detailed Description
This study will investigate the safety and effectiveness of the LimFlow System for creating an arterio-venous fistula in the below-the-knee vascular system using an endovascular, minimally invasive approach for the treatment of critical limb ischemia in subjects ineligible for conventional endovascular or surgical limb salvage procedures.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Critical Limb Ischemia
Keywords
Desert foot, No-option patients, Venous arterialization
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
28 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Percutaneous deep vein arterialization
Arm Type
Experimental
Arm Description
Creation of an arterio-venous fistula in the below-the-knee vasculature using the LimFlow System endovascular, minimally invasive approach
Intervention Type
Procedure
Intervention Name(s)
Percutaneous deep vein arterialization
Intervention Description
Creation of an arterio-venous fistula in the below-the-knee vasculature using the LimFlow System endovascular, minimally invasive approach
Intervention Type
Device
Intervention Name(s)
LimFlow System
Intervention Description
Creation of an arterio-venous fistula in the below-the-knee vasculature using the LimFlow System endovascular, minimally invasive approach
Primary Outcome Measure Information:
Title
Amputation-free survival
Description
Freedom from death or major amputation
Time Frame
Throughout one year
Secondary Outcome Measure Information:
Title
Wound healing
Description
Complete index wound healing as assessed by wound pictures
Time Frame
Throughout one year
Title
Primary and secondary patency as assessed by duplex ultrasound
Description
Stent graft patency as assessed by duplex ultrasound
Time Frame
Throughout one year
Title
Limb salvage
Description
Freedom from major amputation
Time Frame
Throughout one year
Title
Technical success (procedure completion)
Description
Procedure completion and immediate morphological success with successful placement of the arterial and venous catheters in the desired location in the limb, and ability to place the stent graft, as assessed angiographically
Time Frame
Immediately post-procedure
Title
Procedural success (technical success without death, major amputation, or re-intervention)
Description
Combination of technical success without death, major amputation, or re-intervention
Time Frame
One month post-procedure
Title
Quality of Life
Description
Quality of Life, as assessed by the EuroQol EQ-5D questionnaire (https://euroqol.org/)
Time Frame
Throughout one year
10. Eligibility
Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
95 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subject must be > 21 and < 95 years of age
Clinical diagnosis of symptomatic critical limb ischemia, defined as Rutherford category 5 or 6
Assessment that no conventional surgical or endovascular treatment is possible
Proximally, the target in-flow artery at the cross-over point must be treatable with a 3.5 - 4.0 mm stent after pre-treatment (by visual estimate), and be <50% stenosed
Subject is willing and has adequate support to comply with protocol requirements, including medication regimen and follow-up visits
Exclusion Criteria:
Concomitant hepatic insufficiency, deep venous thrombus in target limb, uncorrected coagulation disorders, or current immunodeficiency disorder
Prior vein stripping surgery and/or vessel harvesting for CABG in the limb intended for study
Life expectancy less than 12 months
Patient currently taking coumarin/warfarin which, in the opinion of the attending physician, interferes with the patient's treatment
Any significant medical condition which, in the attending physician's opinion, may interfere with the patient's optimal treatment
Patient currently participating in another investigational drug or device study that has not completed the primary endpoint or that clinically interferes with the endpoints of this treatment
Patient unable to give consent
Pregnant or breastfeeding women
Documented myocardial infarction or stroke within previous 90 days
Patients suffering from renal insufficiency (GFR value less than 30 ml/min/1.73 m²) who are not on hemodialysis
Patients with vasculitis and/or untreated popliteal aneurysms
Patients with acute limb ischemia
Prior peripheral arterial bypass procedure above or below the knee which could inhibit proximal inflow to the stent graft
Lower extremity venous disease with significant edema in the target limb that may inhibit the procedure and/or jeopardize wound healing, in the investigator's opinion
Known or suspected systemic or severe infection (e.g., WIfI foot Infection grade of 3)
Known or suspected allergies or contraindications to stainless steel, nickel, or contrast agent that cannot be adequately pre-treated, or patients who cannot receive anticoagulation or antiplatelet aggregation therapy
Severe heart failure, which in the opinion of the investigator may compromise subject's ability to safely undergo a percutaneous procedure (e.g., known ejection fraction of < 40%, NYHA Classification III-IV)
Facility Information:
Facility Name
North Bristol NHS Trust
City
Bristol
ZIP/Postal Code
BS10 5NB
Country
United Kingdom
Facility Name
Glenfield Hospital
City
Leicester
ZIP/Postal Code
LE3 9QP
Country
United Kingdom
Facility Name
Royal Liverpool and Broadgreen University Hospitals NHS Trust
City
Liverpool
ZIP/Postal Code
L7 8XP
Country
United Kingdom
Facility Name
Guy's and St Thomas' NHS Foundation Trust
City
London
ZIP/Postal Code
SE1 9RT
Country
United Kingdom
Facility Name
St George's University Hospitals NHS Foundation Trust
City
London
ZIP/Postal Code
SW17 0RE
Country
United Kingdom
Facility Name
Manchester University NHS Foundation Trust
City
Manchester
ZIP/Postal Code
M13 9WL
Country
United Kingdom
12. IPD Sharing Statement
Plan to Share IPD
Undecided
IPD Sharing Plan Description
Undecided
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Percutaneous Deep Vein Arterialization Post-Market Study
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