Safety and Feasibility of SurModics SurVeil (TM) Drug Coated Balloon (PREVEIL)
Primary Purpose
Peripheral Arterial Disease, Peripheral Vascular Diseases
Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
SurVeil Drug Coated Balloon
Angioplasty
Sponsored by
About this trial
This is an interventional treatment trial for Peripheral Arterial Disease focused on measuring Paclitaxel, Percutaneous Transluminal Angioplasty, PAD, Peripheral Artery Disease, Pharmacokinetics
Eligibility Criteria
Inclusion Criteria:
Subjects must meet all of the following criteria to participate in the trial:
- Subject is ≥ 18 years.
- Subject has lifestyle-limiting claudication or rest pain with Rutherford classification 2, 3 or 4.
- Subject has provided written informed consent.
- Subject is willing to comply with study follow-up requirements.
- A de novo target lesion in the femoral or popliteal arteries.
- Target lesion must have angiographic evidence of ≥ 50% stenosis by operator visual estimate.
- Target lesion must be ≤ 90 mm in length (one long lesion or multiple serial lesions) by operator visual estimate. Note: Multiple serial lesions are allowed provided that they can be treated as a single lesion with one balloon.
- Target vessel must have an reference vessel diameter (RVD) of 4 mm to 6 mm by operator visual estimate.
- After pre-dilatation, the target lesion is ≤ 70% residual stenosis, absence of a flow limiting dissection and treatable with a single balloon (lesion length ≤90 mm, limited to 100-mm balloon in EFS).
- A patent inflow artery free from significant stenosis (≥ 50% stenosis) as confirmed by angiography.
- At least one patent native outflow artery to the ankle or foot, free from significant stenosis (≥ 50% stenosis) as confirmed by angiography.
Exclusion Criteria:
Subjects will be excluded from the trial if any of the following criteria are met:
- Subject has acute limb ischemia.
- Subject has Rutherford classification of 0, 1, 5 or 6.
- Subject previously underwent any lower extremity percutaneous transluminal angioplasty (PTA) using a DCB within 3 months.
- Subject has had prior vascular intervention within 2 weeks before the planned study index procedure or subject has planned vascular intervention within 30 days after the study index procedure.
- Subject is pregnant and/or breast-feeding or intends to become pregnant during the time of the study OR subject is a male intending to father children within 60 days of index procedure.
- Life expectancy less than 2 years.
- Subject has a known allergy to contrast medium that cannot be adequately pre-medicated.
- Subject is allergic to ALL antiplatelet treatments.
- Subject has impaired renal function (i.e. serum creatinine level ≥ 2.5 mg/dl).
- Subject is dialysis dependent.
- Subject is receiving immunosuppressant therapy.
- Subject has known or suspected active infection at the time of the index procedure.
- Subject has platelet count < 100,000/mm3 or > 700,000/mm3.
- Subject has white blood cell (WBC) count < 3,000/mm3.
- Subject has history of gastrointestinal hemorrhage requiring a transfusion within 3 months prior to the index procedure.
- Subject is diagnosed with coagulopathy that precludes treatment with systemic anticoagulation and/or dual antiplatelet therapy (DAPT).
- Subject is unable to tolerate blood transfusions because of religious beliefs or other reasons.
- Subject is unwilling or unable to comply with procedures specified in the protocol or has difficulty or inability to return for follow-up visits as specified by the protocol.
- Subject is known to be incarcerated, mentally incompetent and/or an alcohol or drug abuser.
- Subject is participating in another investigational drug or medical device study that has not completed primary endpoint(s) evaluation or that clinically interferes with the endpoints from this study, or subject is planning to participate in such studies prior to the completion of this study.
- Subject has had major surgical or interventional procedures unrelated to this study within 30 days prior to this study or has planned surgical or interventional procedures within 30 days of entry into this study.
- Previous intervention at the lesion site including previous stenting within 3 cm of the target lesion or previous bypass surgery of the target lesion.
- Previous treatment of the target vessel with thrombolysis or surgery.
- Severe concentric calcification of the target lesion.
- Target lesion involves an aneurysm or is adjacent to an aneurysm.
- Target lesion requires treatment with alternative therapy such as stenting, laser, atherectomy, cryoplasty, brachytherapy or re-entry devices.
- Significant vessel tortuosity or other parameters prohibiting access to the target lesion.
- Presence of thrombus in the target vessel.
- Iliac inflow disease requiring treatment , unless the iliac artery disease is successfully treated first during the index procedure. Success is defined as ≤ 30% residual diameter stenosis without death or major complications.
- Absence of at least one patent native outflow artery.
- Presence of an aortic, iliac or femoral artificial graft.
- Failure to cross the target lesion with a guide wire. Successful crossing of the target lesion occurs when the tip of the guide wire is distal to the target lesion without the occurrence of flow-limiting dissection or perforation.
- Failure to successfully pre-dilate the target lesion. Successful pre-dilatation is defined as residual stenosis ≤ 70% with no flow-limiting dissection.
Sites / Locations
- NC Heart and Vascular Research
- OhioHealth Research Institute
- Wellmont Health System
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
SurVeil Drug Coated Balloon catheter
Arm Description
Paclitaxel Coated Balloon catheter for angioplasty
Outcomes
Primary Outcome Measures
Peak paclitaxel plasma concentration
Paclitaxel plasma levels will be assessed at baseline, immediately post-index procedure, at 1h, 2h, 4h, 12h (or upon discharge), and 30 days post-index procedure.
Secondary Outcome Measures
Area under the drug concentration time curve
Area under the drug concentration time curve from the time of intervention to the time where the paclitaxel level is no longer quantifiable will be measured. Paclitaxel plasma levels will be assessed at baseline, immediately post-index procedure, at 1h, 2h, 4h, 12h(or upon discharge), and 30 days post-index procedure.
Technical success
Technical success, defined as successful delivery, inflation, deflation and retrieval of the intact study balloon device.
Device success
Device success, defined as achievement of < 50% residual stenosis of the target lesion (by core lab assessed quantitative angiography (QA)) using only the study device.
Procedure success
Procedure success, defined as achievement of < 50% residual stenosis of the target lesion (by core lab assessed QA) using the study device with or without the use of additional devices, without the occurrence of death, amputation or repeat revascularization of the target vessel during index hospital stay.
Resting ankle brachial index
Change in Rutherford classification
Change in 6-minute walk test
Primary patency
defined as freedom from clinically-driven target lesion revascularization (TLR) and freedom from restenosis. Restenosis is defined by Duplex Ultrasound (DUS) peak systolic velocity ratio (PSVR) ≥ 2.5 (core lab assessed) or by ≥ 50% stenosis by QA (core lab assessed)
Continuous DUS Peak systolic velocity ratio (PSVR) as measured by Duplex ultrasound
Late lumen loss
Defined as the difference in minimum luminal diameter of the target lesion between the index intervention and 6-month angiographic follow-up.
Quality of life
Assessed by Change in walking Impairment Questionnaire (WIQ) scores
Evidence of Paclitaxel toxicity
Evidence of paclitaxel toxicity (rash, myelosuppression on blood counts, hepatitis, neuromuscular changes, hypotension, electrocardiogram (ECG) abnormalities, or gastrointestinal upset).
Major vascular complications
Thrombolysis in Myocardial Infarction (TIMI)-defined major and minor bleeding
Major adverse events
defined as a composite of death, index limb amputation and TLR
All-cause death
Index limb above the ankle amputation
Index limb below the ankle amputation
Clinically-driven TLR
Clinically-driven target vessel revascularization (TVR)
Arterial thrombosis of the treated segment on angiography
Embolic events of the index limb
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02648620
Brief Title
Safety and Feasibility of SurModics SurVeil (TM) Drug Coated Balloon
Acronym
PREVEIL
Official Title
A Prospective, Multi-Center, Single-Arm Trial to Assess the Safety and Feasibility of the SurModics Drug Coated Balloon in the Treatment of Subjects With De Novo Lesions of the Femoropopliteal Artery
Study Type
Interventional
2. Study Status
Record Verification Date
July 2022
Overall Recruitment Status
Completed
Study Start Date
April 5, 2016 (Actual)
Primary Completion Date
January 2017 (Actual)
Study Completion Date
February 11, 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
SurModics, Inc.
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
PREVEIL is a prospective, multi-center, single-arm clinical trial to assess the safety and functionality of the SurModics drug coated balloon (DCB) in the treatment of subjects with symptomatic peripheral artery disease (PAD) due to de novo stenoses of the femoral and popliteal arteries. The trial will enroll up to 15 subjects.
Detailed Description
PREVEIL will enroll patients presenting with angiographic evidence of significant stenosis in the femoral or popliteal arteries. All enrolled subjects will be treated with the SurVeil DCB.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peripheral Arterial Disease, Peripheral Vascular Diseases
Keywords
Paclitaxel, Percutaneous Transluminal Angioplasty, PAD, Peripheral Artery Disease, Pharmacokinetics
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
13 (Actual)
8. Arms, Groups, and Interventions
Arm Title
SurVeil Drug Coated Balloon catheter
Arm Type
Experimental
Arm Description
Paclitaxel Coated Balloon catheter for angioplasty
Intervention Type
Device
Intervention Name(s)
SurVeil Drug Coated Balloon
Other Intervention Name(s)
SurModics SurVeil
Intervention Description
Angioplasty procedure with the SurModics SurVeil Paclitaxel-Coated, Percutaneous Transluminal Angioplasty (PTA) Balloon Catheter (Paclitaxel-coated PTA Catheter)
Intervention Type
Procedure
Intervention Name(s)
Angioplasty
Other Intervention Name(s)
SurModics SurVeil
Intervention Description
Angioplasty procedure with the SurModics SurVeil Paclitaxel-Coated, Percutaneous Transluminal Angioplasty (PTA) Balloon Catheter (Paclitaxel-coated PTA Catheter)
Primary Outcome Measure Information:
Title
Peak paclitaxel plasma concentration
Description
Paclitaxel plasma levels will be assessed at baseline, immediately post-index procedure, at 1h, 2h, 4h, 12h (or upon discharge), and 30 days post-index procedure.
Time Frame
Up to 30 days
Secondary Outcome Measure Information:
Title
Area under the drug concentration time curve
Description
Area under the drug concentration time curve from the time of intervention to the time where the paclitaxel level is no longer quantifiable will be measured. Paclitaxel plasma levels will be assessed at baseline, immediately post-index procedure, at 1h, 2h, 4h, 12h(or upon discharge), and 30 days post-index procedure.
Time Frame
Up to 30 days
Title
Technical success
Description
Technical success, defined as successful delivery, inflation, deflation and retrieval of the intact study balloon device.
Time Frame
At procedure
Title
Device success
Description
Device success, defined as achievement of < 50% residual stenosis of the target lesion (by core lab assessed quantitative angiography (QA)) using only the study device.
Time Frame
At procedure
Title
Procedure success
Description
Procedure success, defined as achievement of < 50% residual stenosis of the target lesion (by core lab assessed QA) using the study device with or without the use of additional devices, without the occurrence of death, amputation or repeat revascularization of the target vessel during index hospital stay.
Time Frame
At procedure up to 12 hours
Title
Resting ankle brachial index
Time Frame
within 90 days of index procedure, and at 6, 12, 24 and 36 months post-index procedure
Title
Change in Rutherford classification
Time Frame
baseline, 30 days, 6, 12, 24, and 36 months
Title
Change in 6-minute walk test
Time Frame
baseline, 30 days, 6, 12, 24, and 36 months
Title
Primary patency
Description
defined as freedom from clinically-driven target lesion revascularization (TLR) and freedom from restenosis. Restenosis is defined by Duplex Ultrasound (DUS) peak systolic velocity ratio (PSVR) ≥ 2.5 (core lab assessed) or by ≥ 50% stenosis by QA (core lab assessed)
Time Frame
6 months
Title
Continuous DUS Peak systolic velocity ratio (PSVR) as measured by Duplex ultrasound
Time Frame
30 days, 6, 12, 24, and 36 months
Title
Late lumen loss
Description
Defined as the difference in minimum luminal diameter of the target lesion between the index intervention and 6-month angiographic follow-up.
Time Frame
baseline, 6 months
Title
Quality of life
Description
Assessed by Change in walking Impairment Questionnaire (WIQ) scores
Time Frame
baseline, 30 days, 6, 12, 24, and 36 months
Title
Evidence of Paclitaxel toxicity
Description
Evidence of paclitaxel toxicity (rash, myelosuppression on blood counts, hepatitis, neuromuscular changes, hypotension, electrocardiogram (ECG) abnormalities, or gastrointestinal upset).
Time Frame
At hospital discharge, 30 days
Title
Major vascular complications
Time Frame
At hospital discharge, 30 days
Title
Thrombolysis in Myocardial Infarction (TIMI)-defined major and minor bleeding
Time Frame
At hospital discharge, 30 days
Title
Major adverse events
Description
defined as a composite of death, index limb amputation and TLR
Time Frame
30 days, 6, 12, 24, and 36 months
Title
All-cause death
Time Frame
30 days, 6, 12, 24, and 36 months
Title
Index limb above the ankle amputation
Time Frame
30 days, 6, 12, 24, and 36 months
Title
Index limb below the ankle amputation
Time Frame
30 days, 6, 12, 24, and 36 months
Title
Clinically-driven TLR
Time Frame
30 days, 6, 12, 24, and 36 months
Title
Clinically-driven target vessel revascularization (TVR)
Time Frame
30 days, 6, 12, 24, and 36 months
Title
Arterial thrombosis of the treated segment on angiography
Time Frame
30 days, 6, 12, 24, and 36 months
Title
Embolic events of the index limb
Time Frame
30 days, 6, 12, 24, and 36 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subjects must meet all of the following criteria to participate in the trial:
Subject is ≥ 18 years.
Subject has lifestyle-limiting claudication or rest pain with Rutherford classification 2, 3 or 4.
Subject has provided written informed consent.
Subject is willing to comply with study follow-up requirements.
A de novo target lesion in the femoral or popliteal arteries.
Target lesion must have angiographic evidence of ≥ 50% stenosis by operator visual estimate.
Target lesion must be ≤ 90 mm in length (one long lesion or multiple serial lesions) by operator visual estimate. Note: Multiple serial lesions are allowed provided that they can be treated as a single lesion with one balloon.
Target vessel must have an reference vessel diameter (RVD) of 4 mm to 6 mm by operator visual estimate.
After pre-dilatation, the target lesion is ≤ 70% residual stenosis, absence of a flow limiting dissection and treatable with a single balloon (lesion length ≤90 mm, limited to 100-mm balloon in EFS).
A patent inflow artery free from significant stenosis (≥ 50% stenosis) as confirmed by angiography.
At least one patent native outflow artery to the ankle or foot, free from significant stenosis (≥ 50% stenosis) as confirmed by angiography.
Exclusion Criteria:
Subjects will be excluded from the trial if any of the following criteria are met:
Subject has acute limb ischemia.
Subject has Rutherford classification of 0, 1, 5 or 6.
Subject previously underwent any lower extremity percutaneous transluminal angioplasty (PTA) using a DCB within 3 months.
Subject has had prior vascular intervention within 2 weeks before the planned study index procedure or subject has planned vascular intervention within 30 days after the study index procedure.
Subject is pregnant and/or breast-feeding or intends to become pregnant during the time of the study OR subject is a male intending to father children within 60 days of index procedure.
Life expectancy less than 2 years.
Subject has a known allergy to contrast medium that cannot be adequately pre-medicated.
Subject is allergic to ALL antiplatelet treatments.
Subject has impaired renal function (i.e. serum creatinine level ≥ 2.5 mg/dl).
Subject is dialysis dependent.
Subject is receiving immunosuppressant therapy.
Subject has known or suspected active infection at the time of the index procedure.
Subject has platelet count < 100,000/mm3 or > 700,000/mm3.
Subject has white blood cell (WBC) count < 3,000/mm3.
Subject has history of gastrointestinal hemorrhage requiring a transfusion within 3 months prior to the index procedure.
Subject is diagnosed with coagulopathy that precludes treatment with systemic anticoagulation and/or dual antiplatelet therapy (DAPT).
Subject is unable to tolerate blood transfusions because of religious beliefs or other reasons.
Subject is unwilling or unable to comply with procedures specified in the protocol or has difficulty or inability to return for follow-up visits as specified by the protocol.
Subject is known to be incarcerated, mentally incompetent and/or an alcohol or drug abuser.
Subject is participating in another investigational drug or medical device study that has not completed primary endpoint(s) evaluation or that clinically interferes with the endpoints from this study, or subject is planning to participate in such studies prior to the completion of this study.
Subject has had major surgical or interventional procedures unrelated to this study within 30 days prior to this study or has planned surgical or interventional procedures within 30 days of entry into this study.
Previous intervention at the lesion site including previous stenting within 3 cm of the target lesion or previous bypass surgery of the target lesion.
Previous treatment of the target vessel with thrombolysis or surgery.
Severe concentric calcification of the target lesion.
Target lesion involves an aneurysm or is adjacent to an aneurysm.
Target lesion requires treatment with alternative therapy such as stenting, laser, atherectomy, cryoplasty, brachytherapy or re-entry devices.
Significant vessel tortuosity or other parameters prohibiting access to the target lesion.
Presence of thrombus in the target vessel.
Iliac inflow disease requiring treatment , unless the iliac artery disease is successfully treated first during the index procedure. Success is defined as ≤ 30% residual diameter stenosis without death or major complications.
Absence of at least one patent native outflow artery.
Presence of an aortic, iliac or femoral artificial graft.
Failure to cross the target lesion with a guide wire. Successful crossing of the target lesion occurs when the tip of the guide wire is distal to the target lesion without the occurrence of flow-limiting dissection or perforation.
Failure to successfully pre-dilate the target lesion. Successful pre-dilatation is defined as residual stenosis ≤ 70% with no flow-limiting dissection.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Christopher Metzger, MD, FACC, FSCAI
Organizational Affiliation
Wellmont CVA Heart Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
NC Heart and Vascular Research
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27607
Country
United States
Facility Name
OhioHealth Research Institute
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43214
Country
United States
Facility Name
Wellmont Health System
City
Kingsport
State/Province
Tennessee
ZIP/Postal Code
37660
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
Undecided
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Safety and Feasibility of SurModics SurVeil (TM) Drug Coated Balloon
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