TORUS 2 IDE Clinical Study
Primary Purpose
Peripheral Arterial Disease
Status
Active
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
TORUS Stent Graft System
Sponsored by
About this trial
This is an interventional treatment trial for Peripheral Arterial Disease focused on measuring Peripheral Artery Disease, Superficial Femoral Artery, Popliteal Artery, Stent Graft
Eligibility Criteria
Inclusion Criteria:
- Patient is male or female, with age > 18 and ≤ 90 years at date of enrollment.
- Patient provides written informed consent before any study-specific investigations or procedures.
- Patient is willing to undergo all follow-up assessments according to the specified schedule over 36 months.
- Patient is a suitable candidate for angiography and endovascular intervention and, if required, is eligible for standard surgical repair.
- Patient has symptomatic peripheral arterial disease (PAD) of the lower extremities requiring intervention to relieve de novo obstruction or occlusion or restenosis of the native femoropopliteal artery.
- Patient has PAD classified as Rutherford classification 2, 3 or 4.
- Patient has documented PAD by either (i) a resting ankle-brachial index (ABI) of ≤ 0.90 (or ≤ 0.75 after exercise of the target limb). Resting toe brachial index (TBI) is performed only if unable to reliably assess ABI. TBI must be <0.70; or (ii) Normal ABI with angiographic, ultrasound, MRA, or CT evidence of ≥ 60% diameter stenosis.
- Patient has single or multiple stenotic, restenotic or occlusive lesions within the native femoropopliteal artery ("target lesions") that can be crossed with a guidewire and fully dilated.
- Single target lesion must be covered by a single stent. Tandem target lesions are considered a single continuous lesion if the gap between lesions is ≤ 5 cm and > 30% diameter stenosis between the lesion(s).
- Target lesion(s) eligible for treatment under the protocol are at least least 3 cm above the bottom of the femur.
- Target lesion(s) reference vessel diameter is between 5.0 mm and 6.7 mm by operator's visual estimate.
- Target lesion measures ≥ 80 mm to ≤ 180 mm in overall length, with ≥ 60% diameter stenosis by operator's visual estimate. Tandem target lesions are considered a single continuous lesion if the gap between lesions is ≤ 5 cm and > 30% diameter stenosis between the lesion(s).
- Patient has a patent popliteal artery (no stenosis ≥ 50%) distal to the treated segment.
- Patient has at least one patent infrapopliteal vessel (< 50% stenosis) with run-off to the ankle.
Exclusion Criteria:
- Patient is unable or is unwilling to comply with the procedural requirements of the study protocol or will have difficulty in complying with the requirements for attending follow-up visits.
- Patient has a comorbidity that in the investigator's opinion would limit life expectancy to less than 24 months.
- Patient has any planned major surgical procedure (including any amputation of the target limb) within 30 days after the index procedure for this study.
- Patient has a target vessel that has been treated with any type of surgical procedure prior to enrollment.
- Patient has a target vessel that has been treated with bypass surgery.
- Patient has PAD classified as Rutherford classification 0, 1, 5 or 6.
- Patient has known or suspected active systemic infection at the time of enrollment.
- Patient has a known coagulopathy or has bleeding diatheses, thrombocytopenia with platelet count less than 100,000/microliter or INR (international normalized ratio) >1.8.
- Patient has a stroke diagnosis within three months prior to enrollment.
- Patient has a history of unstable angina or myocardial infarction within 60 days prior to enrollment.
- Patient has a contraindication to antiplatelet, anticoagulant or thrombolytic therapies.
- Patient has known allergy to contrast agents or medications used to perform endovascular intervention that cannot be adequately pre-medicated.
- Patient has known allergy to titanium, nickel or tantalum (does not include mild contact dermatitis due to nickel allergy).
- Patient has received thrombolysis within 72 hours prior to the index procedure.
- Patient has acute or chronic renal disease (e.g., as measured by a serum creatinine of > 2.5 mg/dL or > 220 μmol/L or GFR < 30 ml/min), or on peritoneal or hemodialysis.
- Patient requiring coronary intervention within seven days prior to enrollment.
- Patient is pregnant or breast-feeding.
- Patient is participating in another research study involving an investigational product (pharmaceutical, biologic or medical device).
- Patient has other medical, social or psychological problems that, in the opinion of the investigator, preclude them from receiving this treatment, and the procedures and evaluations pre- and post-treatment.
- Patient has significant disease or obstruction (≥ 50%) of the inflow tract that has not been successfully treated at the time of the index procedure (success measured as ≤ 30% residual stenosis, without complication).
- Patient has no patent (≥ 50% stenosis) outflow vessel providing run-off to the ankle.
- There is a lack of full expansion in the predilatation balloon.
- Evidence of aneurysm or acute thrombus in target vessel.
Sites / Locations
- Southwest CVA
- Vascular Heart & Lung Associates
- Phoenix Cardiovascular Research Group
- Yuma Cardiology Associates
- Arkansas Heart
- Bay Area Vein & Vascular Institute
- UCSF
- Rocky Mountain Regional VAMC
- The Vascular Experts
- First Coast Cardiovascular Institute
- Palm Vascular Centers
- Coastal Vascular & Interventional
- Florida Cardiology
- AMITA Health
- MedStar Health Research Insitute
- McLaren Bay Region
- Michigan Vascular Center
- Eastlake Cardiovascular
- Northern Mississippi Medical Center
- Columbia University Medical Center
- Novant Health
- NC Heart & Vascular Research
- The Lindner Center for Research & Education
- Naadi
- The Miriam Hospital
- Prisma Health
- North Central Heart
- Stern Cardiovascular Foundation
- Texas Tech
- North Dallas Research Associates
- Sentara Vascular Specialists
- Bellin Hospital
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
TORUS Stent Graft System
Arm Description
The TORUS Stent Graft System (SGS) is comprised of a Stent Graft (SG) and a Stent Graft Delivery System (SGDS).
Outcomes
Primary Outcome Measures
Freedom from a Major Adverse Event (MAE)
An MAE is defined as all-cause death, target limb major amputation and clinically-driven target lesion revascularization (CD-TLR)
Primary Patency
Primary patency is defined as the absence of clinically-driven target lesion revascularization (CD-TLR) and absence of recurrent target lesion diameter stenosis >50% by duplex ultrasound with a peak systolic velocity ratio of >2.5.
Secondary Outcome Measures
Technical Success
Technical success is defined as the ability to cross and dilate the lesion to achieve residual stenosis of ≤30%
Procedural Success
Procedural Success is defined as technical success with out any MAEs.
Major Adverse Event (MAE) Rate
Composite rate of all-cause death, target limb major amputation and clinically-driven target lesion revascularization (CD-TLR).
Patency Rate
Absence of CD-TLR and absence of recurrent target lesion diameter stenosis >50% by duplex ultrasound with a peak systolic velocity ratio of >2.5.
Assisted Primary Patency Rate
Revascularization of non-occlusive (<99%) stenosis within the stent graft or immediately above or below the treated arterial segment (end of the graft and 1cm of artery beyond) with less than 50% residual stenosis.
Secondary Patency Rate
Revascularization of occlusion (100%) within the stent graft or immediately above or below the treated arterial segment (end of the graft and 1cm of artery beyond) with less than 50% residual stenosis.)
Alternative Patency Rate
Patency of target vessel based on systolic velocity ratio ≤ 2.0 and absence of CD-TLR.
Walking Improvement Questionnaire (WIQ) Assessment
Assessment of walking improvement
Quality of Life Assessment by the EQ5D
Assessment of improved quality of life
Clinically Driven Target Lesion Revascularization
Target Vessel Revascularization
Major Amputation on Target Limb
Stent Fracture Rate
Stent fracture rate using VIVA definitions
Change in Ankle-Brachial Index
Change in Toe Pressures
Change in Rutherford Clinical Classification
Adverse Event Rate
Full Information
NCT ID
NCT04130737
First Posted
October 10, 2019
Last Updated
May 3, 2023
Sponsor
PQ Bypass, Inc.
Collaborators
Syntactx
1. Study Identification
Unique Protocol Identification Number
NCT04130737
Brief Title
TORUS 2 IDE Clinical Study
Official Title
The PQ Bypass Pivotal IDE Intra-arterial Stent Graft Study for Occlusive and Re-stenotic Fem-pop Revascularization - 2 Trial: TORUS 2
Study Type
Interventional
2. Study Status
Record Verification Date
May 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
October 31, 2019 (Actual)
Primary Completion Date
January 6, 2023 (Actual)
Study Completion Date
December 24, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
PQ Bypass, Inc.
Collaborators
Syntactx
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Data Monitoring Committee
No
5. Study Description
Brief Summary
The primary objective of the TORUS 2 IDE Clinical Study is to evaluate the safety and effectiveness of the TORUS Stent Graft System in the treatment of obstructive atherosclerotic lesions of the native SFA or the superficial femoral and/or 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
Keywords
Peripheral Artery Disease, Superficial Femoral Artery, Popliteal Artery, Stent Graft
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
188 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
TORUS Stent Graft System
Arm Type
Experimental
Arm Description
The TORUS Stent Graft System (SGS) is comprised of a Stent Graft (SG) and a Stent Graft Delivery System (SGDS).
Intervention Type
Device
Intervention Name(s)
TORUS Stent Graft System
Other Intervention Name(s)
TORUS Stent Graft, PQ Bypass™ Stent Graft System
Intervention Description
The TORUS Stent Graft is an intravascular prosthesis intended to improve blood flow in the area in which it is implanted and the TORUS Stent Graft Delivery System is a standard pin-and-pull delivery system used to implant the SG in the desired area. Use of the TORUS Stent Graft allows for improving blood flow in the peripheral vasculature.
Primary Outcome Measure Information:
Title
Freedom from a Major Adverse Event (MAE)
Description
An MAE is defined as all-cause death, target limb major amputation and clinically-driven target lesion revascularization (CD-TLR)
Time Frame
30 days
Title
Primary Patency
Description
Primary patency is defined as the absence of clinically-driven target lesion revascularization (CD-TLR) and absence of recurrent target lesion diameter stenosis >50% by duplex ultrasound with a peak systolic velocity ratio of >2.5.
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Technical Success
Description
Technical success is defined as the ability to cross and dilate the lesion to achieve residual stenosis of ≤30%
Time Frame
At the time of the index procedure
Title
Procedural Success
Description
Procedural Success is defined as technical success with out any MAEs.
Time Frame
Within 24 hours of the procedure
Title
Major Adverse Event (MAE) Rate
Description
Composite rate of all-cause death, target limb major amputation and clinically-driven target lesion revascularization (CD-TLR).
Time Frame
12 months
Title
Patency Rate
Description
Absence of CD-TLR and absence of recurrent target lesion diameter stenosis >50% by duplex ultrasound with a peak systolic velocity ratio of >2.5.
Time Frame
Through 36 months
Title
Assisted Primary Patency Rate
Description
Revascularization of non-occlusive (<99%) stenosis within the stent graft or immediately above or below the treated arterial segment (end of the graft and 1cm of artery beyond) with less than 50% residual stenosis.
Time Frame
Through 36 months
Title
Secondary Patency Rate
Description
Revascularization of occlusion (100%) within the stent graft or immediately above or below the treated arterial segment (end of the graft and 1cm of artery beyond) with less than 50% residual stenosis.)
Time Frame
Through 36 months
Title
Alternative Patency Rate
Description
Patency of target vessel based on systolic velocity ratio ≤ 2.0 and absence of CD-TLR.
Time Frame
Through 36 months
Title
Walking Improvement Questionnaire (WIQ) Assessment
Description
Assessment of walking improvement
Time Frame
From procedure to 1, 6 and 12 months
Title
Quality of Life Assessment by the EQ5D
Description
Assessment of improved quality of life
Time Frame
From procedure to 1, 6 and 12 months
Title
Clinically Driven Target Lesion Revascularization
Time Frame
Through 36 months
Title
Target Vessel Revascularization
Time Frame
Through 36 months
Title
Major Amputation on Target Limb
Time Frame
Through 36 months
Title
Stent Fracture Rate
Description
Stent fracture rate using VIVA definitions
Time Frame
12 months
Title
Change in Ankle-Brachial Index
Time Frame
From procedure through 36 months
Title
Change in Toe Pressures
Time Frame
From procedure through 36 months
Title
Change in Rutherford Clinical Classification
Time Frame
From procedure through 36 months
Title
Adverse Event Rate
Time Frame
Through 36 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patient is male or female, with age > 18 and ≤ 90 years at date of enrollment.
Patient provides written informed consent before any study-specific investigations or procedures.
Patient is willing to undergo all follow-up assessments according to the specified schedule over 36 months.
Patient is a suitable candidate for angiography and endovascular intervention and, if required, is eligible for standard surgical repair.
Patient has symptomatic peripheral arterial disease (PAD) of the lower extremities requiring intervention to relieve de novo obstruction or occlusion or restenosis of the native femoropopliteal artery.
Patient has PAD classified as Rutherford classification 2, 3 or 4.
Patient has documented PAD by either (i) a resting ankle-brachial index (ABI) of ≤ 0.90 (or ≤ 0.75 after exercise of the target limb). Resting toe brachial index (TBI) is performed only if unable to reliably assess ABI. TBI must be <0.70; or (ii) Normal ABI with angiographic, ultrasound, MRA, or CT evidence of ≥ 60% diameter stenosis.
Patient has single or multiple stenotic, restenotic or occlusive lesions within the native femoropopliteal artery ("target lesions") that can be crossed with a guidewire and fully dilated.
Single target lesion must be covered by a single stent. Tandem target lesions are considered a single continuous lesion if the gap between lesions is ≤ 5 cm and > 30% diameter stenosis between the lesion(s).
Target lesion(s) eligible for treatment under the protocol are at least least 3 cm above the bottom of the femur.
Target lesion(s) reference vessel diameter is between 5.0 mm and 6.7 mm by operator's visual estimate.
Target lesion measures ≥ 80 mm to ≤ 180 mm in overall length, with ≥ 60% diameter stenosis by operator's visual estimate. Tandem target lesions are considered a single continuous lesion if the gap between lesions is ≤ 5 cm and > 30% diameter stenosis between the lesion(s).
Patient has a patent popliteal artery (no stenosis ≥ 50%) distal to the treated segment.
Patient has at least one patent infrapopliteal vessel (< 50% stenosis) with run-off to the ankle.
Exclusion Criteria:
Patient is unable or is unwilling to comply with the procedural requirements of the study protocol or will have difficulty in complying with the requirements for attending follow-up visits.
Patient has a comorbidity that in the investigator's opinion would limit life expectancy to less than 24 months.
Patient has any planned major surgical procedure (including any amputation of the target limb) within 30 days after the index procedure for this study.
Patient has a target vessel that has been treated with any type of surgical procedure prior to enrollment.
Patient has a target vessel that has been treated with bypass surgery.
Patient has PAD classified as Rutherford classification 0, 1, 5 or 6.
Patient has known or suspected active systemic infection at the time of enrollment.
Patient has a known coagulopathy or has bleeding diatheses, thrombocytopenia with platelet count less than 100,000/microliter or INR (international normalized ratio) >1.8.
Patient has a stroke diagnosis within three months prior to enrollment.
Patient has a history of unstable angina or myocardial infarction within 60 days prior to enrollment.
Patient has a contraindication to antiplatelet, anticoagulant or thrombolytic therapies.
Patient has known allergy to contrast agents or medications used to perform endovascular intervention that cannot be adequately pre-medicated.
Patient has known allergy to titanium, nickel or tantalum (does not include mild contact dermatitis due to nickel allergy).
Patient has received thrombolysis within 72 hours prior to the index procedure.
Patient has acute or chronic renal disease (e.g., as measured by a serum creatinine of > 2.5 mg/dL or > 220 μmol/L or GFR < 30 ml/min), or on peritoneal or hemodialysis.
Patient requiring coronary intervention within seven days prior to enrollment.
Patient is pregnant or breast-feeding.
Patient is participating in another research study involving an investigational product (pharmaceutical, biologic or medical device).
Patient has other medical, social or psychological problems that, in the opinion of the investigator, preclude them from receiving this treatment, and the procedures and evaluations pre- and post-treatment.
Patient has significant disease or obstruction (≥ 50%) of the inflow tract that has not been successfully treated at the time of the index procedure (success measured as ≤ 30% residual stenosis, without complication).
Patient has no patent (≥ 50% stenosis) outflow vessel providing run-off to the ankle.
There is a lack of full expansion in the predilatation balloon.
Evidence of aneurysm or acute thrombus in target vessel.
Facility Information:
Facility Name
Southwest CVA
City
Mesa
State/Province
Arizona
ZIP/Postal Code
85206
Country
United States
Facility Name
Vascular Heart & Lung Associates
City
Mesa
State/Province
Arizona
ZIP/Postal Code
85206
Country
United States
Facility Name
Phoenix Cardiovascular Research Group
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85018
Country
United States
Facility Name
Yuma Cardiology Associates
City
Yuma
State/Province
Arizona
ZIP/Postal Code
85349
Country
United States
Facility Name
Arkansas Heart
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72211
Country
United States
Facility Name
Bay Area Vein & Vascular Institute
City
Burlingame
State/Province
California
ZIP/Postal Code
94010
Country
United States
Facility Name
UCSF
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Facility Name
Rocky Mountain Regional VAMC
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
The Vascular Experts
City
Darien
State/Province
Connecticut
ZIP/Postal Code
06820
Country
United States
Facility Name
First Coast Cardiovascular Institute
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32256
Country
United States
Facility Name
Palm Vascular Centers
City
Miami Beach
State/Province
Florida
ZIP/Postal Code
33140
Country
United States
Facility Name
Coastal Vascular & Interventional
City
Pensacola
State/Province
Florida
ZIP/Postal Code
32504
Country
United States
Facility Name
Florida Cardiology
City
Winter Park
State/Province
Florida
ZIP/Postal Code
32792
Country
United States
Facility Name
AMITA Health
City
Elk Grove
State/Province
Illinois
ZIP/Postal Code
60007
Country
United States
Facility Name
MedStar Health Research Insitute
City
Hyattsville
State/Province
Maryland
ZIP/Postal Code
20782
Country
United States
Facility Name
McLaren Bay Region
City
Bay City
State/Province
Michigan
ZIP/Postal Code
48708
Country
United States
Facility Name
Michigan Vascular Center
City
Flint
State/Province
Michigan
ZIP/Postal Code
48507
Country
United States
Facility Name
Eastlake Cardiovascular
City
Roseville
State/Province
Michigan
ZIP/Postal Code
48066
Country
United States
Facility Name
Northern Mississippi Medical Center
City
Tupelo
State/Province
Mississippi
ZIP/Postal Code
38801
Country
United States
Facility Name
Columbia University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Novant Health
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28204
Country
United States
Facility Name
NC Heart & Vascular Research
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27607
Country
United States
Facility Name
The Lindner Center for Research & Education
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45219
Country
United States
Facility Name
Naadi
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73116
Country
United States
Facility Name
The Miriam Hospital
City
Providence
State/Province
Rhode Island
ZIP/Postal Code
02906
Country
United States
Facility Name
Prisma Health
City
Greenville
State/Province
South Carolina
ZIP/Postal Code
29615
Country
United States
Facility Name
North Central Heart
City
Sioux Falls
State/Province
South Dakota
ZIP/Postal Code
57108
Country
United States
Facility Name
Stern Cardiovascular Foundation
City
Germantown
State/Province
Tennessee
ZIP/Postal Code
38138
Country
United States
Facility Name
Texas Tech
City
Lubbock
State/Province
Texas
ZIP/Postal Code
79430
Country
United States
Facility Name
North Dallas Research Associates
City
McKinney
State/Province
Texas
ZIP/Postal Code
75069
Country
United States
Facility Name
Sentara Vascular Specialists
City
Norfolk
State/Province
Virginia
ZIP/Postal Code
23507
Country
United States
Facility Name
Bellin 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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TORUS 2 IDE Clinical Study
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