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Evaluation of Safety and Effectiveness of the BioMimics 3D Stent System

Not Applicable
Completed
Conditions
Peripheral Arterial Disease
Interventions
Device: BioMimics 3D Vascular Stent System
Registration Number
NCT02400905
Lead Sponsor
Veryan Medical Ltd.
Brief Summary

To demonstrate that the BioMimics 3D Stent System meets the performance goals defined by VIVA Physicians, Inc. for the safety and effectiveness of Nitinol stents used in the treatment of symptomatic disease of the femoropopliteal artery. It is a prospective, single-arm, multicenter clinical trial.

Detailed Description

The BioMimics 3D stent is intended to improve luminal diameter in the treatment of symptomatic de-novo, obstructive or occlusive lesions in native femoropopliteal arteries with reference vessel diameters ranging from 4.0 - 6.0 mm. Subjects with symptomatic atherosclerotic disease of the femoropopliteal artery who comply with all study eligibility criteria may be considered for enrollment.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
271
Inclusion Criteria
  • Symptomatic peripheral arterial disease (PAD) of the lower extremities requiring intervention to relieve de novo obstruction or occlusion of the native femoropopliteal artery.
  • PAD classified as Rutherford clinical category 2, 3 or 4.
  • Resting ankle-brachial index (ABI) of ≤0.90 (or ≤0.75 after exercise of the target limb) or angiographic or DUS evidence of >/= 60%.
  • Single or multiple stenotic or occlusive lesions within the native femoropopliteal artery ("target lesions") that can be crossed with a guidewire and fully dilated.
  • Single or multiple target lesions must be covered by a single stent or two overlapping stents.
  • Target lesion(s) eligible for treatment at least 1 cm distal to the origin of the deep femoral artery and at least 3 cm above the bottom of the femur.
  • Target lesion(s) reference vessel diameter is between 4.0 mm and 6.0 mm.
  • Single or multiple target lesions measure ≥40 mm to ≤140 mm in overall length, with ≥60% diameter stenosis by operator's visual estimate.
  • Patent popliteal artery (no stenosis ≥50%) distal to the treated segment.
  • At least one patent infrapopliteal vessel (<50% stenosis) with run-off to the ankle.
Exclusion Criteria
  • Iliac stent in target limb that has required re-intervention within 12 months prior to index.
  • Target vessel that has been treated with bypass surgery.
  • PAD classified as Rutherford clinical category 0, 1, 5 or 6.
  • Known coagulopathy or has bleeding diatheses, thrombocytopenia with platelet count less than 100,000/microliter or INR >1.8.
  • Stroke diagnosis within 3 months prior to enrollment.
  • History of unstable angina or myocardial infarction within 60 days prior to enrollment.
  • Thrombolysis within 72 hours prior to the index procedure.
  • Acute or chronic renal disease (e.g., as measured by a serum creatinine of >2.5 mg/dL or >220 umol/L), or on peritoneal or hemodialysis.
  • 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).
  • No patent (≥50% stenosis) outflow vessel providing run-off to the ankle.
  • Target lesion(s) requires percutaneous interventional treatment, beyond standard balloon angioplasty alone, prior to placement of the study stent.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
BioMimics 3D Vascular StentBioMimics 3D Vascular Stent SystemImplantation of BioMimics 3D nitinol stent using the BioMimics 3D Vascular Stent System
Primary Outcome Measures
NameTimeMethod
Primary Safety Endpoint (Freedom From a Composite of Major Adverse Events (MAE)30 days

Freedom from a composite of major adverse events (MAE) comprising death, any major amputation performed on the target limb or clinically-driven target lesion revascularization (TLR) through 30 days.

Primary Effectiveness Endpoint (Primary Stent Patency Rate)12 months

The primary effectiveness endpoint of the MIMICS-2 Study was defined as the primary stent patency rate at 12 months. Patency was defined as no significant reduction in luminal diameter (\< 50% diameter stenosis) since the index procedure. Loss of patency was determined by an independent core laboratory when the peak systolic velocity ratio (PSVR) exceeds 2.0, or where angiography revealed \> 50% diameter stenosis, or where the subject had a CDTLR.

Secondary Outcome Measures
NameTimeMethod
Clinical Outcome (Six-Minute Walk Test)Baseline, Day 30, Months 12 & 24

Comparison of measured at Baseline, Day 30, Months 12 and 24 (subgroup of US investigational sites only).

Number of Participants With Serious Adverse Events36 Months

Overall rate and incidence of type of serious adverse events from Day 0 through completion of Study follow-up at Month 36.

Long Term Safety (Overall MAE Rate at Month 12)12 months

Overall MAE rate at Month 12 and contribution of individual event rates to the overall MAE.

Number of Participants With Improvement of Rutherford Clinical Category by 1 or MoreBaseline, Day 30, Months 12 & 24

Comparison of Rutherford Clinical Category measured at Baseline, Day 30, Months 12 and 24.

Categories 0 - Asymptomatic

1. - Mild claudication

2. - Moderate claudication

3. - Severe claudication

4. - Ischemic rest pain

5. - Minor tissue loss

6. - Major tissue loss

Functional Outcome (Ankle Brachial Index (ABI) Measurement)Baseline, Day 30, Months 12 & 24

Comparison of the ankle brachial index (ABI) measurement at Baseline, within 30 days after index procedure, then at Months 12 and 24.

Number of Participants With Freedom From Stent FractureMonths 12, 24 & 36

Stent integrity measured as freedom from fracture, defined as clear interruption of a stent strut observed in a minimum of two projections, determined by core lab examination of X-rays taken with the leg in extension at 12, 24 and 36 Months.

Secondary Safety (Overall MAE Rate at 30 Days)30 Days

Contribution of individual MAE rates for death, major amputation performed on the target limb and clinically-driven target lesion revascularization to the overall MAE rate at 30 days.

Technical SuccessProcedural (at end of index procedure)

Percentage of subjects in which a final result of ≤50% residual diameter stenosis (in-stent) was achieved at index procedure

Primary Stent PatencyMonths 12 & 24

Determined at Months-12 and 24 using values of: PSVR \>2.0, \>2.4; \>2.5; and \>3.5, each to indicate loss of patency on duplex ultrasound or where angiography reveals \>50% diameter stenosis or where the subject undergoes clinically-driven TLR.

Further analysis of the patency data purely using a reference PSVR of \>2.4, \>2.5 and \>3.5 was not feasible from the data that was collected.

Change of Walking Impairment Questionnaire ScoreBaseline, Day 30, Months 12 & 24

Comparison of the Walking Impairment Questionnaire at Baseline, within 30 days after index procedure, then at Months 12 and 24.

The WIQ consists of 3 primary categories assessing walking distance, stair-climbing, and walking speed, as previously described. Individuals are asked to rate the degree of difficulty of various activities with responses ranging from 0 (unable) to 4 (none).

Trial Locations

Locations (42)

Riverside Methodist Hospital

🇺🇸

Columbus, Ohio, United States

MediQuest Research Group/ Munroe Regional Medical Center

🇺🇸

Ocala, Florida, United States

Coastal Vascular

🇺🇸

Pensacola, Florida, United States

Kings Daughters Medical Center

🇺🇸

Ashland, Kentucky, United States

Endovascular Technologies / Grace Research

🇺🇸

Bossier City, Louisiana, United States

Michigan Vascular Center

🇺🇸

Flint, Michigan, United States

Deborah Heart & Lung Center

🇺🇸

Browns Mills, New Jersey, United States

NC Heart & Vascular Research

🇺🇸

Raleigh, North Carolina, United States

Berks Cardiologists

🇺🇸

Wyomissing, Pennsylvania, United States

Austin Heart Research

🇺🇸

Austin, Texas, United States

Mission Research Institute/Guadalupe Regional Medical Center

🇺🇸

New Braunfels, Texas, United States

Grace Research

🇺🇸

Huntsville, Texas, United States

Cardiovascular Associates of East Texas

🇺🇸

Tyler, Texas, United States

Karolinen-Hospital

🇩🇪

Arnsberg, Germany

Universitaets-Herzzentrum Freiburg-Bad Krozingen

🇩🇪

Bad Krozingen, Germany

Westküstenklinikum Heide

🇩🇪

Heide, Germany

Diakonissenkrankenhaus Flensburg

🇩🇪

Flensburg, Germany

Universitätsklinikum Leipzig AoR Leipzig

🇩🇪

Leipzig, Germany

St. Bonifatius Hospital

🇩🇪

Lingen, Germany

Kansai Rosai Hospital

🇯🇵

Hyogo, Japan

Kokura Memorial Hospital

🇯🇵

Kitakyushu-shi, Japan

Kasukabe Chuo General Hospital

🇯🇵

Kasukabe, Japan

Morinomiya Hospital

🇯🇵

Osaka, Japan

Cardiology Associates of Mobile

🇺🇸

Mobile, Alabama, United States

OSF St. Francis Medical Center

🇺🇸

Peoria, Illinois, United States

Prairie Education and Research Cooperative

🇺🇸

Springfield, Illinois, United States

WakeMed Research

🇺🇸

Raleigh, North Carolina, United States

Doylestown Hospital

🇺🇸

Doylestown, Pennsylvania, United States

Pinnacle Health Harrisburg

🇺🇸

Harrisburg, Pennsylvania, United States

Cardiovascular Specialist of TX / North Austin Medical Center

🇺🇸

Austin, Texas, United States

Minneapolis Heart

🇺🇸

Minneapolis, Minnesota, United States

Brookwood Medical Center

🇺🇸

Birmingham, Alabama, United States

Arizona Heart Hospital

🇺🇸

Phoenix, Arizona, United States

Michigan Outpatient Vascular Institute

🇺🇸

Dearborn, Michigan, United States

Bradenton Cardiology Center

🇺🇸

Bradenton, Florida, United States

Omihachiman Community Medical Center

🇯🇵

Shiga, Japan

Kore Cardiovascular Research

🇺🇸

Jackson, Tennessee, United States

Yale New Haven Hospital

🇺🇸

New Haven, Connecticut, United States

Toho University Ohashi Medical Center

🇯🇵

Tokyo, Japan

St. John Hospital & Medical Center

🇺🇸

Detroit, Michigan, United States

Cardiovascular Institute of the South

🇺🇸

Lafayette, Louisiana, United States

North Central Heart

🇺🇸

Sioux Falls, South Dakota, United States

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