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The GORE VBX FORWARD Clinical Study: A Comparison of the GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis to Bare Metal Stenting for Patients With Complex Iliac Occlusive Disease

Not Applicable
Recruiting
Conditions
Aortoiliac Occlusive Disease
Peripheral Arterial Disease
Interventions
Device: Stenting of the Common and/or External Iliac Arteries with the GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis
Device: Stenting of the Common and/or External Iliac Arteries with Bare Metal Stent
Registration Number
NCT05811364
Lead Sponsor
W.L.Gore & Associates
Brief Summary

The objective of this prospective, multicenter, randomized, controlled clinical trial is to demonstrate the superiority of the VBX Device for primary patency when compared to bare metal stenting in complex iliac occlusive disease.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
244
Inclusion Criteria
  • Age ≥ 18 years at time of informed consent signature
  • Informed Consent Form (ICF) is signed by the subject
  • Subject can comply with protocol requirements, including follow-up
  • Patient has symptomatic claudication, rest pain, or minor tissue loss (Rutherford Category 2-5)
  • Patient has de novo or restenotic lesion(s) found in the common and/or external iliac artery(ies)
  • Patient has: Unilateral or bilateral single or multiple lesions (>50% stenosis or chronic total occlusion) each between 4 and 11 cm in length
  • Patient has a target vessel diameter visually estimated to be approximately between 5 mm and 13 mm
  • Patient has a sufficient (<50% stenotic) common femoral artery and at least one sufficient (<50% stenotic) femoral artery (deep or superficial).
  • Patient has at least one sufficient (<50% stenotic) infrapopliteal run-off vessel.
Exclusion Criteria
  • Life expectancy <1 year
  • Patient is pregnant at time of informed consent.
  • Patient has a known allergy to stent or stent graft components (including nitinol, stainless steel, or heparin).
  • Patient has severe chronic renal insufficiency (serum creatinine level > 2.5mg/dL) and not undergoing hemodialysis.
  • Patient has evidence of a systemic infection.
  • Patient has a known intolerance to antithrombotic medications that prevent compliance with study or control device Instructions for Use.
  • Patient has had vascular catheterization of the lower extremities within 30 days of randomization (excluding diagnostic angiograms for the study procedure).
  • Patient has previous stenting in the iliac arteries.
  • Patient has previous surgical bypass in the target limb.
  • Patient is currently participating in another investigative clinical study unless received written approval by the sponsor.
  • Patient has a lesion requiring drug-coated balloon angioplasty, atherectomy, lithotripsy, or any ablative device to facilitate stent delivery.
  • Patient has an abdominal aortic artery lesion or aneurysm.
  • Patient has a lesion that requires stent placement within 2 cm of the inguinal ligament.
  • Patient has isolated common iliac artery stenosis that can be treated with a single device (i.e., common iliac artery stenosis that does not require kissing stents or extend into the external iliac artery).
  • Patient has outflow disease that requires concomitant interventions (i.e. common femoral endarterectomy or femoral / tibial revascularization).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
VBX Device GroupStenting of the Common and/or External Iliac Arteries with the GORE® VIABAHN® VBX Balloon Expandable EndoprosthesisSubject in this group will receive treatment with the GORE VIABAHN® VBX Balloon Expandable Endoprosthesis (VBX)
BMS Control GroupStenting of the Common and/or External Iliac Arteries with Bare Metal StentSubjects in this group will receive treatment with a commercially available bare metal stent (BMS) that is approved for treatment of the disease
Primary Outcome Measures
NameTimeMethod
Primary Patency1 year

Blood flow through the target lesion (no evidence of binary restenosis \>50% or occlusion) without a Target Lesion Revascularization (TLR).

Secondary Outcome Measures
NameTimeMethod
SurvivalThrough 5 years

Freedom from all-cause mortality

Technical successat the procedure

Deployment of device with \< 30% residual stenosis on final angiography.

Change in EQ-5D-5LThrough 5 years

Change in EQ-5D-5L responses as compared to baseline. The EQ-5D-5L Questionnaire measures quality of life (QoL) over 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension is measured over five levels from no problems to extreme problems. Scored on a 0 to 100 scale with 0 as the worst possible health and 100 is the best possible health.

Acute procedural successat the procedure

Binary assessment based on technical success and freedom from device or procedure-related serious adverse events (SAE) requiring intervention.

Clinical successThrough 1 month

Improvement from baseline of at least 1 Rutherford Category and freedom from device or procedure-related SAE requiring intervention.

Change in WIQThrough 5 years

Change in Walking Impairment Questionnaire (WIQ) responses as compared to baseline. The WIQ is a validated QoL measurement of walking abilities over 3 dimensions: distance, speed, and stair-climbing. Scored on a 0 to 100 scale with 0 as no degree of difficulty and 100 is the highest degree of difficulty.

Freedom from binary restenosisThrough 5 years

Freedom from binary restenosis. binary restenosis defined as evidence of \>50% restenosis or occlusion of the target lesion(s) based on core lab adjudicated duplex ultrasound or angiography

Hemodynamic StatusThrough 5 years

Change in Ankle-brachial index (ABI)/toe-brachial index (TBI) as compared to baseline

Primary patencyThrough 5 years

Blood flow through the target lesion (no evidence of binary restenosis \>50% or occlusion) without a Target Lesion Revascularization (TLR).

Primary assisted patencyThrough 5 years

Blood flow maintained (no evidence of occlusion) through the target lesion with or without a Target Lesion Revascularization (TLR).

Secondary patencyThrough 5 years

Blood flow through the target lesion with or without a Target Lesion Revascularization (TLR).

Freedom from target lesion revascularizationThrough 5 years

Freedom from target lesion revascularization (TLR). TLR defined as endovascular or surgical intervention performed on the target lesion(s).

Cumulative reintervention rateThrough 5 years

Rate of first and recurrent Target Lesion Revascularization (TLR).

Freedom from clinically driven target lesion revascularizationThrough 5 years

Freedom from clinically driven target lesion revascularization. Endovascular or surgical intervention performed on the target lesion(s) in response to recurrent symptoms (increase ≥ 1 Rutherford Category).

Amputation-free survivalThrough 5 years

Binary assessment based on freedom from major amputation (target limb, amputation above the metatarsals) and all-cause mortality

Change in Rutherford CategoryThrough 5 years

Change in Rutherford Category as compared to baseline. Scaled from 0 to 6, with 0 as asymptotic and 6 as major tissue loss, extending above the transmetatarsal (TM) level, functional foot no longer salvageable.

Trial Locations

Locations (7)

North Suburban Medical Center

🇺🇸

Denver, Colorado, United States

Radiology and Imaging Specialists of Lakeland

🇺🇸

Lakeland, Florida, United States

University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

The University of Texas Southwestern Medical Center

🇺🇸

Dallas, Texas, United States

Krankenhaus der Barmherzigen Brüder

🇩🇪

Regensburg, Germany

Rijnstate Hospital

🇳🇱

Arnhem, Netherlands

Auckland City Hospital

🇳🇿

Auckland, New Zealand

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