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临床试验/NCT02963649
NCT02963649已完成不适用

Randomized Study of IN.PACT 014 Paclitaxel-Coated Percutaneous Transluminal Angioplasty Balloon Catheter vs. Optimal Percutaneous Transluminal Angioplasty for the Treatment of Chronic Total Occlusions in the Infrapopliteal Arteries

Medtronic Endovascular17 个研究点 分布在 5 个国家目标入组 50 人开始时间: 2017年3月2日最近更新:
适应症

试验速览

阶段
不适用
状态
已完成
发起方
入组人数
50
试验地点
17
主要终点
Primary Effectiveness Endpoint: Late Lumen Loss (LLL) at 9 Months

研究概览

简要总结

To assess the safety and efficacy of the paclitaxel drug-coated balloon IN.PACT 014 versus conventional optimal percutaneous transluminal angioplasty (PTA) for the treatment of patients with chronic total occlusions in the infrapopliteal arteries.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Treatment
盲法
Single (Outcomes Assessor)

入排标准

年龄范围
18 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Age ≥18 years.
  • Subject has been informed of the nature of the study, agrees to participate and has signed an EC approved consent form.
  • Female subjects of childbearing potential have a negative pregnancy test ≤7 days before the procedure and are willing to use a reliable method of birth control for the duration of study participation.
  • Subject has documented chronic Critical Limb Ischemia (CLI) in the target limb prior to the study procedure with Rutherford Clinical Category 4 or
  • Subjects with documented infection grade 0-2 and ischemia grade 2-3 according to WIfi classification.
  • Life expectancy >1 year in the Investigator's opinion.
  • Reference Vessel Diameter (RVD) 2 - 4 mm, and confirmed by DUS assessment.
  • Total occlusions with total lesion length ≥ 40 mm (by visual estimate).
  • Lesion must be located in the infrapopliteal arteries and above the ankle joint.
  • Multiple lesions can be treated if located in separate vessels.
  • Presence of documented run-off to the foot.
  • Inflow free from flow-limiting lesion confirmed by angiography.
  • Successful pre-dilatation of the (entire) target lesion.

排除标准

  • Subject unwilling or unlikely to comply to the appropriate follow-up times for the duration of the study.
  • Planned index limb amputation above the metatarsal level, or any other planned major surgery within 30 days pre or post-procedure.
  • Lesion and/or occlusions located or extending in the popliteal artery or below the ankle joint space.
  • Significant (≥50% DS) inflow lesion or occlusion in the ipsilateral iliac, SFA and popliteal arteries left untreated.
  • Failure to obtain ≤ 30% residual stenosis in pre-existing, hemodynamically significant inflow lesions in the ipsilateral iliac, SFA and popliteal artery.
  • Prior stent(s) or bypass surgery within the target vessel(s) (including stents placed within target vessels during the index procedure prior to randomization.
  • Previous DCB procedure in the target vessel within 6 months prior to index procedure.
  • Aneurysm in the target vessel.
  • Angiographic evidence of thrombus within target limb.
  • Pre-dilatation resulted in major (≥ Grade D) flow-limiting dissection or residual stenosis > 30%.
  • Use of alternative therapy e.g. atherectomy, cutting balloon, laser, radiation therapy, stents as part of target vessel treatment.
  • Recent MI or stroke < 30 days prior to the index procedure.
  • Heart failure with Ejection Fraction < 30%.
  • Known or suspected active infection at the time of the index procedure, excluding an infection of a lower extremity wound on the target limb.
  • Subjects with infection grade 3 and ischemia grade 0 and 1 according to the Wifi classification.
  • Subjects with neutrotrophic ulcers, heel pressure ulcers or calcaneal ulcers with a risk of major amputation.
  • Subjects with documented active osteomyelitis, excluding the phalanges, that is beyond cortical involvement of the bone per clinical judgement.
  • Impaired renal function (GFR <20 mL/min) and patients on dialysis.
  • Subject with vasculitis, systemic Lupus Erythematosus or Polymyalgia Rheumatica on active treatment.
  • Patient receiving systemic corticosteroid therapy.
  • Known allergies or sensitivities to heparin, aspirin (ASA), other anticoagulant/anti-platelet therapies which could not be substituted, and/or paclitaxel or an allergy to contrast media that cannot be adequately pre-treated prior to the index procedure.
  • The patient is currently enrolled in another investigational device or drug trial that is interfering with the endpoints of this study.
  • Female subjects who are breastfeeding at the time of enrollment.

结局指标

主要结局

Primary Effectiveness Endpoint: Late Lumen Loss (LLL) at 9 Months

时间窗: 9 Months

Late lumen loss (LLL) - The difference between minimum lumen diameter (MLD) immediately after percutaneous balloon angioplasty PTA and MLD at follow up, measured at 9 months

次要结局

  • Composite Safety Endpoint(9 Months)
  • Major Adverse Event (MAE) Rate(through 3, 6, 9, 12, 24, 36, 48 and 60 months)
  • Functional Flow Assessment(at 3, 6, 9, 12, 24 and 36 months)
  • Death of Any Cause(through 3, 6, 9, 12, 24, 36, 48 and 60 months)
  • Major Target Limb Amputation Rate(through 30 days, 3, 6, 9, 12, 24, 36, 48 and 60 months)
  • Target Lesion Revascularization (TLR) Rate(through 3, 6, 9, 12, 24, 36, 48 and 60 months)
  • Clinically-driven Target Lesion Revascularization (CD-TLR) Rate(through 3, 6, 9, 12, 24, 36, 48 and 60 months)
  • Mechanically-driven Target Lesion Revascularization (TLR) Rate(through 37 days)
  • Clinically-driven Target Vessel Revascularization (CD-TVR) Rate(through 3, 6, 9, 12, 24, 36, 48 and 60 months)
  • Target Vessel Revascularization (TVR) Rate(through 3, 6, 9, 12, 24, 36, 48 and 60 months)
  • Status of Wound Healing(at 30 days, 3, 6, 9, 12, 24 and 36 months)
  • Rate of Thrombosis at the Target Lesion(through 30 days, 3, 6, 9, 12, 24, 36, 48 and 60 months)
  • Device Success(at the time of procedure)
  • Clinical Success(up to discharge visit [between index procedure and 30-day (+/- 7 days) follow-up visit. The average days until discharge was: 9 days (with a max. of 31days) in the IN.PACT 014 arm, and 6 days (with a max. of 21days) in the PTA arm.])

研究者

发起方
Medtronic Endovascular
申办方类型
Industry
责任方
Sponsor

研究点 (17)

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