MedPath

IN.PACT Global Clinical Study

Not Applicable
Completed
Conditions
Peripheral Arterial Disease
Interventions
Device: IN.PACT Admiral™ Drug Eluting Balloon
Registration Number
NCT01609296
Lead Sponsor
Medtronic Endovascular
Brief Summary

The purpose of this study is to collect safety and efficacy data on the IN.PACT Admiral™ Drug Eluting Balloon (DEB) in treatment of atherosclerotic disease in the superficial femoral and/or popliteal arteries in a "real world" patient population.

Detailed Description

Peripheral artery disease (PAD) commonly results from progressive narrowing of the arteries in the lower extremities, usually due to atherosclerosis. Progression of PAD can result in critical limb ischemia (CLI), manifested by ischemic pain at rest or in the breakdown of the skin, resulting in ulcers or gangrene which ultimately may lead to amputation and death.

The IN.PACT Global Clinical Study aims to expand and understand the safety and efficacy data on the IN.PACT Admiral™ DEB in a real world population of subjects with intermittent claudication and/or rest pain (Rutherford class 2-3-4) due to obstructive disease of the superficial femoral and/or popliteal arteries.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1535
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
IN.PACT Admiral DEBIN.PACT Admiral™ Drug Eluting BalloonThe subjects in this trial will be treated with the IN.PACT Admiral™ percutaneous transluminal angioplasty (PTA) paclitaxel drug eluting balloon (hereinafter referred as "IN.PACT Admiral™ DEB")manufactured by Medtronic. The IN.PACT Admiral™ is a CE (Conformité Europeénne, European Confirmity) marked medical device utilized within its intended use in the IN.PACT Global trial.
Primary Outcome Measures
NameTimeMethod
Clinical Cohort ITT - Primary Effectiveness Endpoint12 months

Freedom from clinically-driven target lesion revascularization (TLR) within 12 months post-index procedure, which is defined as: • Any re-intervention within the target lesion(s) due to symptoms or drop of ABI ≥ 20% or \> 0.15 when compared to post-index procedure baseline ABI.

Clinical Cohort ITT - Primary Safety Endpoint12 months

A composite of freedom from device- and procedure-related mortality through 30 days, freedom from major target limb amputation and TLR within 12 months post-index procedure.

Imaging Cohort ITT - Primary Effectiveness Endpoint12 months

Primary Patency within 12 months post-index procedure, which is defined as:

* Freedom from clinically-driven TLR and

* Freedom from restenosis as determined by DUS Peak Systolic Velocity Ratio (PSVR) ≤ 2.4.

* Restenosis determined by either PSVR \>2.4 as assessed by an independent DUS core lab or \>50% stenosis as assessed by an independent angiographic core lab.

150mm DEB ITT Cohort - Primary Effectiveness Endpoint12 months

Freedom from clinically-driven target lesion revascularization (TLR) within 12 months post-index procedure, which is defined as:

• Any re-intervention within the target lesion(s) due to symptoms or drop of ABI ≥ 20% or \> 0.15 when compared to post-index procedure baseline ABI.

Secondary Outcome Measures
NameTimeMethod
Clinical Cohort ITT - MAEs48 Months

MAE is defined as all-cause mortality, clinically-driven TVR, major target limb amputation, thrombosis at the target lesion site.

Clinical Cohort ITT - TLR48 Months

Any Target lesion revascularisation

Clinical Cohort ITT - TVR6 Months

Any Target lesion revascularisation

Clinical Cohort ITT - Device SuccessIndex-procedure

Device success is defined as successful delivery, balloon inflation and deflation and retrieval of the intact study device without burst below the rated burst pressure (RBP)

Clinical Cohort ITT - Clinical Successprior to discharge

Clinical success is defined as procedural success without procedural complications (mortality, major target limb amputation, thrombosis of the target lesion, or TVR) prior to discharge

Clinical Cohort ITT - Clinically-driven TLR48 Months

Clinically-driven TLR is defined as any re-intervention at the target lesion due to symptoms or drop of ABI of ≥ 20% or \> 0.15 when compared to post-index procedure baseline ABI.

Clinical Cohort ITT - Time to First Clinically-driven TLR (Days)60 months
Clinical Cohort ITT - Time to All-cause Mortality Through 60 Months Post-index Procedure.60 months

All-cause mortality is reported by using the survival estimate of all cause mortality through 60 months

150mm DEB ITT Cohort - Clinical Successprior to discharge

Clinical success is defined as procedural success without procedural complications (mortality, major target limb amputation, thrombosis of the target lesion, or TVR) prior to discharge

Clinical Cohort ITT - Primary Sustained Clinical Improvement36 Months

Primary sustained clinical improvement is defined as sustained upward shift of at least 1 category on Rutherford classification as compared to baseline without the need for repeated TLR or surgical revascularization in amputation-free surviving subjects

Clinical Cohort ITT - Secondary Sustained Clinical Improvement36 Months

Secondary sustained clinical improvement is defined as sustained upward shift of at least 1 category on Rutherford classification as compared to baseline including the need for repeated TLR or surgical revascularization in amputation-free surviving subjects.

Clinical Cohort ITT - Immediate Hemodynamic Improvement at Post-index ProcedurePost procedure

Immediate hemodynamic improvement is defined as an ABI improvement of ≥ 0.1 or to an ABI ≥ 0.9

Clinical Cohort ITT - Sustained Hemodynamic Improvement36 Months

Sustained hemodynamic improvement is defined as persistent improvement of ABI- values with ≥ 0.1 as compared to baseline values or to an ABI ≥ 0.9 throughout follow-up without the need for repeated TLR or surgical revascularization in amputation-free surviving subjects.

Clinical Cohort ITT - Walking Impairment Evaluation by Walking Impairment Questionnaire (WIQ)36 Months
Clinical Cohort ITT - Health Related Quality of Life Scores (EQ5D Index)36 Months

The total EQ-5D-3L UK Index Score was computed using the algorithm specified by the EuroQol Research Foundation with possible values ranging from -0.594 to 1 where higher values are better.

Clinical Cohort ITT - Procedural Successat procedure

Procedural Success is defined as residual stenosis of ≤ 50% (non-stented subjects) or ≤ 30% (stented subjects) by visual estimate

Imaging Cohort ITT - Duplex-defined Binary Restenosis (PSVR > 2.0) of the Target Lesionat 12 months, or at the time of re-intervention
Imaging Cohort ITT - Duplex-defined Binary Restenosis (PSVR > 3.4) of the Target LesionAt 12 months, or at the time of re-intervention
150mm DEB ITT Cohort - MAEs60 months

Major Adverse Events (MAE) defined as all-cause death, clinically-driven TVR, major target limb amputation, thrombosis at the target lesion site at 60 months.

150mm DEB ITT Cohort - Clinically-driven TLR60 months

Clinically-driven TLR is defined as any re-intervention at the target lesion due to symptoms or drop of ABI of ≥ 20% or \> 0.15 when compared to post-index procedure baseline ABI.

150mm DEB ITT Cohort - TLR60 Months

Any Target lesion revascularisation

150mm DEB ITT Cohort - TVR60 Months

Any Target lesion revascularisation

150mm DEB ITT Cohort - Time to First Clinically-driven TLR (Days)60 months
150mm DEB ITT Cohort - Time to All-cause Mortality Through 60 Months Post-index Procedure.60 months

All-cause mortality is reported by using the survival estimate of all-cause mortality through 60 months

150mm DEB ITT Cohort - Primary Sustained Clinical Improvement36 months

Primary sustained clinical improvement is defined as sustained upward shift of at least 1 category on Rutherford classification as compared to baseline without the need for repeated TLR or surgical revascularization in amputation-free surviving subjects.

150mm DEB ITT Cohort - Secondary Sustained Clinical Improvement36 Months

Secondary sustained clinical improvement is defined as sustained upward shift of at least 1 category on Rutherford classification as compared to baseline including the need for repeated TLR or surgical revascularization in amputation-free surviving subjects.

150mm DEB ITT Cohort - Immediate Hemodynamic Improvement at Post-index ProcedurePost procedure

Immediate hemodynamic improvement is defined as an ABI improvement of ≥ 0.1 or to an ABI ≥ 0.9

150mm DEB ITT Cohort - Sustained Hemodynamic Improvement36 Months

Sustained hemodynamic improvement is defined as persistent improvement of ABI- values with ≥ 0.1 as compared to baseline values or to an ABI ≥ 0.9 throughout follow-up without the need for repeated TLR or surgical revascularization in amputation-free surviving subjects.

150mm DEB ITT Cohort - Walking Impairment Evaluation by Walking Impairment Questionnaire (WIQ)36 Months
150mm DEB ITT Cohort - Health Related Quality of Life Scores (EQ5D Index)36 Months

The total EQ-5D-3L UK Index Score was computed using the algorithm specified by the EuroQol Research Foundation with possible values ranging from -0.594 to 1 where higher values are better.

150mm DEB ITT Cohort - Device SuccessIndex-procedure

Device success is defined as successful delivery, balloon inflation and deflation and retrieval of the intact study device without burst below the rated burst pressure (RBP)

150mm DEB ITT Cohort - Procedural Successat procedure

Procedural Success is defined as residual stenosis of ≤ 50% (non-stented subjects) or ≤ 30% (stented subjects) by visual estimate

Clinical Cohort ITT - All-cause Mortality60 Months

The difference in death count calculation between the compliance table (participant flow: 253 deaths) and the event table (244 deaths) is explained as follow:

1. Calendar days (365/year) is used for compliance table whereas 360-day annual cutoff is used for event rate calculation

2. Compliance table used visit window as specified by protocol (60 days for 5-year follow-up) whereas, not window is used for event rate calculation

3. Nine patients died between 1801 and 1885 (1825 + 60) and were therefore not included in the 5-year death rate summary but were included in the compliance summary for patients that died through the upper window of the 60 month visit.

4. The denominator of 1215 for 1800-day event rate includes those who had an event within 1800 days and those who did not have any event but had at least 1740 days of follow-up (1740 is the low bound of the 60-day visit window from the target day of 1800)

Clinical Cohort ITT - Clinically-driven TVR60 Months

Clinically-driven TVR is defined as any re-intervention within the target vessel due to symptoms or drop of ABI of ≥ 20% or \> 0.15 when compared to post-index procedure baseline ABI.

Clinical Clinical Cohort ITT - Clinically-driven TVR24 Months

Clinically-driven TVR is defined as any re-intervention within the target vessel due to symptoms or drop of ABI of ≥ 20% or \> 0.15 when compared to post-index procedure baseline ABI.

Clinical Cohort ITT - Major Target Limb Amputation60 Months
150mm DEB ITT Cohort - All-cause Mortality60 Months
150mm DEB ITT Cohort - Clinically-driven TVR60 Months

Clinically-driven TVR is defined as any re-intervention within the target vessel due to symptoms or drop of ABI of ≥ 20% or \> 0.15 when compared to post-index procedure baseline ABI.

150mm DEB ITT Cohort - Major Target Limb Amputation60 Months

Trial Locations

Locations (65)

Fundación Favaloro

🇦🇷

Buenos Aires, Argentina

Royal Prince Alfred Hospital

🇦🇺

Sydney, Australia

Clinica La Sagrada Familia

🇦🇷

Bueos Aires, Argentina

Medizinische Universität Graz

🇦🇹

Graz, Austria

Imelda Ziekenhuis

🇧🇪

Bonheiden, Belgium

Onze-Lieve-Vrouwziekenuis

🇧🇪

Aalst, Belgium

AZ St. Blasius

🇧🇪

Dendermonde, Belgium

Ziekenhuis Oost Limburg - Campus St.-Jan

🇧🇪

Genk, Belgium

Universitair Ziekenhuis Antwerpen

🇧🇪

Edegem, Belgium

Universitair Ziekenhuis Gent

🇧🇪

Gent, Belgium

Regionaal Ziekenhuis Heilig Hart

🇧🇪

Tienen, Belgium

Helsingin Seudun Yliopistollinen Keskussairaala

🇫🇮

Helsinki, Finland

Centre hospitalier universitaire Sherbrooke (CHUS)

🇨🇦

Sherbrooke, Canada

Toronto General Hospital

🇨🇦

Toronto, Canada

Faculty Hospital Hradec Kralove

🇨🇿

Hradec Kralove, Czechia

As-Salam International Hospital

🇪🇬

Cairo, Egypt

Les Hospitaux Universitaires de Strasbourg

🇫🇷

Strasbourg, France

Group Hospitalier Pellegrin - CHU

🇫🇷

Bordeaux Cedex, France

Herzzentrum Bad Krozingen

🇩🇪

Bad Krozingen, Germany

Augusta Krankenhaus

🇩🇪

Düsseldorf, Germany

Universitätsklinikum Heidelberg

🇩🇪

Heidelberg, Germany

Augusta-Krankenhaus

🇩🇪

Duesseldorf, Germany

Universitatsklinikum Leipzig AoR

🇩🇪

Leipzig, Germany

St. Franziskus Hospital GmbH

🇩🇪

Münster, Germany

Clinica Santa Maria

🇨🇴

Medellin, Colombia

Clinica Medilaser Neiva

🇨🇴

Neiva, Colombia

Egypt Air Hospital

🇪🇬

Cairo, Egypt

Park-Krankenhaus Leipzig

🇩🇪

Leipzig, Germany

Policlinico Gemelli

🇮🇹

Rome, Italy

Catharina Ziekenhuis

🇳🇱

Eindhoven, Netherlands

Euromedic Medical Center

🇵🇱

Katowice, Poland

Kantonspital Luzern

🇨🇭

Luzern, Switzerland

Rijnstate Ziekenhuis

🇳🇱

Arnhem, Netherlands

Policlinico Vittorio Emanuele

🇮🇹

Catania, Italy

Severence Hospital

🇰🇷

Seoul, Korea, Republic of

Carmel Medical Centre

🇮🇱

Haifa, Israel

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

University Hospital of Patras

🇬🇷

Patra, Greece

Maria Eleonora Hospital

🇮🇹

Palermo, Italy

RoMed Klinikum Rosenheim

🇩🇪

Rosenheim, Germany

Bacs Kiskun Megyei Korhaz

🇭🇺

Kecskemét, Hungary

Universitätsklinikum Tübingen

🇩🇪

Tübingen, Germany

Jeroen Bosch Ziekenhuis

🇳🇱

's Hertogenbosch, Netherlands

Rabin Medical Center - Beilison Hospital

🇮🇱

Petach Tikva, Israel

Kaunas Mecial University Clinic

🇱🇹

Kaunas, Lithuania

Sint Antonius Hospital

🇳🇱

Nieuwegein, Netherlands

Universitair Medisch Centrum Utrecht

🇳🇱

Utrecht, Netherlands

Changi General Hospital

🇸🇬

Singapore, Singapore

Karolinska Universitetssjukhuset

🇸🇪

Solna, Sweden

Northern General Hospital

🇬🇧

Sheffield, United Kingdom

City Clinical Hospital named after M.E. Zhadkevich

🇷🇺

Moscow, Russian Federation

Samodzielny Publiczny Szpital Kliniczny Nr 2

🇵🇱

Szczecin, Poland

Hospital Santa Marta

🇵🇹

Lisbon, Portugal

Východoslovenský ústav srdcových a cievnych chorôb, a.s.(VUSH)

🇸🇰

Kosice, Slovakia

Manchester Royal Infirmary

🇬🇧

Manchester, United Kingdom

Stredoslovensky ustav srdcovych a cievnych chorob (SUSCCH)

🇸🇰

Banská Bystrica, Slovakia

Národný ústav srdcových a cievnych chorôb a.s. (NUSCH)

🇸🇰

Bratislava, Slovakia

University Medical Centre Maribor

🇸🇮

Maribor, Slovenia

Inselspital - Universitätsspial Bern

🇨🇭

Bern, Switzerland

Hopital Cantonal HFR

🇨🇭

Fribourg, Switzerland

Semmelweis University

🇭🇺

Budapest, Hungary

Korea University Guro Hospital

🇰🇷

Seoul, Korea, Republic of

Ajou University Hospital

🇰🇷

Suwon, Korea, Republic of

Landesklinikum Thermenregion Mödling

🇦🇹

Mödling, Austria

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