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In-Stent Restenosis Post-Approval Study

Not Applicable
Completed
Conditions
Peripheral Artery Disease
Vascular Disease
Interventions
Device: Gore VIABAHN Endoprosthesis
Registration Number
NCT02542267
Lead Sponsor
W.L.Gore & Associates
Brief Summary

The objective of the ISR 14-04 study is to evaluate post-market safety and effectiveness of GORE® VIABAHN® Endoprosthesis for treatment of In-Stent Restenosis of the Superficial Femoral Artery.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
108
Inclusion Criteria
  • Patient has a previously implanted (> 30 days) non-covered stent(s) located in the SFA
  • Patient has life-style limiting claudication, resting leg pain or minor tissue loss (Rutherford Category 2 - 5)
  • Patient demonstrates an Ankle Brachial Index (ABI) <=0.9. If ABI >0.9 or not measurable, patient is eligible for study if Toe Brachial Index is <=0.5
  • Patient has >=50% in-stent restenosis and / or an occlusion in a previously implanted (>30 days) non-covered stent(s) located in the superficial femoral artery defined as beginning at least 1cm below the origin of the profunda femoris artery and ending at least 1cm above the intercondylar notch.
  • Patient has a maximum total lesion length of 270mm, consisting of in-stent and adjacent occlusive disease
  • Patient has a reference vessel diameter between 4.0 and 6.5mm
  • Patient has at least one patent infrapopliteal runoff vessel (<50% stenosis) not requiring reintervention
  • Note: Additional Inclusion Criteria may apply
Exclusion Criteria
  • Patient has a known allergy to stent graft components (nickel-titanium or expanded-polytetrafluoroethylene)
  • Patient has a known intolerance to anticoagulation or antiplatelet therapy
  • Patient has known coagulation disorder, including hypercoagulability.
  • Patient has major distal amputation (above the transmetatarsal)
  • Patient has any previous surgery in the target vessel
  • Patient has had previous target vessel in-stent restenosis treated by relining with another stent
  • Patient has untreated flow-limiting aortoiliac stenotic disease
  • Note: Additional Exclusion Criteria may apply

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Gore VIABAHN EndoprosthesisGore VIABAHN EndoprosthesisGore VIABAHN Endoprosthesis deployed to treat failed non-covered stent(s) in the Superficial Femoral Artery
Primary Outcome Measures
NameTimeMethod
Number of Subjects Free From Procedure and Device-Related Serious Adverse Events Within 30 Days of Index Procedure30 Days

Primary Safety is defined as freedom from procedure and device-related serious adverse events within 30 days of index procedure

Primary Effectiveness12 Months

Primary Effectiveness is Primary Patency defined as patent blood flow through the study device, which requires either a Peak Systolic Velocity Ratio measurement ≤ 2.5 or patent flow indicated by the Core Lab, and without repeat intervention measured at 12 months and assessed by Kaplan-Meier analysis.

Secondary Outcome Measures
NameTimeMethod
Change in Ankle Brachial Index at 30 DaysPre-procedure and 30 Days

The Ankle Brachial Index (ABI) is the ankle systolic pressure in the study limb divided by the highest systolic pressure in either arm. ABI values \<= 0.90 are considered abnormal, 0.91-0.99 borderline, 1.00-1.40 normal, and \>1.40 noncompressible. The change in ABI was measured relative to that obtained pre-procedure.

Primary Patency at 30 Days and 12, 24, and 36 Months30 days and 12, 24, and 36 months

Primary patency is defined as patent blood flow through the study device, which requires either a PSVR measurement ≤ 2.5 or patent flow indicated by the Core Lab, without repeat intervention.

Change in Rutherford Category at 30 DaysPre-procedure and 30 Days

The Rutherford Category is a lower limb ischemia classification with 7 categories ranging from least severe (category 0) to most severe (category 6): Category 0 - No claudication; Category 1 - Mild claudication; Category 2 - Moderate claudication; Category 3 - Severe claudication; Category 4 - Ischemic rest pain; Category 5 - Minor tissue loss, non-healing ulcer, focal gangrene with diffuse pedal ischemia; Category 6 - Major tissue loss, extending above transmetatarsal level, functional foot no longer salvageable. The change is Rutherford Category was measured relative to that obtained pre-procedure and a negative change corresponds to improved outcome.

Number of Subjects With Acute Procedural SuccessDuring hospitalization, approximately 1-2 days

Acute Procedural Success is defined as successful delivery of the study device and complete coverage of the target lesion without a procedure or device-related Serious Adverse Event prior to hospital discharge.

Change in Rutherford Category at 2 YearsPre-procedure and 2 Years

The Rutherford Category is a lower limb ischemia classification with 7 categories ranging from least severe (category 0) to most severe (category 6): Category 0 - No claudication; Category 1 - Mild claudication; Category 2 - Moderate claudication; Category 3 - Severe claudication; Category 4 - Ischemic rest pain; Category 5 - Minor tissue loss, non-healing ulcer, focal gangrene with diffuse pedal ischemia; Category 6 - Major tissue loss, extending above transmetatarsal level, functional foot no longer salvageable. The change is Rutherford Category was measured relative to that obtained pre-procedure and a negative change corresponds to improved outcome.

Change in Rutherford Category at 3 YearsPre-procedure and 3 Years

The Rutherford Category is a lower limb ischemia classification with 7 categories ranging from least severe (category 0) to most severe (category 6): Category 0 - No claudication; Category 1 - Mild claudication; Category 2 - Moderate claudication; Category 3 - Severe claudication; Category 4 - Ischemic rest pain; Category 5 - Minor tissue loss, non-healing ulcer, focal gangrene with diffuse pedal ischemia; Category 6 - Major tissue loss, extending above transmetatarsal level, functional foot no longer salvageable. The change is Rutherford Category was measured relative to that obtained pre-procedure and a negative change corresponds to improved outcome.

Primary Assisted Patency at 30 Days and 12, 24, and 36 Months30 days and 12, 24, and 36 months

Primary assisted patency is defined as blood flow through the study device regardless of repeat interventions to maintain patency prior to occlusion.

Freedom From Target Lesion Revascularization at 30 Days and 12, 24, and 36 Months30 days and 12, 24, and 36 months

Target Lesion Revascularization is defined as a repeat intervention within the study device and 5 mm proximal or distal to the edge of the study device to maintain or re-establish patency.

Change in Ankle Brachial Index at 1 YearPre-procedure and 1 Year

The Ankle Brachial Index (ABI) is the ankle systolic pressure in the study limb divided by the highest systolic pressure in either arm. ABI values \<= 0.90 are considered abnormal, 0.91-0.99 borderline, 1.00-1.40 normal, and \>1.40 noncompressible. The change in ABI was measured relative to that obtained pre-procedure.

Secondary Patency at 30 Days and 12, 24, and 36 Months30 days and 12, 24, and 36 months

Secondary patency is defined as blood flow through the study device regardless of repeat interventions to restore patency after occlusion.

Freedom From Major Amputation at 30 Days and 12, 24, and 36 Months30 days and 12, 24, and 36 months

Major Amputation is defined as removal of the study limb above the metatarsals, resulting from a vascular event.

Change in Ankle Brachial Index at 2 YearsPre-procedure and 2 Years

The Ankle Brachial Index (ABI) is the ankle systolic pressure in the study limb divided by the highest systolic pressure in either arm. ABI values \<= 0.90 are considered abnormal, 0.91-0.99 borderline, 1.00-1.40 normal, and \>1.40 noncompressible. The change in ABI was measured relative to that obtained pre-procedure.

Change in Ankle Brachial Index at 3 YearsPre-procedure and 3 Years

The Ankle Brachial Index (ABI) is the ankle systolic pressure in the study limb divided by the highest systolic pressure in either arm. ABI values \<= 0.90 are considered abnormal, 0.91-0.99 borderline, 1.00-1.40 normal, and \>1.40 noncompressible. The change in ABI was measured relative to that obtained pre-procedure.

Change in Rutherford Category at 1 YearPre-procedure and 1 Year

The Rutherford Category is a lower limb ischemia classification with 7 categories ranging from least severe (category 0) to most severe (category 6): Category 0 - No claudication; Category 1 - Mild claudication; Category 2 - Moderate claudication; Category 3 - Severe claudication; Category 4 - Ischemic rest pain; Category 5 - Minor tissue loss, non-healing ulcer, focal gangrene with diffuse pedal ischemia; Category 6 - Major tissue loss, extending above transmetatarsal level, functional foot no longer salvageable. The change is Rutherford Category was measured relative to that obtained pre-procedure and a negative change corresponds to improved outcome.

Stent Fracture at 12, 24, and 36 Months12, 24, and 36 months

Device stent fractures that are clearly distinguishable from previously implanted stents will be assessed by the study core lab through x-ray images.

Trial Locations

Locations (23)

Munson Medical Center

🇺🇸

Traverse City, Michigan, United States

North Carolina Heart and Vascular

🇺🇸

Raleigh, North Carolina, United States

Sanford Health

🇺🇸

Fargo, North Dakota, United States

Covenant Medical Center, Inc.

🇺🇸

Saginaw, Michigan, United States

Rockford CardioVascular Associates

🇺🇸

Rockford, Illinois, United States

University of Iowa Hospitals and Clinics

🇺🇸

Iowa City, Iowa, United States

Cardiovascular Institute of the South

🇺🇸

Houma, Louisiana, United States

Texas Health Research - Presbyterian Heart and Vascular

🇺🇸

Dallas, Texas, United States

Texas Health Research - Presbyterian Hospital of Plano

🇺🇸

Plano, Texas, United States

Midwest Aortic and Vascular Institute (MAVI)

🇺🇸

North Kansas City, Missouri, United States

New York University Langone Medical Center

🇺🇸

New York, New York, United States

New York Presbyterian Hospital/Weill Cornell Medical Center

🇺🇸

New York, New York, United States

St. Vincent's Consultants in Cardiovascular Disease

🇺🇸

Erie, Pennsylvania, United States

Greenville Hospital System

🇺🇸

Greenville, South Carolina, United States

The Miriam Hospital

🇺🇸

Providence, Rhode Island, United States

Azienda Ospedaliera Santa Maria Nuova di Reggio Emilia

🇮🇹

Reggio Emilia, Italy

Skånes Universitetssjukhus

🇸🇪

Malmo, Sweden

Klinikum Rosenheim

🇩🇪

Rosenheim, Germany

Charleston Area Medical Center

🇺🇸

Charleston, West Virginia, United States

Mount Sinai Medical Center

🇺🇸

Miami, Florida, United States

Kaiser Foundation Hospital

🇺🇸

Honolulu, Hawaii, United States

Swedish Medical Center - Heart and Vascular Research

🇺🇸

Seattle, Washington, United States

Providence Heart Clinic

🇺🇸

Portland, Oregon, United States

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