The DES BTK Vascular Stent System vs PTA in Subjects With Critical Limb Ischemia

NCT ID: NCT03551496

Last Updated: 2024-07-01

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

201 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-08-31

Study Completion Date

2023-12-20

Brief Summary

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Single phased global, prospective, multicenter clinical trial designed to demonstrate a superior patency rate and acceptable safety in below the knee arteries with lesions treated with the DES BTK Vascular Stent System vs. percutaneous transluminal angioplasty (PTA).

Detailed Description

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A global, prospective, multicenter, 2:1 randomized trial evaluating the safety and effectiveness of the DES BTK Vascular Stent System compared to standard percutaneous transluminal angioplasty to treat infrapopliteal artery lesions in subjects with critical limb ischemia(CLI).

Approximately 201 subjects will be randomized/enrolled to support a 2:1 randomization.

Conditions

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Critical Limb Ischemia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Approximately 201 subjects will be randomized in a 2:1 fashion for phase A RCT. Randomizations will be stratified by investigational center and lesion length with 2 subjects receiving the DES BTK for every 1 subject receiving treatment with standard PTA.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
A review of the wound assessment data will be completed by independent reviewer(s) who will be blinded to the randomized therapy.

Study Groups

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DES BTK

Treatment with DES BTK

Group Type EXPERIMENTAL

Drug Eluting Stent - Below the Knee

Intervention Type COMBINATION_PRODUCT

Treatment arm with DES-BTK, starting with one size of the device - 3.5 mm X 80 mm

Conventional PTA

Treatment with standard PTA

Group Type ACTIVE_COMPARATOR

Standard PTA Control Arm

Intervention Type DEVICE

The PTA device used must be market-released in the investigational center's geography and the size (ie, diameter, balloon length and catheter length) will be determined by the investigator.

Interventions

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Drug Eluting Stent - Below the Knee

Treatment arm with DES-BTK, starting with one size of the device - 3.5 mm X 80 mm

Intervention Type COMBINATION_PRODUCT

Standard PTA Control Arm

The PTA device used must be market-released in the investigational center's geography and the size (ie, diameter, balloon length and catheter length) will be determined by the investigator.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Subject is 18 years or older and has signed and dated the trial informed consent form (ICF)
2. Subject is willing and able to comply with the trial testing, procedures and follow-up schedule
3. Subject has chronic, symptomatic lower limb ischemia, determined by Rutherford categories 4 or 5 in the target limb, with wound(s) confined to toes/forefoot
4. Subject is a male or non-pregnant female. If female of child-bearing potential, and if sexually active must be using, or agree to use, a medically-acceptable method of birth control as confirmed by the investigator


1. Stenotic, restenotic or occlusive target lesion(s) located in the tibioperoneal trunk, anterior tibial, posterior tibial and/or peroneal artery(ies).
2. Target lesion(s) must be at least 4cm above the ankle joint
3. A single target lesion per vessel, in up to 2 vessels, in a single limb
4. Degree of stenosis ≥ 70% by visual angiographic assessment
5. Reference vessel diameter is between 2.5 - 3.25mm for phase A RCT
6. Total target lesion length (or series of lesion segments) to be treated is ≤ 70 mm for phase A RCT prior to the data monitoring committee's approval for stent overlap. (Note: Lesion segment(s) must be fully covered with one DES BTK stent, if randomized to stent)
7. Total target lesion length (or series of lesion segments) to be treated is ≤ 140 mm for phase A RCT after the data monitoring committee's approval for stent overlap (Note: Lesion segment(s) must be fully covered with up to two DES BTK stents, if randomized to stent)
8. Target vessel(s) reconstitute(s) at or above the stenting limit zone (4cm above the ankle joint)
9. Target lesion(s) is located in an area that may be stented without blocking access to patent main branches
10. Treatment of all above the knee inflow lesion(s) is successful prior to treatment of the target lesion
11. Guidewire has successfully crossed the target lesion(s)

Exclusion Criteria

1. Life expectancy ≤ 1year
2. Stroke ≤ 90 days prior to the procedure date
3. Prior or planned major amputation in the target limb
4. Previous surgery in the target vessel(s) (including prior ipsilateral crural bypass)
5. Previously implanted stent in the target vessel(s)
6. Failed PTA of target lesion/vessel ≤ 60 days prior to the procedure date
7. Renal failure as measured by a GFR ≤ 30ml/min per 1.73m2, measured ≤ 30 days prior to the procedure date
8. Subject has a platelet count ≤ 50 or ≥ 600 X 103/µL ≤ 30 days prior to the procedure date
9. NYHA class IV heart failure
10. Subject has symptomatic coronary artery disease (ie, unstable angina)
11. History of myocardial infarction or thrombolysis ≤ 90 days prior to the procedure date
12. Non-atherosclerotic disease resulting in occlusion (eg, embolism, Buerger's disease, vasculitis)
13. Subject is currently taking Canagliflozin
14. Body Mass Index (BMI) \<18
15. Active septicemia or bacteremia
16. Coagulation disorder, including hypercoagulability
17. Contraindication to anticoagulation or antiplatelet therapy
18. Known allergies to stent or stent components
19. Known allergy to contrast media that cannot be adequately pre-medicated prior to the interventional procedure
20. Known hypersensitivity to heparin
21. Subject is on a high dose of steroids or is on immunosuppressive therapy
22. Subject is currently participating, or plans to participate in, another investigational trial that may confound the results of this trial (unless written approval is received from the Boston Scientific study team)


1. Angiographic evidence of intra-arterial acute/subacute thrombus or presence of atheroembolism
2. Treatment required in \> 2 target vessels (Note: a target lesion originating in one vessel and extending into another vessel is considered 1 target vessel)
3. Treatment requires the use of alternate therapy in the target vessel(s)/lesion(s), (eg, atherectomy, cutting balloon, re-entry devices, laser, radiation therapy)
4. Aneurysm is present in the target vessel(s)
5. Extremely calcified lesions
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Boston Scientific Corporation

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jihad Mustapha, MD

Role: PRINCIPAL_INVESTIGATOR

Advanced Cardiac & Vascular Centers for Amputation Prevention

Hendrik van Overhagen, MD

Role: PRINCIPAL_INVESTIGATOR

HAGA Ziekenhuis (HagaZiekenhuis van Den Haag)

Patrick Geraghty, MD

Role: PRINCIPAL_INVESTIGATOR

Washington University School of Medicine

Masato Nakamura, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Toho University Ohashi Medical Center - Division of Cardiovascular Medicine

Locations

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St. Bernards Medical Center

Jonesboro, Arkansas, United States

Site Status

Arkansas Heart Hospital

Little Rock, Arkansas, United States

Site Status

University of California, San Francisco

San Francisco, California, United States

Site Status

Colorado VA

Denver, Colorado, United States

Site Status

Bradenton Cardiology

Bradenton, Florida, United States

Site Status

Willis Knighton Bossier Medical Center - Grace Research, LLC

Bossier City, Louisiana, United States

Site Status

Cardiovascular Institute of the South Clinical Research Corporation

Houma, Louisiana, United States

Site Status

Advanced Cardiac & Vascular Centers for Amputation Prevention

Grand Rapids, Michigan, United States

Site Status

United Heart and Vascular Clinic

Saint Paul, Minnesota, United States

Site Status

Washington University School of Medicine

St Louis, Missouri, United States

Site Status

Hackensack University Medical Center

Hackensack, New Jersey, United States

Site Status

Holy Name Medical Center

Teaneck, New Jersey, United States

Site Status

New Mexico Heart Institute, PA

Albuquerque, New Mexico, United States

Site Status

New York University Medical Center

New York, New York, United States

Site Status

Mount Sinai Medical Center

New York, New York, United States

Site Status

Amputation Prevention Center of North Carolina

Cary, North Carolina, United States

Site Status

NC Heart and Vascular Research, LLC

Raleigh, North Carolina, United States

Site Status

Wake Medical Center

Raleigh, North Carolina, United States

Site Status

Cleveland Clinic

Cleveland, Ohio, United States

Site Status

OhioHealth Research and Innovation Institute - Riverside Methodist Hospital

Columbus, Ohio, United States

Site Status

Integris Baptist Medical Center

Oklahoma City, Oklahoma, United States

Site Status

Saint Vincent Consultants in Cardiovascular Diseases at St. Vincent Hospital

Erie, Pennsylvania, United States

Site Status

Jackson-Madison County General Hospital

Jackson, Tennessee, United States

Site Status

Heart Hospital of Austin

Austin, Texas, United States

Site Status

Texas Tech University Health

Lubbock, Texas, United States

Site Status

THR Presbyterian Plano

Plano, Texas, United States

Site Status

AZ Sint-Blasius

Dendermonde, , Belgium

Site Status

ZOL Genk (Ziekenhuis Oost-Limburg)

Genk, , Belgium

Site Status

UZ Gent (Universitair Ziekenhuis Gent)

Ghent, , Belgium

Site Status

CHU Nantes

Nantes, , France

Site Status

Hopital Paris Saint Joseph

Paris, , France

Site Status

Hopital Europeen Georges Pompidou

Paris, , France

Site Status

Clinique Pasteur

Toulouse, , France

Site Status

Tokyo Bay Urayasu Ichikawa Medical Center

Urayasu-shi, Chiba, Japan

Site Status

Kokura Memorial Hospital

Kitakyushu, Fukuoka, Japan

Site Status

Asahikawa Medical University Hospital

Asahikawa-shi, Hokkaido, Japan

Site Status

Kansai Rosai Hospital

Amagasaki, Hyōgo, Japan

Site Status

Nara Medical University Hospital

Kashihara, Nara, Japan

Site Status

Kishiwada Tokushukai Hospital

Kishiwada, Osaka, Japan

Site Status

Tokyo Medical and Dental University, Medical Hospital

Bunkyō-Ku, Tokyo, Japan

Site Status

Toho University Ohashi Medical Center

Meguro City, Tokyo, Japan

Site Status

HAGA Ziekenhuis (Haga Ziekenhuis van Den Haag)

The Hague, , Netherlands

Site Status

Countries

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United States Belgium France Japan Netherlands

References

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Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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S2348

Identifier Type: -

Identifier Source: org_study_id

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