VISION and VQI Paclitaxel Safety Analysis

NCT ID: NCT04204564

Last Updated: 2019-12-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

20000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2012-10-01

Study Completion Date

2020-06-01

Brief Summary

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Objectives

1. The VQI-VISION Paclitaxel Device Safety Analysis seeks to assess the comparative safety of paclitaxel-coated balloons and stents in the treatment of PAD through analysis of the Vascular Quality Initiative (VQI) Peripheral Vascular Intervention (PVI) registry module with linkage to claims. By linking VQI patients to Medicare claims retrospectively from 2012 to 2016, we will be able to identify additional paclitaxel devices enabling longitudinal follow-up of mortality out to 5 years for paclitaxel-eluting stents and 3 years for paclitaxel-coated balloons.
2. To analyze factors associated with mortality, specifically comparing paclitaxel patients surviving vs. paclitaxel patients with mortality. The goal is to identify independent factors predictive of mortality in US pivotal trials and model registry data exposures with sufficient factors to track competing risk paradox and show emulation or not of mortality outcomes with both PTX and PTA exposures.
3. To confirm the effectiveness of paclitaxel devices by comparing reintervention for paclitaxel and non-paclitaxel devices. In-hospital mortality from open and percutaneous target vessel revascularization (TVR) will be reported to determine the impact of subsequent revascularizations on survival. Major amputation will be comparted for patients with chronic limb-threatening ischemia.

Detailed Description

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The proposed safety analyses will evaluate two types of paclitaxel-coated interventional devices used to treat PAD and compare patient outcomes with propensity score-matched patients of similar risk who receive non-paclitaxel devices.

The primary outcome will be freedom from all-cause death using propensity-matched survival analysis.

Three principle analyses are planned:

1. Paclitaxel DCB (including the Bard Lutonix, Medtronic In.Pact Admiral, and Philips Spectranetics Stellarex DCB's) as compared with propensity-matched patients treated with plain balloons.
2. Paclitaxel delivering DES (Cook Zilver PTX) as compared with propensity-matched cases using bare-metal stents (BMS).
3. Patients treated with either Paclitaxel DCB or Paclitaxel DES compared with propensity-matched controls (with DCB patients matched to patients treated with plain balloons, and DES patients matched to patients treated with BMS).

Note that this analysis is planned at the device class level and is not intended to compare early or late mortality between specific devices or brands.

Conditions

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PAD

Keywords

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paclitaxel drug coated balloon drug eluting stent perihpheral vascular intervention registry

Study Design

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Observational Model Type

COHORT

Study Time Perspective

OTHER

Study Groups

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paclitaxel coated balloon angioplasty

Procedures with paclitaxel coated balloon angioplasty of the superficial femoral-popliteal artery

pactlitaxel PAD device

Intervention Type DEVICE

Peripheral vascular intervention on femoral-popliteal occlusive disease with paclitaxel and non-paclitaxel devices.

plain balloon angioplasty

Procedures with plain balloon angioplasty of the superficial femoral-popliteal artery

No interventions assigned to this group

paclitaxel eluting stent

Procedures with paclitaxel eluting stenting of the superficial femoral-popliteal artery

pactlitaxel PAD device

Intervention Type DEVICE

Peripheral vascular intervention on femoral-popliteal occlusive disease with paclitaxel and non-paclitaxel devices.

bare metal stenting

Procedures with bare metal self expanding stenting of the superficial femoral-popliteal artery

No interventions assigned to this group

Interventions

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pactlitaxel PAD device

Peripheral vascular intervention on femoral-popliteal occlusive disease with paclitaxel and non-paclitaxel devices.

Intervention Type DEVICE

Other Intervention Names

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Medtronic INPact Admiral Bard Lutonix Cook Zilver PTX stent

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 65 years old
* Date of index procedure is within 10/1/2012 to 12/31/2016
* Symptomatic disease ranging from intermittent claudication to chronic limb-threatening ischemia (including ischemic rest pain and/or tissue loss)
* Elective or urgent procedures

Exclusion Criteria

* Aneurysmal disease of the superficial femoral or popliteal artery
* Treatment for acute limb ischemia
* Treatment of common femoral artery or profunda femoral artery occlusive disease
* Emergency procedures
* PVI and concomitant femoral endarterectomy, suprainguinal or infrainguinal bypass
Minimum Eligible Age

65 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Medical Device Epidemiology Network (MDEpiNet)

UNKNOWN

Sponsor Role collaborator

Society for Vascular Surgery Patient Safety Organization

OTHER

Sponsor Role collaborator

University of Vermont Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Daniel Bertges, MD

Associate Professor of Surgery and Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Daniel Bertges, MD

Role: PRINCIPAL_INVESTIGATOR

SVS VQI

Philip Goodney, MD

Role: STUDY_DIRECTOR

SVS VQI

Art Sedrakyan, PhD

Role: STUDY_DIRECTOR

Weill Medical College of Cornell University

Jens Jorgensen

Role: STUDY_CHAIR

SVS PSO

References

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Katsanos K, Spiliopoulos S, Kitrou P, Krokidis M, Karnabatidis D. Risk of Death Following Application of Paclitaxel-Coated Balloons and Stents in the Femoropopliteal Artery of the Leg: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc. 2018 Dec 18;7(24):e011245. doi: 10.1161/JAHA.118.011245.

Reference Type BACKGROUND
PMID: 30561254 (View on PubMed)

Columbo JA, Kang R, Hoel AW, Kang J, Leinweber KA, Tauber KS, Hila R, Ramkumar N, Sedrakyan A, Goodney PP. A comparison of reintervention rates after endovascular aneurysm repair between the Vascular Quality Initiative registry, Medicare claims, and chart review. J Vasc Surg. 2019 Jan;69(1):74-79.e6. doi: 10.1016/j.jvs.2018.03.423. Epub 2018 Jun 15.

Reference Type BACKGROUND
PMID: 29914838 (View on PubMed)

Schillinger M, Minar E. Past, present and future of femoropopliteal stenting. J Endovasc Ther. 2009 Feb;16 Suppl 1:I147-52. doi: 10.1583/1545-1550-16.16.I-147.

Reference Type BACKGROUND
PMID: 19317587 (View on PubMed)

Dick P, Wallner H, Sabeti S, Loewe C, Mlekusch W, Lammer J, Koppensteiner R, Minar E, Schillinger M. Balloon angioplasty versus stenting with nitinol stents in intermediate length superficial femoral artery lesions. Catheter Cardiovasc Interv. 2009 Dec 1;74(7):1090-5. doi: 10.1002/ccd.22128.

Reference Type BACKGROUND
PMID: 19859954 (View on PubMed)

Chowdhury MM, McLain AD, Twine CP. Angioplasty versus bare metal stenting for superficial femoral artery lesions. Cochrane Database Syst Rev. 2014 Jun 24;2014(6):CD006767. doi: 10.1002/14651858.CD006767.pub3.

Reference Type BACKGROUND
PMID: 24959692 (View on PubMed)

Eliason JL, Wainess RM, Proctor MC, Dimick JB, Cowan JA Jr, Upchurch GR Jr, Stanley JC, Henke PK. A national and single institutional experience in the contemporary treatment of acute lower extremity ischemia. Ann Surg. 2003 Sep;238(3):382-9; discussion 389-90. doi: 10.1097/01.sla.0000086663.49670.d1.

Reference Type BACKGROUND
PMID: 14501504 (View on PubMed)

Earnshaw JJ, Whitman B, Foy C. National Audit of Thrombolysis for Acute Leg Ischemia (NATALI): clinical factors associated with early outcome. J Vasc Surg. 2004 May;39(5):1018-25. doi: 10.1016/j.jvs.2004.01.019.

Reference Type BACKGROUND
PMID: 15111854 (View on PubMed)

Howard DP, Banerjee A, Fairhead JF, Hands L, Silver LE, Rothwell PM; Oxford Vascular Study. Population-Based Study of Incidence, Risk Factors, Outcome, and Prognosis of Ischemic Peripheral Arterial Events: Implications for Prevention. Circulation. 2015 Nov 10;132(19):1805-15. doi: 10.1161/CIRCULATIONAHA.115.016424. Epub 2015 Sep 8.

Reference Type BACKGROUND
PMID: 26350058 (View on PubMed)

Baril DT, Ghosh K, Rosen AB. Trends in the incidence, treatment, and outcomes of acute lower extremity ischemia in the United States Medicare population. J Vasc Surg. 2014 Sep;60(3):669-77.e2. doi: 10.1016/j.jvs.2014.03.244. Epub 2014 Apr 24.

Reference Type BACKGROUND
PMID: 24768362 (View on PubMed)

Gerhard-Herman MD, Gornik HL, Barrett C, Barshes NR, Corriere MA, Drachman DE, Fleisher LA, Fowkes FGR, Hamburg NM, Kinlay S, Lookstein R, Misra S, Mureebe L, Olin JW, Patel RAG, Regensteiner JG, Schanzer A, Shishehbor MH, Stewart KJ, Treat-Jacobson D, Walsh ME. 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017 Mar 21;69(11):1465-1508. doi: 10.1016/j.jacc.2016.11.008. Epub 2016 Nov 13. No abstract available.

Reference Type BACKGROUND
PMID: 27851991 (View on PubMed)

Oakes D, Feng C. Combining stratified and unstratified log-rank tests in paired survival data. Stat Med. 2010 Jul 20;29(16):1735-45. doi: 10.1002/sim.3921.

Reference Type BACKGROUND
PMID: 20572124 (View on PubMed)

M Grambsch and TM Therneau, Proportional Hazards Tests and Diagnostics Based on Weighted Residuals, Biometrika 1994, 81(3): 515-526, https://doi.org/10.1093/biomet/81.3.515

Reference Type BACKGROUND

Royston P, Parmar MK. Restricted mean survival time: an alternative to the hazard ratio for the design and analysis of randomized trials with a time-to-event outcome. BMC Med Res Methodol. 2013 Dec 7;13:152. doi: 10.1186/1471-2288-13-152.

Reference Type BACKGROUND
PMID: 24314264 (View on PubMed)

Parzen M, Lipsitz SR. A global goodness-of-fit statistic for Cox regression models. Biometrics. 1999 Jun;55(2):580-4. doi: 10.1111/j.0006-341x.1999.00580.x.

Reference Type BACKGROUND
PMID: 11318217 (View on PubMed)

Heinze G, Wallisch C, Dunkler D. Variable selection - A review and recommendations for the practicing statistician. Biom J. 2018 May;60(3):431-449. doi: 10.1002/bimj.201700067. Epub 2018 Jan 2.

Reference Type BACKGROUND
PMID: 29292533 (View on PubMed)

Provided Documents

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Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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1

Identifier Type: -

Identifier Source: org_study_id