Shockwave™ vs Surgical Endarterectomy for Calcified Severe Common Femoral Artery Stenosis: Comparison of Efficacy, Safety and Long-Term Outcomes

NCT ID: NCT06829914

Last Updated: 2025-10-08

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

RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-03-07

Study Completion Date

2026-03-30

Brief Summary

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The investigators hypothesize that Shockwave with DCB is non-inferior to surgical endarterectomy for common femoral artery (CFA) stenosis with regard to primary efficacy and safety endpoints. The study will challenge the current guideline that recommends common femoral endarterectomy (CFE) as the primary treatment for symptomatic CFA stenosis.

Detailed Description

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This is a pilot, prospective, randomized clinical trial. This trial compares patients with severe symptomatic moderate to severe calcified CFA stenosis undergoing traditional gold standard CFA endarterectomy to innovative technique of endovascular treatment using Shockwave™ Intra vascular Lithotripsy (IVL) using M5+ balloon with Drug coated balloon to achieve removal and debulking of plaque and achieve luminal gain. Patients who meet inclusion criteria will be informed and consented by a clinical coordinator if they wish to participate in the trial. If participants are candidates for surgery, they will then be randomized into one of two cohorts, receiving either Shockwave™ IVL + DCB (drug-coated balloon) procedure or a standard surgical endarterectomy. The study compares the 1-year efficacy and 6-month safety outcomes post-procedure for patients with severe, symptomatic CFA stenosis receiving Shockwave™ IVL with DCB versus surgical endarterectomy.

Conditions

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Common Femoral Artery Stenosis Calcification; Heart

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Prospective, randomized pilot study
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Shockwave Catheter

Shockwave™ Intravenous Lithotripsy (IVL)+ DCB (Drug Coated Balloon)

Group Type ACTIVE_COMPARATOR

Shockwave Catheter

Intervention Type DEVICE

Shockwave™ IVL + DCB procedure

surgical endarterectomy

Surgery should be performed with patch angioplasty, with or without profunda femoris endarterectomy.

Group Type ACTIVE_COMPARATOR

CFA Endarterectomy

Intervention Type PROCEDURE

Standard CFA endarterectomy

Interventions

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Shockwave Catheter

Shockwave™ IVL + DCB procedure

Intervention Type DEVICE

CFA Endarterectomy

Standard CFA endarterectomy

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

A patient will be eligible for inclusion in this study if he or she meets all of the following criteria (confirmed by core lab):

1. CFA atherosclerotic stenosis 60-100%
2. Moderate to severe calcification reported on imaging
3. Lifestyle-limiting intermittent claudication (IC) or chronic limb-threatening ischemia (CLTI) as described by Rutherford chronic limb ischemia (CLI) category 2-5
4. Failing conservative therapy
5. Operative candidate for CFE prior to enrollment
6. ≥18 years of age

Exclusion Criteria

A patient will be ineligible for inclusion in this study if he or she meets any of the following criteria:

1. History of CFE or bypass in affected limb
2. Thrombosis of affected CFA
3. Aneurysm in the common femoral artery of target limb
4. Known target lesion restenosis (re-narrowing of the artery to ≥50% following the alleviation of a previous narrowing within 3 months)
5. Any preceding percutaneous cardiovascular intervention within 2 weeks
6. Inability to tolerate DAPT
7. Known coagulopathy or bleeding diathesis, thrombocytopenia with platelet count \<100,000/µL
8. Uncontrolled diabetes (HbA1c ≥10.0%)
9. Non-ambulatory
10. Extensive tissue loss requiring amputation or salvageable only with complex foot reconstruction or non-traditional transmetatarsal amputations
11. MI within 6 weeks (defined as presumed ischemic symptoms (chest pain, ST-segment deviation and troponin higher than 2 times the upper limit of normal))
12. Stroke within 3 months (defined as sudden transient or irreversible focal neurological deficit resulting from a cerebrovascular cause)
13. Pregnant
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Baylor Research Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Sameh Sayfo, MD

Role: PRINCIPAL_INVESTIGATOR

Baylor Scott & White The Heart Hospital - Plano

John Kedora, MD

Role: PRINCIPAL_INVESTIGATOR

Baylor Scott & White The Heart Hospital - Plano

Locations

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Baylor Scott & White The Heart Hospital - Plano

Plano, Texas, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Bonnie Ostergren

Role: CONTACT

469-814-4181

Sarah Hale

Role: CONTACT

469-814-4845

Facility Contacts

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Bonnie Ostergren

Role: primary

469-814-4181

Sarah Hale

Role: backup

469-814-4845

References

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Kang JL, Patel VI, Conrad MF, Lamuraglia GM, Chung TK, Cambria RP. Common femoral artery occlusive disease: contemporary results following surgical endarterectomy. J Vasc Surg. 2008 Oct;48(4):872-7. doi: 10.1016/j.jvs.2008.05.025. Epub 2008 Jul 17.

Reference Type BACKGROUND
PMID: 18639427 (View on PubMed)

Kuma S, Tanaka K, Ohmine T, Morisaki K, Kodama A, Guntani A, Ishida M, Okazaki J, Mii S. Clinical Outcome of Surgical Endarterectomy for Common Femoral Artery Occlusive Disease. Circ J. 2016;80(4):964-9. doi: 10.1253/circj.CJ-15-1177. Epub 2016 Feb 19.

Reference Type BACKGROUND
PMID: 26902450 (View on PubMed)

Nguyen BN, Amdur RL, Abugideiri M, Rahbar R, Neville RF, Sidawy AN. Postoperative complications after common femoral endarterectomy. J Vasc Surg. 2015 Jun;61(6):1489-94.e1. doi: 10.1016/j.jvs.2015.01.024. Epub 2015 Feb 19.

Reference Type BACKGROUND
PMID: 25702917 (View on PubMed)

Shammas NW, Abi Doumet A, Karia R, Khalafallah R. An Overview of the Treatment of Symptomatic Common Femoral Artery Lesions with a Focus on Endovascular Therapy. Vasc Health Risk Manag. 2020 Feb 20;16:67-73. doi: 10.2147/VHRM.S242291. eCollection 2020.

Reference Type BACKGROUND
PMID: 32110032 (View on PubMed)

Bonvini RF, Rastan A, Sixt S, Noory E, Schwarz T, Frank U, Roffi M, Dorsaz PA, Schwarzwalder U, Burgelin K, Macharzina R, Zeller T. Endovascular treatment of common femoral artery disease: medium-term outcomes of 360 consecutive procedures. J Am Coll Cardiol. 2011 Aug 16;58(8):792-8. doi: 10.1016/j.jacc.2011.01.070.

Reference Type BACKGROUND
PMID: 21835313 (View on PubMed)

Linni K, Ugurluoglu A, Hitzl W, Aspalter M, Holzenbein T. Bioabsorbable stent implantation vs. common femoral artery endarterectomy: early results of a randomized trial. J Endovasc Ther. 2014 Aug;21(4):493-502. doi: 10.1583/14-4699R.1.

Reference Type BACKGROUND
PMID: 25101576 (View on PubMed)

Stavroulakis K, Schwindt A, Torsello G, Beropoulis E, Stachmann A, Hericks C, Bollenberg L, Bisdas T. Directional Atherectomy With Antirestenotic Therapy vs Drug-Coated Balloon Angioplasty Alone for Common Femoral Artery Atherosclerotic Disease. J Endovasc Ther. 2018 Feb;25(1):92-99. doi: 10.1177/1526602817748319. Epub 2017 Dec 18.

Reference Type BACKGROUND
PMID: 29251204 (View on PubMed)

Garcia LA, Lyden SP. Atherectomy for infrainguinal peripheral artery disease. J Endovasc Ther. 2009 Apr;16(2 Suppl 2):II105-15. doi: 10.1583/08-2656.1.

Reference Type BACKGROUND
PMID: 19624078 (View on PubMed)

Brodmann M, Werner M, Brinton TJ, Illindala U, Lansky A, Jaff MR, Holden A. Safety and Performance of Lithoplasty for Treatment of Calcified Peripheral Artery Lesions. J Am Coll Cardiol. 2017 Aug 15;70(7):908-910. doi: 10.1016/j.jacc.2017.06.022. No abstract available.

Reference Type BACKGROUND
PMID: 28797363 (View on PubMed)

Brodmann M, Werner M, Holden A, Tepe G, Scheinert D, Schwindt A, Wolf F, Jaff M, Lansky A, Zeller T. Primary outcomes and mechanism of action of intravascular lithotripsy in calcified, femoropopliteal lesions: Results of Disrupt PAD II. Catheter Cardiovasc Interv. 2019 Feb 1;93(2):335-342. doi: 10.1002/ccd.27943. Epub 2018 Nov 25.

Reference Type BACKGROUND
PMID: 30474206 (View on PubMed)

Adams G, Shammas N, Mangalmurti S, Bernardo NL, Miller WE, Soukas PA, Parikh SA, Armstrong EJ, Tepe G, Lansky A, Gray WA. Intravascular Lithotripsy for Treatment of Calcified Lower Extremity Arterial Stenosis: Initial Analysis of the Disrupt PAD III Study. J Endovasc Ther. 2020 Jun;27(3):473-480. doi: 10.1177/1526602820914598. Epub 2020 Apr 3.

Reference Type BACKGROUND
PMID: 32242768 (View on PubMed)

Adams G, Soukas PA, Mehrle A, Bertolet B, Armstrong EJ. Intravascular Lithotripsy for Treatment of Calcified Infrapopliteal Lesions: Results from the Disrupt PAD III Observational Study. J Endovasc Ther. 2022 Feb;29(1):76-83. doi: 10.1177/15266028211032953. Epub 2021 Aug 12.

Reference Type BACKGROUND
PMID: 34380334 (View on PubMed)

Baig M, Kwok M, Aldairi A, Imran HM, Khan MS, Moustafa A, Hyder ON, Saad M, Aronow HD, Soukas PA. Endovascular Intravascular Lithotripsy in the Treatment of Calcific Common Femoral Artery Disease: A Case Series With an 18-Month Follow-Up. Cardiovasc Revasc Med. 2022 Oct;43:80-84. doi: 10.1016/j.carrev.2022.05.003. Epub 2022 May 7.

Reference Type BACKGROUND
PMID: 35595607 (View on PubMed)

Rutherford RB, Baker JD, Ernst C, Johnston KW, Porter JM, Ahn S, Jones DN. Recommended standards for reports dealing with lower extremity ischemia: revised version. J Vasc Surg. 1997 Sep;26(3):517-38. doi: 10.1016/s0741-5214(97)70045-4.

Reference Type BACKGROUND
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Tepe G, Brodmann M, Werner M, Bachinsky W, Holden A, Zeller T, Mangalmurti S, Nolte-Ernsting C, Bertolet B, Scheinert D, Gray WA; Disrupt PAD III Investigators. Intravascular Lithotripsy for Peripheral Artery Calcification: 30-Day Outcomes From the Randomized Disrupt PAD III Trial. JACC Cardiovasc Interv. 2021 Jun 28;14(12):1352-1361. doi: 10.1016/j.jcin.2021.04.010.

Reference Type BACKGROUND
PMID: 34167675 (View on PubMed)

Varcoe RL, DeRubertis BG, Kolluri R, Krishnan P, Metzger DC, Bonaca MP, Shishehbor MH, Holden AH, Bajakian DR, Garcia LA, Kum SWC, Rundback J, Armstrong E, Lee JK, Khatib Y, Weinberg I, Garcia-Garcia HM, Ruster K, Teraphongphom NT, Zheng Y, Wang J, Jones-McMeans JM, Parikh SA; LIFE-BTK Investigators. Drug-Eluting Resorbable Scaffold versus Angioplasty for Infrapopliteal Artery Disease. N Engl J Med. 2024 Jan 4;390(1):9-19. doi: 10.1056/NEJMoa2305637. Epub 2023 Oct 25.

Reference Type BACKGROUND
PMID: 37888915 (View on PubMed)

Spertus J, Jones P, Poler S, Rocha-Singh K. The peripheral artery questionnaire: a new disease-specific health status measure for patients with peripheral arterial disease. Am Heart J. 2004 Feb;147(2):301-8. doi: 10.1016/j.ahj.2003.08.001.

Reference Type BACKGROUND
PMID: 14760329 (View on PubMed)

Other Identifiers

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021-263

Identifier Type: -

Identifier Source: org_study_id

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