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Atrium iCAST Iliac Stent Pivotal Study

Atrium iCAST Iliac Stent Pivotal Study

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00593385
Acronym
iCARUS
Enrollment
165
Registered
2008-01-15
Start date
2007-10-31
Completion date
2014-05-31
Last updated
2018-05-17

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Peripheral Vascular Disease

Keywords

Symptomatic claudication or rest pain and angiographic confirmation of either de novo or restenotic lesions in the common and/or external iliac artery.

Brief summary

Prospective, multicenter, non-randomized, single-arm registry to evaluate the safety and effectiveness of the iCAST Covered Stent System in the treatment of patients with symptomatic claudication or rest pain and angiographic confirmation of de novo or restenotic lesions in the common and/or external iliac artery.

Detailed description

STUDY DESIGN: Prospective, multicenter, non-randomized, single-arm registry OBJECTIVE: The primary objective is to evaluate the iCAST covered stent to a performance metric derived from studies of FDA-approved iliac stent devices for treating iliac artery stenoses in patients with de novo or restenotic lesions in the common and/or external iliac arteries. NUMBER OF SUBJECTS: 165 subjects, including up to 25 subjects with totally occluded lesions. PRIMARY ENDPOINTS: The primary endpoint is a composite endpoint defined as the occurrence of death within 30 days, target site revascularization or restenosis (by ultrasound determination) within 9 months post-procedure. SECONDARY ENDPOINTS: Secondary endpoints include: 1. Major adverse vascular events (MAVE) defined as a composite rate of myocardial infarction at 30 days, stent thrombosis, clinically apparent distal embolization, defined as causing end-organ damage (e.g. lower extremity ulceration, tissue necrosis, or gangrene), arterial rupture, acute limb ischemia, target limb amputation or procedure related bleeding event requiring transfusion. 2. A major adverse event (MAE) is defined as a composite rate of MAVE or any death, or stroke, up to 30 days post-procedure. 3. Device success, defined as the successful delivery and deployment of the study stent and intact retrieval of the delivery system. 4. Acute procedural success, defined as device success and achievement of \< 30% residual stenosis immediately after stent deployment, mean transtenotic pressure gradient of \< 5 mmHg and without occurrence of in-hospital MAVE. 5. Clinical success, assessed both early (30 days) and late (6, 9 and 12 months). 6. Patency assessed at each follow-up time point, categorized as primary, primary-assisted or secondary patency. 7. Composite rate of 30 day death, 9 month target site revascularization and 9 month restenosis in subjects without iliac total occlusions. PATIENT POPULATION: Eligible patients have symptomatic claudication or rest pain and angiographic confirmation of either de novo or restenotic lesions in the common and/or external iliac artery.

Interventions

DEVICEiCAST covered stent

Iliac stent implantation

Sponsors

Atrium Medical Corporation
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

1. Subject is 18 years of age or older. 2. Subject has lifestyle limiting claudication or rest pain (Rutherford-Becker scale 2-4). 3. Presence of de novo and/or restenotic lesions in the common and/or external iliac artery. 4. Subject has single, bilateral or multiple target lesions that is (are) ≥ 50% stenosed by visual estimate. 5. The target lesion(s) can be successfully crossed with a guide wire and dilated. 6. The target segment of subject's lesion(s) is between 5 and 12mm in diameter and less than 110 mm in length. 7. Subject has angiographic evidence of a patent profunda or superficial femoral artery (SFA) in the target limb. 8. Subject has provided written informed consent. 9. Subject is able and willing to adhere to the required follow-up visits and testing through month 36. 10. Subject is able and willing to adhere to the required follow-up medication regimen.

Exclusion criteria

1. Presence of other non-target ipsilateral arterial lesions requiring treatment within 30 days post-procedure (Note that treatment of ipsilateral SFA lesions may be allowed under certain circumstances). Treatment of lesions in any other vascular bed must be completed at least 30 days prior to enrollment. 2. The target lesion(s) has adjacent, acute thrombus. 3. The target lesion(s) is highly calcified or was previously treated with a stent. 4. Target lesion involves the internal iliac artery resulting in crossing of the side-branch with the iCAST device (e.g. jailing of the side-branch). 5. Subject has an abdominal aortic aneurysm contiguous with the iliac artery target lesion. 6. Subject has a pre-existing target iliac artery aneurysm or perforation or dissection of the target iliac artery prior to initiation of the iCAST implant procedure. 7. Subject has a post-surgical stenosis and anastomotic suture treatments of the target vessel. 8. Subject has a vascular graft previously implanted in the native iliac vessel. 9. Subject has tissue loss, defined as Rutherford-Becker classification category 5 or 6. 10. Subject has contrast agent hypersensitivity that cannot be adequately pre-medicated, has a hypersensitivity to stainless steel, expanded polytetrafluoroethylene (ePTFE) or has intolerance to antiplatelet, anticoagulant, or thrombolytic medications. 11. History of neutropenia (WBC \<3,000/mm3), coagulopathy, or thrombocytopenia (platelet count \<80,000/ μL) that has not resolved or has required treatment in the past 6 months. 12. Known bleeding or hypercoagulability disorder or significant anemia (Hb\< 8.0) that cannot be corrected. 13. Subject has the following laboratory values: 1. platelet count less than 80,000/ μL, 2. prothrombin time (PT)/partial thromboplastin time (PTT) not within normal limits 3. serum creatinine level greater than 2.5 mg/dL 14. Subject requires general anesthesia for the procedure. 15. Subject is pregnant. 16. Subject has a co-morbid illness that may result in a life expectancy of less than 1 year. 17. Subject is participating in an investigational study of a new drug, biologic or device at the time of study screening. Note: Subjects who are participating in the long term follow-up phase of a previously investigational and now FDA-approved product are not excluded by this criterion.

Design outcomes

Primary

MeasureTime frameDescription
Percentage of ITT Population Experiencing Death Within 30 Days, Target Site Revascularization or RestenosisWithin 9 Months post-procedureThe primary endpoint is a composite endpoint defined as the occurrence of death within 30 days, target site revascularization within 9 months or restenosis (by ultrasound determination) at 9 months.

Secondary

MeasureTime frameDescription
Acute Procedural SuccessPost-procedureDevice success and achievement of \< 30% residual stenosis immediately after stent placement and without occurrence of in-hospital MAVE.
Device SuccessPost-procedureSuccessful delivery and deployment of the study stent and intact retrieval of the delivery system.
Major Adverse Event (MAE)30 DaysComposite rate of MAVE or any death, or stroke.
Major Adverse Vascular Event (MAVE)30 DaysComposite rate of myocardial infarction at 30 days, stent thrombosis, clinically apparent distal embolization, arterial rupture, acute limb ischemia, target limb amputation, or procedure related bleeding event requiring transfusion.
Primary Patency1 MonthContinuous flow without revascularization, bypass or target limb amputation.
Late Clinical Success6 MonthsMaintained improvement in ankle brachial index (ABI), the ratio of the blood pressure at the ankle to the blood pressure in the upper arm.
Primary-Assisted Patency1 MonthContinuous flow assisted when the target vessel has restenosed at any time post-procedure.
Secondary Patency1 MonthRe-establishment of flow to distal arteries after occlusion has occurred at the target vessel.
Early Clinical Success1 MonthImprovement of the Rutherford-Becker clinical criteria by ≥ 1 category. (Classification system for evaluating clinical improvement as defined by Rutherford R, Becker G. Standards for evaluating and reporting the results of surgical and percutaneous therapy for peripheral arterial disease. Journal of Vascular Interventional Radiology 1991;2:169-174.)

Countries

Germany, United States

Participant flow

Participants by arm

ArmCount
Device: ICAST Covered Stent
Implantation of ≥ 1 ICAST stent
152
Total152

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyDeath14
Overall StudyLost to Follow-up17
Overall StudyWithdrawal by Subject9

Baseline characteristics

CharacteristicDevice: ICAST Covered Stent
Age, Continuous65.23 years
STANDARD_DEVIATION 9.96
Cerebrovascular Accident11 Participants
Cigarette Smoking Status
Current smoker
76 Participants
Cigarette Smoking Status
Former smoker
62 Participants
Cigarette Smoking Status
Non-smoker
13 Participants
Cigarette Smoking Status
Unknown
0 Participants
Coronary Artery Bypass Graft Surgery34 Participants
Coronary Artery Disease77 Participants
Diabetes Mellitus56 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
149 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
Hypercholesterolemia130 Participants
Hypertension129 Participants
Previous Amputation2 Participants
Previous Myocardial Infarction (MI)35 Participants
Previous percutaneous coronary revascularization39 Participants
Previous Peripheral Artery Revascularization/Surgery25 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
Race (NIH/OMB)
Asian
0 Participants
Race (NIH/OMB)
Black or African American
8 Participants
Race (NIH/OMB)
More than one race
2 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
Race (NIH/OMB)
White
142 Participants
Region of Enrollment
Germany
20 participants
Region of Enrollment
United States
132 participants
Renal Insufficiency19 Participants
Sex: Female, Male
Female
58 Participants
Sex: Female, Male
Male
94 Participants
Transient Ischemic Attack7 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
14 / 165
other
Total, other adverse events
22 / 165
serious
Total, serious adverse events
86 / 165

Outcome results

Primary

Percentage of ITT Population Experiencing Death Within 30 Days, Target Site Revascularization or Restenosis

The primary endpoint is a composite endpoint defined as the occurrence of death within 30 days, target site revascularization within 9 months or restenosis (by ultrasound determination) at 9 months.

Time frame: Within 9 Months post-procedure

Population: ITT population: Subjects who signed the written informed consent, enrolled in the study and met the study entry criteria.

ArmMeasureValue (NUMBER)
iCAST Covered StentPercentage of ITT Population Experiencing Death Within 30 Days, Target Site Revascularization or Restenosis8.1 Percentage of subjects
Comparison: The composite event rate to determine the performance metric of 16.57% was based on a meta-analysis performed on data from 3 previous studies(9.67%). A 6.9% margin was deemed acceptable at the time of study design. Rejection of the null hypothesis requires that the iCAST Covered Stent primary endpoint rate was significantly below 16.57%. Other assumptions for the analysis included a power of 80% and one-sided alpha error of 5%.p-value: 0.005Exact test of the binomial distribution
Secondary

Acute Procedural Success

Device success and achievement of \< 30% residual stenosis immediately after stent placement and without occurrence of in-hospital MAVE.

Time frame: Post-procedure

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentAcute Procedural Success140 Participants
Secondary

Device Success

Successful delivery and deployment of the study stent and intact retrieval of the delivery system.

Time frame: Post-procedure

Population: ITT population: Subjects who signed the written informed consent, enrolled in the study and met the study entry criteria.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentDevice Success150 Participants
Secondary

Early Clinical Success

Improvement of the Rutherford-Becker clinical criteria by ≥ 1 category. (Classification system for evaluating clinical improvement as defined by Rutherford R, Becker G. Standards for evaluating and reporting the results of surgical and percutaneous therapy for peripheral arterial disease. Journal of Vascular Interventional Radiology 1991;2:169-174.)

Time frame: 1 Month

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentEarly Clinical Success133 Participants
Secondary

Late Clinical Success

Maintained improvement in ankle brachial index (ABI), the ratio of the blood pressure at the ankle to the blood pressure in the upper arm.

Time frame: 6 Months

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentLate Clinical Success80 Participants
Secondary

Late Clinical Success

Maintained improvement in ankle brachial index (ABI), the ratio of the blood pressure at the ankle to the blood pressure in the upper arm.

Time frame: 12 Months

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentLate Clinical Success86 Participants
Secondary

Late Clinical Success

Maintained improvement in ankle brachial index (ABI), the ratio of the blood pressure at the ankle to the blood pressure in the upper arm.

Time frame: 24 Months

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentLate Clinical Success80 Participants
Secondary

Late Clinical Success

Maintained improvement in ankle brachial index (ABI), the ratio of the blood pressure at the ankle to the blood pressure in the upper arm.

Time frame: 36 Months

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentLate Clinical Success76 Participants
Secondary

Late Clinical Success

Maintained improvement in ankle brachial index (ABI), the ratio of the blood pressure at the ankle to the blood pressure in the upper arm.

Time frame: 9 Months

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentLate Clinical Success98 Participants
Secondary

Major Adverse Event (MAE)

Composite rate of MAVE or any death, or stroke.

Time frame: 30 Days

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentMajor Adverse Event (MAE)8 Participants
Secondary

Major Adverse Vascular Event (MAVE)

Composite rate of myocardial infarction at 30 days, stent thrombosis, clinically apparent distal embolization, arterial rupture, acute limb ischemia, target limb amputation, or procedure related bleeding event requiring transfusion.

Time frame: 180 Days

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentMajor Adverse Vascular Event (MAVE)10 Participants
Secondary

Major Adverse Vascular Event (MAVE)

Composite rate of myocardial infarction at 30 days, stent thrombosis, clinically apparent distal embolization, arterial rupture, acute limb ischemia, target limb amputation, or procedure related bleeding event requiring transfusion.

Time frame: 270 Days

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentMajor Adverse Vascular Event (MAVE)10 Participants
Secondary

Major Adverse Vascular Event (MAVE)

Composite rate of myocardial infarction at 30 days, stent thrombosis, clinically apparent distal embolization, arterial rupture, acute limb ischemia, target limb amputation, or procedure related bleeding event requiring transfusion.

Time frame: 360 Days

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentMajor Adverse Vascular Event (MAVE)10 Participants
Secondary

Major Adverse Vascular Event (MAVE)

Composite rate of myocardial infarction at 30 days, stent thrombosis, clinically apparent distal embolization, arterial rupture, acute limb ischemia, target limb amputation, or procedure related bleeding event requiring transfusion.

Time frame: 30 Days

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentMajor Adverse Vascular Event (MAVE)7 Participants
Secondary

Primary-Assisted Patency

Continuous flow assisted when the target vessel has restenosed at any time post-procedure.

Time frame: 24 Months

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentPrimary-Assisted Patency128 Participants
Secondary

Primary-Assisted Patency

Continuous flow assisted when the target vessel has restenosed at any time post-procedure.

Time frame: 12 Months

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentPrimary-Assisted Patency138 Participants
Secondary

Primary-Assisted Patency

Continuous flow assisted when the target vessel has restenosed at any time post-procedure.

Time frame: 9 Months

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentPrimary-Assisted Patency139 Participants
Secondary

Primary-Assisted Patency

Continuous flow assisted when the target vessel has restenosed at any time post-procedure.

Time frame: 6 Months

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentPrimary-Assisted Patency144 Participants
Secondary

Primary-Assisted Patency

Continuous flow assisted when the target vessel has restenosed at any time post-procedure.

Time frame: 1 Month

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentPrimary-Assisted Patency151 Participants
Secondary

Primary-Assisted Patency

Continuous flow assisted when the target vessel has restenosed at any time post-procedure.

Time frame: 36 Months

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentPrimary-Assisted Patency114 Participants
Secondary

Primary Patency

Continuous flow without revascularization, bypass or target limb amputation.

Time frame: 9 Months

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentPrimary Patency134 Participants
Secondary

Primary Patency

Continuous flow without revascularization, bypass or target limb amputation.

Time frame: 1 Month

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentPrimary Patency151 Participants
Secondary

Primary Patency

Continuous flow without revascularization, bypass or target limb amputation.

Time frame: 6 Months

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentPrimary Patency143 Participants
Secondary

Primary Patency

Continuous flow without revascularization, bypass or target limb amputation.

Time frame: 12 Months

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentPrimary Patency129 Participants
Secondary

Primary Patency

Continuous flow without revascularization, bypass or target limb amputation.

Time frame: 24 Months

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentPrimary Patency113 Participants
Secondary

Primary Patency

Continuous flow without revascularization, bypass or target limb amputation.

Time frame: 36 Months

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentPrimary Patency100 Participants
Secondary

Secondary Patency

Re-establishment of flow to distal arteries after occlusion has occurred at the target vessel.

Time frame: 1 Month

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentSecondary Patency151 Participants
Secondary

Secondary Patency

Re-establishment of flow to distal arteries after occlusion has occurred at the target vessel.

Time frame: 6 Months

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentSecondary Patency144 Participants
Secondary

Secondary Patency

Re-establishment of flow to distal arteries after occlusion has occurred at the target vessel.

Time frame: 9 Months

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentSecondary Patency139 Participants
Secondary

Secondary Patency

Re-establishment of flow to distal arteries after occlusion has occurred at the target vessel.

Time frame: 12 Months

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentSecondary Patency138 Participants
Secondary

Secondary Patency

Re-establishment of flow to distal arteries after occlusion has occurred at the target vessel.

Time frame: 24 Months

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentSecondary Patency129 Participants
Secondary

Secondary Patency

Re-establishment of flow to distal arteries after occlusion has occurred at the target vessel.

Time frame: 36 Months

Population: Subset of ITT population with available data for analysis (ITT population included subjects who signed the written informed consent, enrolled in the study and met the study entry criteria).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iCAST Covered StentSecondary Patency115 Participants

Source: ClinicalTrials.gov · Data processed: Mar 3, 2026