Critical Limb Ischemia, Infrapopliteal Arterial Occlusive Disease
Conditions
Brief summary
The objectives of this study are to compare directly conventional balloon angioplasty alone versus. balloon angioplasty with routine stenting - that is, to determine whether angioplasty with self-expanding stent is superior to conventional balloon angioplasty - in the infrapopliteal arterial occlusive lesions of critical limb ischemia patients by collecting and analyzing the cases of each patient group in a prospective multicenter randomized clinical trial, and to clarify main factors affecting mid- and long-term clinical effects of angioplasty with self-expanding stent in the infrapopliteal arteries. Hypothesis: Balloon PTA followed by routine stenting with self-expanding nitinol stent in critical limb ischemia patients with infrapopliteal arterial occlusive lesions is superior to conventional PTA in the aspect of vascular restenosis rate.
Interventions
A group of patients who will undergo subsequent primary stenting following successful conventional balloon angioplasty
A group of patients who will undergo routine conventional balloon angioplasty alone without stenting
Sponsors
Study design
Intervention model description
Provisional stenting with SMART(n=173), Provisional stenting with Complete SE(n=173)
Eligibility
Inclusion criteria
* Symptomatic critical limb ischemia (Rutherford 4 - 6) * Patients with signed informed consent * Target lesion length \< 8 cm by angiographic estimation * Stenosis of \>50% or occlusive atherosclerotic lesion of the ipsilateral infrapopliteal artery * Reference vessel diameter should be 2.0-4.5 mm
Exclusion criteria
* Patient has a known allergy to heparin, aspirin, or other anticoagulant/antiplatelet therapies or a bleeding diatheses or is unable, or unwilling, to tolerate such therapies * Patient takes warfarin * Patient has a history of previous life-threatening contrast media reaction * Patient is currently enrolled in another investigational device or drug trial * Patient is currently breast-feeding, is pregnant, or intends to become pregnant * Patient is mentally ill or retarded * Acute critical limb ischemia * Major bleeding history within prior 2 months * Severe hepatic dysfunction (\> 3 times normal reference values) * Significant leucopenia, neutropenia, thrombocytopenia, anemia, or known bleeding diathesis * Life expectancy \<1 year due to comorbidity * Reference segment diameter is not suitable for available stent design * Previously implanted stent(s) or PTA at the same lesion site * Inflow-limiting arterial lesions left untreated
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Angiographic binary restenosis rate | 12 months |
Countries
South Korea