Peripheral Artery Disease
Conditions
Brief summary
All-comers, prospective, multi-center, single-arm, non-interventional post market clinical follow-up (PMCF) Cohort 1 - Claudicants: Rutherford Clinical Category (RCC) 2-3 Cohort 2 - Critical Limb Ischemia: Rutherford Clinical Category (RCC) 4-6
Detailed description
To prospectively collect and assess safety and efficacy data on the AcoArt drug-coated PTA balloon catheters carrying the CE Mark per current Instructions for Use in a real-world cohort of patients with symptomatic arterial disease undergoing endovascular lower limb revascularization per the institution's standard practice.
Interventions
All comers Post Market Clinical Follow-up to continue the surveillance of the Acotec Drug Coated PTA Catheter AcoArt Orchid, AcoArt Tulip and AcoArt Litos in lower limb treatment
Sponsors
Study design
Eligibility
Inclusion criteria
* 1\. Patient is ≥ 18 years old at the time of consent. * 2\. Significant stenosis (≥70%) or occlusions of de-novo or restenotic lesion(s) located in iliac, superficial femoral, popliteal and/or infra-popliteal arteries suitable for angioplasty per operator visual assessment. * 3\. Lesion(s) can be treated with available AcoArt Orchid (0.035), AcoArt Tulip (0.018) and AcoArt Litos (0.014) DCB device per current IFU. * 4\. Subject has provided written informed consent prior to participation in the PMCF, understands the purpose of this PMCF and agrees to comply with all protocol-specified examinations and follow-up appointments. * 5\. Rutherford Classification Category 2-6 Subjects with Rutherford Category 2 have gone through a conservative therapy without success. * 6\. Inflow lesion treated prior to target lesion treatment
Exclusion criteria
* 1\. Rutherford Classification Category 0, 1 * 2\. Patient already enrolled in other investigational (interventional) studies that would interfere with study endpoints * 3\. Inability to tolerate required antithrombotic or antiplatelet therapies. * 4\. Non-dilatable severely calcified lesion. * 5\. Known hypersensitivity/allergy to components of the investigational device * 6\. Un-treated acute or subacute thrombus in the target lesion. * 7\. Life expectancy \< 1 year. * 8\. Pregnancy or female patient with child bearing potential not taking adequate contraceptives or currently lactating. * 9\. Other comorbidities, which in the opinion of the investigator limit longevity or likelihood of compliance with protocol follow up. * 10\. Myocardial infarction or stroke within 30 days prior to index procedure.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Primary safety endpoint- CLI group | 12 Months | A composite of freedom from device- and procedure-related mortality, freedom from major target limb amputation and TLR within 12 months post-index procedure |
| Primary safety endpoint- non-CLI group | 30 days | A composite of freedom from major adverse limb events and perioperative death (MALE-POD) through 30 days after index procedure. A major adverse limb event is defined as above-ankle amputation or major reintervention (ie, new bypass graft, major surgical graft revision such as a jump graft or an interposition graft, or thrombectomy/thrombolysis) of the treated limb. |
| Primary efficacy endpoint - non-CLI group | 12 Months | Freedom from clinically-driven target lesion revascularization (CD-TLR) within 12 months after index procedure, which is defined as any re-intervention within the target lesion(s) due to recurrent clinical symptoms of PAD (increase of one Rutherford class or more) and/or drop of ankle-brachial index (≥20% or \>0.15 when compared with maximum early post-procedural level). |
| Primary efficacy endpoint -CLI group | 6 Months | Freedom from clinically-driven TLR within 6 months after index procedure, which is defined as any re-intervention within the target lesion(s) due to delayed or worsening wound healing, new or recurrent wound, or worsening Rutherford class. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rate of All-cause mortality | 6 months,12 months,24 months, 36months,48 months,60months | All-cause mortality at 6, 12, 24, 36, 48, 60 months post procedure |
| Rate of Device- or procedure-related death | 30 days, 6 months | Device- or procedure-related death at 30 days and 6 months |
| Rate of Major amputation | 6 months,12 months,24 months, 36months,48 months,60 months | Major amputation at 6, 12, 24, 36, 48, 60 months post procedure |
| Rate of Technical success | Post procedure | Technical success defined as final in-lesion residual diameter stenosis ≤50% by angiographic visual estimate at the end of the index procedure without device malfunction. |
| Rate of Procedural success | Post procedure | Procedural success defined as technical success without procedural complications (death, major target limb amputation, thrombosis of the target lesion, or CD-TLR) prior to discharge |
| Change in Rutherford clinical category (target limb) | 6 months,12 months,24 months, 36months,48 months,60 months | Changes in Rutherford clinical category (target limb) at 6, 12, 24, 36, 48, 60 months post-procedure compared to baseline |
| Rate of Any TLR (including clinically-driven and incidental TLR) | 6 months,12 months,24 months, 36months,48 months,60 months | Any TLR (including clinically-driven and incidental TLR) at 6,12, 24, 36, 48, 60 months post-procedure |
| Rate of secondary sustained clinical improvement | 6 months,12 months,24 months, 36months,48 months,60 months | Secondary sustained clinical improvement, defined as improvement in Rutherford classification by one or more categories compared with baseline, including patients with TLR |
| Rate of (Major) Amputation-free survival - CLI group | 6 months,12 months,24 months, 36months,48 months,60 months | (Major) Amputation-free survival at 6, 12, 24, 36, 48, 60 months post-procedure |
| Rate of Minor amputation - CLI group | 6 months,12 months,24 months, 36months,48 months,60 months | Minor amputation at 6, 12, 24, 36, 48, 60 months post-procedure |
| Rate of Wound healing - CLI group | 60 months | healed or not; if not, improving, stagnant,worsening |
| New or recurrent wound of the target limb - CLI group | 60 months | New or recurrent wound of the target limb |
| Rate of primary sustained clinical improvement | 6 months,12 months,24 months, 36months,48 months,60 months | Primary sustained clinical improvement, defined as improvement in Rutherford classification by one or more categories compared with baseline, without TLR. |
| Rate of Target vessel revascularization (TVR) | 6 months,12 months,24 months, 36months,48 months,60 months | Target vessel revascularization (TVR) at 6, 12, 24, 36, 48, 60 months post-procedure |
| Rate of Target limb revascularization | 6 months,12 months,24 months, 36months,48 months,60 months | Target limb revascularization at 6, 12, 24, 36, 48, 60 months post-procedure |
| Rate of CD-TLR | 6 months,12 months,24 months, 36months,48 months,60 months | CD-TLR at 6, 24, 36, 48, 60 months post-procedure |
Countries
Germany