Femoral Artery Stenosis, Popliteal Artery Stenosis
Conditions
Keywords
PTA Scoring Balloon, Optimal Balloon Angioplasty
Brief summary
A Multicenter, Prospective, Randomized Controlled Trial to Evaluate the Efficacy and Safety of DKutting Balloon Versus Chocolate Balloon in the Treatment of Femoral and Popliteal Artery Stenosis
Detailed description
This is a prospective, multi-center, randomized controlled, open-label, noninferior study to evaluate achievement of optimal PTA dilatation. A total of 188 patients will be enrolled from 14 sites in China. All patients enrolled will be assigned to the test group (DKutting LL balloon, n=94) and the control group (Chocolate balloon, n=94) with randomized allocation ratio of 1:1. Primary endpoint is percentage of PTA cases in which \<30% diameter stenosis without a flow limiting dissection is achieved. A 30-day after procedure follow-up will be conducted for all 188 patients.
Interventions
After pre-dilation balloon is used (if any), DKutting LL balloon is used as final dilatation balloon before Stent implantation or Drug Coated Balloon deployment
After pre-dilation balloon is used (if any), Chocolate balloon is used as final dilatation balloon before Stent implantation or Drug Coated Balloon deployment
Sponsors
Study design
Eligibility
Inclusion criteria
* 18-80 year-old male & non-pregnant female * Patients with Arteriosclerosis Obliterans of Lower Extremities, including stenosis or osculation in femoropopliteal artery. * Rutherford clinical category-Becker class: 2 to 5 * Patients understand the purpose of the study, will voluntarily participate in the study and sign informed consent. Patients are willing to undergo clinical follow-up as required by this study. * Digital subtraction angiography (DSA) shows femoropopliteal artery stenosis above 70%, appropriate for treatment with balloon angioplasty * Reference vessel diameter from 2.5 to 7mm; Total length of lesion is less than 200mm; Total length of osculation lesion is less than 100mm * Only one target lesion needs to be Treated. Treatment of non-target lesion, if any, must be completed prior to treatment of target lesion and must be deemed a clinical angiographic success as visually assessed by the physician. The number non-target lesions are limited to maximum 3.
Exclusion criteria
* Acute or sub-acute thrombosis exist in target lesion * Severe calcified lesion (PACSS Grading 4) * Guidewire cannot cross target lesion * Amputation planned within 30 days * In-stent restenosis * Flow-limiting dissection (NHLBI grading: D-F) occurred in target lesion by pre-dilation * No other lumen-reduction devices (such as: cutting balloon, dual-wire balloon, Hawk, ELCA etc.) are treated before or after test/control group treatment. * Before test/control group treatment, target lesion was expanded by Antegrade Dissection Re-entry (ADR) technique. * Patient who cannot accept anticoagulant or antiplatelet therapy * Aware of patient allergic to heparin, contrast, aspirin and clopidogrel, anesthetics * Patients who have not completed clinical trials of other drugs or devices * Patients with poor compliance and unable to complete the study, which is identified by investigator.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Achievement of Optimal PTA in Percent | 1 day | Percentage of PTA cases in which \<30% diameter stenosis without a flow limiting dissection (NHLBI grading: D-F). Residual stenosis in percent and dissection NHLBI grading are accessed by independent core-lab with Medis Suite XA based on in-procedure QCA angiography. \[0-100%, higher the better\] |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Numerical Acute Lumen Gain in mm | 1 day | In-lesion acute lumen gain defined as minimal lumen diameter (MLD) in lumen after dilatation by either arm device minus baseline MLD, as accessed by independent core-lab with Medis Suite XA based on in-procedure QCA angiography. \[0-3mm, higher the better\] |
| Technical Success Rate in percent | 0-7 days | Percentage of target Lesion achieved \<30% diameter stenosis without a flow limiting dissection (NHLBI grading: D-F) and No Adverse Event happened in hospital. \[0-100%, higher the better\] |
| Freedom from clinical-driven TLR rate in percent | 30+/-7 Days post procedure | Freedom from clinical-driven target lesion revascularization 1 month post procedure \[0-100%, higher the better\] |
| Device Success Rate in Percent | 1 day | Device Success defined as successful delivery to the target lesion, deployment without balloon rupture, and retrieval after procedure, as qualitatively accessed by physician. \[0-100%, higher the better\] |
| Freedom from Amputation above ankle rate in percent | 30+/-7 Days post procedure | Percentage of both groups' patient number who is free from Amputation above ankle 1 month post procedure. \[0-100%, higher the better\] |
| Numerical Ankle Brachial Index | 0-7days | Record of both groups' patient's Ankle Brachial Index (ABI) pre/post procedure by Doppler ultrasonic stethoscope. \[ABI≤0.9: confirmed peripheral artery disease; ABI≥0.97: normal people\] |
| Rutherford Grading Reduction in percent | 30+/-7 Days post procedure | Percentage of both groups' patent number, whose Rutherford Grading \[0-6, lower is reduced by at least 1 grade post procedure, compared with pre-procedure grade. \[0-100%, higher the better\] |
Countries
China