JetStream (JS) Atherectomy in Femoropopliteal In-Stent Restenotic Lesions

NCT01722877 | Completed Results

• 1 other identifier: JS-ISR-001, version 1, Rev 2
• Study Type: interventional
• Target: 29
• Locations: 1 country
• Sites: 2

Brief Summary

Several studies have shown that stenting of the femoropopliteal artery in the lower leg leads to improved overall results compared to balloon angioplasty alone. However, scar tissue development can occur within the stent, a process called restenosis. Treatment of these in-stent restenotic lesions has a high procedural success rate but recurrence of scar tissue is frequently seen. Several methods have been proposed to treat in-stent restenosis in the lower leg arteries but mixed results have been noted. In this study we hypothesize that simultaneous tissue excision and aspiration using the JetStream Navitus device (Medrad) can lead to a high rate of acute procedural success with low intraprocedural complications and an acceptable recurrence rate of restenosis at 6-month follow-up.

Conditions

Restenosis; Peripheral Vascular Disease

Keywords

Restenosis; aspiration; in-stent restenosis; atherectomy; superficial femoral artery; popliteal artery

Outcome Measures

Primary Outcomes (1)

• Acute Procedural Success

  Acute procedural success is defined as less than or equal to 30 percent residual stenosis (via Quantitative Vascular Analysis) at the index lesion post JestStream atherectomy and final adjunctive treatment And with no serious adverse events.

  intraprocedural

Secondary Outcomes (2)

• Patency

  6 months

• Target Lesion Revascularization

  6 months

Other Outcomes (1)

• Acute Device Success

  intraprocedural

Study Arms (1)

JetStream Atherectomy

EXPERIMENTAL

Jetstream NAVITUS System is a rotating, aspirating, expandable catheter for active removal of atherosclerotic disease and thrombus in peripheral vasculature.

Device: JetStream Navitus

Interventions

JetStream Navitus DEVICE

Study to use Jetstream device for use of in-stent restenosis in femoral popliteal artery.

JetStream Atherectomy

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Subject is 18 years of age or older.
• Subject presents with clinical evidence of peripheral arterial disease with ISR in the femoropopliteal segment (includes common femoral, superficial femoral and popliteal)
• Subject presents with a Rutherford Classification of 1-5 and has symptoms of rest limb pain, ulcerations or claudication.
• Target lesion(s) must be viewed angiographically and have ≥50% stenosis.
• The atherectomy wire must be placed entirely across all lesions to be treated with no visible evidence of clear or suspected subintimal/substent wire passage.
• The main target vessel reference diameter must be at least 5 mm.
• One patent distal run-off vessel with brisk flow is required.
• Patient is an acceptable candidate for percutaneous intervention using the Jetstream NAVITUS System in accordance with its labeled instructions for use.
• Patient has signed approved informed consent.
• Patient is willing to comply with the follow-up evaluations at specified times.

You may not qualify if:

• Subject is unable to understand the study or has a history of non-compliance with medical advice.
• Subject is unwilling or unable to sign the Informed Consent Form (ICF).
• Subject is currently enrolled in another clinical investigational study that might clinically interfere with the current study endpoints (e.g., limit use of study-recommended medications, etc.).
• Subject is pregnant or planning to become pregnant within the study period.
• Subject has a known sensitivity to contrast media and the sensitivity cannot be adequately pre-medicated for.
• Subject is diagnosed with chronic renal failure or has a creatinine level \> 2.5 mg/dl and is not on chronic dialysis.
• Subject has a known allergy to heparin, ASA, Plavix.
• Subject has a history of bleeding disorders or platelet count \< 80,000 cells/ml.
• Subject experiences ongoing cardiac problems (e.g., cardiac arrhythmias, congestive heart failure exacerbation, myocardial infarction, etc.) that, per the investigator, would not make the subject an ideal candidate for study procedures.
• Subject has a CVA or TIA within 4 weeks prior to JetStream procedure.
• Subject has an anticipated life span of less than 6 months.
• Subject is suspected of having an active systemic infection.
• Subject per the investigator's medical judgment must be excluded from the study.
• Limited vascular access that precludes safe advancement of the Jetstream NAVITUS System to the target lesion(s).
• Patient has evidence of intracranial or gastrointestinal bleeding within the past 3 months.

Sponsors & Collaborators

• Midwest Cardiovascular Research Foundation: lead
• MEDRAD, Inc.: collaborator

Study Sites (2)

Trinity Bettendorf Medical Center

Bettendorf, Iowa, 52722, United States

Location

VA Medical Center

Dallas, Texas, United States

Location

Related Publications (1)

• Shammas NW, Shammas GA, Banerjee S, Popma JJ, Mohammad A, Jerin M. JetStream Rotational and Aspiration Atherectomy in Treating In-Stent Restenosis of the Femoropopliteal Arteries: Results of the JETSTREAM-ISR Feasibility Study. J Endovasc Ther. 2016 Apr;23(2):339-46. doi: 10.1177/1526602816634028. Epub 2016 Feb 26.

  PMID: 26921281 DERIVED

MeSH Terms

Conditions

Peripheral Vascular Diseases

Condition Hierarchy (Ancestors)

Vascular Diseases; Cardiovascular Diseases

Limitations and Caveats

This is a feasibility study that will need to be validated with larger multicenter trials.

Results Point of Contact

• Title: Dr Nicolas W Shammas
• Organization: Midwest Cardiovascular Research Foundation

shammas@mchsi.com

5633200263

Study Officials

• Nicolas W Shammas, MD, MS

  Midwest Cardiovascular Research Foundation

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 5, 2012
• First Posted: November 7, 2012
• Study Start: October 1, 2012
• Primary Completion: August 1, 2014
• Study Completion: September 1, 2015
• Last Updated: March 3, 2020
• Results First Posted: May 5, 2017

Record last verified: 2020-02

Data Sharing

• IPD Sharing: Will share

Locations

US (2)