Drug Eluting Balloon Angioplasty Versus Nitinol Stent Implantation in the Superficial Femoral Artery

NCT02212470 | Completed Phase 4 DMC

• 1 other identifier: IDPC_3 2014
• Study Type: interventional
• Target: 85
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to evaluate whether the results of drug eluting balloon are non-inferior to the Nitinol stent implantation in the femoropopliteal segment.

Conditions

Peripheral Arterial Disease; Arterial Occlusive Diseases; Atherosclerosis; Arteriosclerosis; Cardiovascular Diseases; Peripheral Vascular Diseases; Paclitaxel; Plaque, Atherosclerotic; Critical Limb Ischemia

Keywords

Artery; Atherosclerosis; Peripheral; Arterial; Plaque; PTA; Angioplasty; Femoropopliteal; Self Expandable Nitinol Stents

Outcome Measures

Primary Outcomes (1)

• Primary patency

  Evaluations will be conducted after 3, 6 and 12 months of the procedure. The ultrasonographic evaluation of the degree of stenosis will use the Systolic Velocity Index (division of the velocity of flow at the point of greatest stenosis by the velocity of flow in normal prior segment). Rates higher than 2.4 indicate stenosis greater than 50%

  12 months

Secondary Outcomes (7)

• Rutherford classification

  12 months

• Ankle braquial Index

  12 months

• Target Lesion Revascularization

  12 months

• Stent fracture

  12 months

• Amputation

  12 months

Study Arms (2)

Drug Eluting Balloon

ACTIVE COMPARATOR

Admiral In.Pact Drug Eluting Balloon

Device: Drug Eluting Balloon Angioplasty

Nitinol Stent

ACTIVE COMPARATOR

Complete SE Self-expandible Nitinol stent

Device: Nitinol stenting

Interventions

Drug Eluting Balloon Angioplasty DEVICE

Angioplasty with Drug eluting balloon after pre dilatation

Also known as: Medtronic, Admiral In.Pact

Drug Eluting Balloon

Nitinol stenting DEVICE

Nitinol stent deployment

Also known as: Medtronic, Complete SE

Nitinol Stent

Eligibility Criteria

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

You may qualify if:

• Patients over 18 years with critical lower limb ischemia,
• Ruhtherford 3 or higher,
• with angiographic documentation of greater than 70% or occlusion in the superficial femoral artery,
• with a maximum extension of 10 cm stenosis.
• The popliteal artery and at least one leg artery must be patent.

You may not qualify if:

• Pregnancy,
• thrombophilia,
• coagulation disorders,
• presence of active or recent bleeding,
• severe allergy to iodinated contrast,
• renal or hepatic disease,
• acute limb ischemia,
• prior surgical bypass or angioplasty (with or without stent) on the target artery,
• obstructive disease (stenosis\> 50%) of the aortoiliac segment ipsilateral to the target (if the aortoiliac is pre-treated, the patient may be included)

Sponsors & Collaborators

• Instituto Dante Pazzanese de Cardiologia: lead
• Medtronic: collaborator

Study Sites (1)

Instituto Dante Pazzanese de Cardiologia

São Paulo, 04012909, Brazil

Location

Related Publications (27)

• Schillinger M, Sabeti S, Dick P, Amighi J, Mlekusch W, Schlager O, Loewe C, Cejna M, Lammer J, Minar E. Sustained benefit at 2 years of primary femoropopliteal stenting compared with balloon angioplasty with optional stenting. Circulation. 2007 May 29;115(21):2745-9. doi: 10.1161/CIRCULATIONAHA.107.688341. Epub 2007 May 14.

  PMID: 17502568 BACKGROUND

• Bosiers M, Torsello G, Gissler HM, Ruef J, Muller-Hulsbeck S, Jahnke T, Peeters P, Daenens K, Lammer J, Schroe H, Mathias K, Koppensteiner R, Vermassen F, Scheinert D. Nitinol stent implantation in long superficial femoral artery lesions: 12-month results of the DURABILITY I study. J Endovasc Ther. 2009 Jun;16(3):261-9. doi: 10.1583/08-2676.1.

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• Dick P, Wallner H, Sabeti S, Loewe C, Mlekusch W, Lammer J, Koppensteiner R, Minar E, Schillinger M. Balloon angioplasty versus stenting with nitinol stents in intermediate length superficial femoral artery lesions. Catheter Cardiovasc Interv. 2009 Dec 1;74(7):1090-5. doi: 10.1002/ccd.22128.

  PMID: 19859954 BACKGROUND

• Laird JR, Katzen BT, Scheinert D, Lammer J, Carpenter J, Buchbinder M, Dave R, Ansel G, Lansky A, Cristea E, Collins TJ, Goldstein J, Cao AY, Jaff MR; RESILIENT Investigators. Nitinol stent implantation vs. balloon angioplasty for lesions in the superficial femoral and proximal popliteal arteries of patients with claudication: three-year follow-up from the RESILIENT randomized trial. J Endovasc Ther. 2012 Feb;19(1):1-9. doi: 10.1583/11-3627.1.

  PMID: 22313193 BACKGROUND

• Kawamura Y, Ishii H, Aoyama T, Tanaka M, Takahashi H, Kumada Y, Toriyama T, Murohara T. Nitinol stenting improves primary patency of the superficial femoral artery after percutaneous transluminal angioplasty in hemodialysis patients: a propensity-matched analysis. J Vasc Surg. 2009 Nov;50(5):1057-62. doi: 10.1016/j.jvs.2009.07.017. Epub 2009 Sep 26.

  PMID: 19782527 BACKGROUND

• Nguyen BN, Conrad MF, Guest JM, Hackney L, Patel VI, Kwolek CJ, Cambria RP. Late outcomes of balloon angioplasty and angioplasty with selective stenting for superficial femoral-popliteal disease are equivalent. J Vasc Surg. 2011 Oct;54(4):1051-1057.e1. doi: 10.1016/j.jvs.2011.03.283. Epub 2011 Jun 2.

  PMID: 21636240 BACKGROUND

• Kasapis C, Henke PK, Chetcuti SJ, Koenig GC, Rectenwald JE, Krishnamurthy VN, Grossman PM, Gurm HS. Routine stent implantation vs. percutaneous transluminal angioplasty in femoropopliteal artery disease: a meta-analysis of randomized controlled trials. Eur Heart J. 2009 Jan;30(1):44-55. doi: 10.1093/eurheartj/ehn514. Epub 2008 Nov 21.

  PMID: 19028778 BACKGROUND

• Mwipatayi BP, Hockings A, Hofmann M, Garbowski M, Sieunarine K. Balloon angioplasty compared with stenting for treatment of femoropopliteal occlusive disease: a meta-analysis. J Vasc Surg. 2008 Feb;47(2):461-9. doi: 10.1016/j.jvs.2007.07.059. Epub 2007 Oct 22.

  PMID: 17950563 BACKGROUND

• Krankenberg H, Schluter M, Steinkamp HJ, Burgelin K, Scheinert D, Schulte KL, Minar E, Peeters P, Bosiers M, Tepe G, Reimers B, Mahler F, Tubler T, Zeller T. Nitinol stent implantation versus percutaneous transluminal angioplasty in superficial femoral artery lesions up to 10 cm in length: the femoral artery stenting trial (FAST). Circulation. 2007 Jul 17;116(3):285-92. doi: 10.1161/CIRCULATIONAHA.107.689141. Epub 2007 Jun 25.

  PMID: 17592075 BACKGROUND

• Serruys PW, Kutryk MJ, Ong AT. Coronary-artery stents. N Engl J Med. 2006 Feb 2;354(5):483-95. doi: 10.1056/NEJMra051091. No abstract available.

  PMID: 16452560 BACKGROUND

• Lammer J, Bosiers M, Zeller T, Schillinger M, Boone E, Zaugg MJ, Verta P, Peng L, Gao X, Schwartz LB. First clinical trial of nitinol self-expanding everolimus-eluting stent implantation for peripheral arterial occlusive disease. J Vasc Surg. 2011 Aug;54(2):394-401. doi: 10.1016/j.jvs.2011.01.047. Epub 2011 Jun 12.

  PMID: 21658885 BACKGROUND

• Dake MD, Scheinert D, Tepe G, Tessarek J, Fanelli F, Bosiers M, Ruhlmann C, Kavteladze Z, Lottes AE, Ragheb AO, Zeller T; Zilver PTX Single-Arm Study Investigators. Nitinol stents with polymer-free paclitaxel coating for lesions in the superficial femoral and popliteal arteries above the knee: twelve-month safety and effectiveness results from the Zilver PTX single-arm clinical study. J Endovasc Ther. 2011 Oct;18(5):613-23. doi: 10.1583/11-3560.1.

  PMID: 21992630 BACKGROUND

• Duda SH, Bosiers M, Lammer J, Scheinert D, Zeller T, Tielbeek A, Anderson J, Wiesinger B, Tepe G, Lansky A, Mudde C, Tielemans H, Beregi JP. Sirolimus-eluting versus bare nitinol stent for obstructive superficial femoral artery disease: the SIROCCO II trial. J Vasc Interv Radiol. 2005 Mar;16(3):331-8. doi: 10.1097/01.RVI.0000151260.74519.CA.

  PMID: 15758128 BACKGROUND

• Duda SH, Bosiers M, Lammer J, Scheinert D, Zeller T, Oliva V, Tielbeek A, Anderson J, Wiesinger B, Tepe G, Lansky A, Jaff MR, Mudde C, Tielemans H, Beregi JP. Drug-eluting and bare nitinol stents for the treatment of atherosclerotic lesions in the superficial femoral artery: long-term results from the SIROCCO trial. J Endovasc Ther. 2006 Dec;13(6):701-10. doi: 10.1583/05-1704.1.

  PMID: 17154704 BACKGROUND

• Werk M, Langner S, Reinkensmeier B, Boettcher HF, Tepe G, Dietz U, Hosten N, Hamm B, Speck U, Ricke J. Inhibition of restenosis in femoropopliteal arteries: paclitaxel-coated versus uncoated balloon: femoral paclitaxel randomized pilot trial. Circulation. 2008 Sep 23;118(13):1358-65. doi: 10.1161/CIRCULATIONAHA.107.735985. Epub 2008 Sep 8.

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• Micari A, Cioppa A, Vadala G, Castriota F, Liso A, Marchese A, Grattoni C, Pantaleo P, Cremonesi A, Rubino P, Biamino G. Clinical evaluation of a paclitaxel-eluting balloon for treatment of femoropopliteal arterial disease: 12-month results from a multicenter Italian registry. JACC Cardiovasc Interv. 2012 Mar;5(3):331-8. doi: 10.1016/j.jcin.2011.11.010.

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• Freyhardt P, Zeller T, Kroncke TJ, Schwarzwaelder U, Schreiter NF, Stiepani H, Sixt S, Rastan A, Werk M. Plasma levels following application of paclitaxel-coated balloon catheters in patients with stenotic or occluded femoropopliteal arteries. Rofo. 2011 May;183(5):448-55. doi: 10.1055/s-0029-1246028. Epub 2011 Jan 27.

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• Geiger MA, Guillaumon AT. Primary stenting for femoropopliteal peripheral arterial disease: analysis up to 24 months. J Vasc Bras. 2019 Jan 30;18:e20160104. doi: 10.1590/1677-5449.010416. eCollection 2019.

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• Krishnan P, Faries P, Niazi K, Jain A, Sachar R, Bachinsky WB, Cardenas J, Werner M, Brodmann M, Mustapha JA, Mena-Hurtado C, Jaff MR, Holden AH, Lyden SP. Stellarex Drug-Coated Balloon for Treatment of Femoropopliteal Disease: Twelve-Month Outcomes From the Randomized ILLUMENATE Pivotal and Pharmacokinetic Studies. Circulation. 2017 Sep 19;136(12):1102-1113. doi: 10.1161/CIRCULATIONAHA.117.028893. Epub 2017 Jul 20.

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• Schroeder H, Werner M, Meyer DR, Reimer P, Kruger K, Jaff MR, Brodmann M; ILLUMENATE EU RCT Investigators. Low-Dose Paclitaxel-Coated Versus Uncoated Percutaneous Transluminal Balloon Angioplasty for Femoropopliteal Peripheral Artery Disease: One-Year Results of the ILLUMENATE European Randomized Clinical Trial (Randomized Trial of a Novel Paclitaxel-Coated Percutaneous Angioplasty Balloon). Circulation. 2017 Jun 6;135(23):2227-2236. doi: 10.1161/CIRCULATIONAHA.116.026493. Epub 2017 Apr 19.

  PMID: 28424223 BACKGROUND

• Schneider PA, Laird JR, Tepe G, Brodmann M, Zeller T, Scheinert D, Metzger C, Micari A, Sachar R, Jaff MR, Wang H, Hasenbank MS, Krishnan P; IN.PACT SFA Trial Investigators. Treatment Effect of Drug-Coated Balloons Is Durable to 3 Years in the Femoropopliteal Arteries: Long-Term Results of the IN.PACT SFA Randomized Trial. Circ Cardiovasc Interv. 2018 Jan;11(1):e005891. doi: 10.1161/CIRCINTERVENTIONS.117.005891.

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• Iida O, Soga Y, Hirano K, Suzuki K, Yokoi H, Nobuyoshi M, Muramatsu T, Inoue N, Nanto S, Uematsu M. Long-term outcomes and risk stratification of patency following nitinol stenting in the femoropopliteal segment: retrospective multicenter analysis. J Endovasc Ther. 2011 Dec;18(6):753-61. doi: 10.1583/11-3581.1.

  PMID: 22149222 RESULT

• Tomoi Y, Soga Y, Takahara M, Fujihara M, Iida O, Kawasaki D, Ando K. Spot stenting versus full coverage stenting after endovascular therapy for femoropopliteal artery lesions. J Vasc Surg. 2019 Oct;70(4):1166-1176. doi: 10.1016/j.jvs.2018.12.044. Epub 2019 Mar 6.

  PMID: 30850285 RESULT

• Abdoli S, Mert M, Lee WM, Ochoa CJ, Katz SG. Network meta-analysis of drug-coated balloon angioplasty versus primary nitinol stenting for femoropopliteal atherosclerotic disease. J Vasc Surg. 2021 May;73(5):1802-1810.e4. doi: 10.1016/j.jvs.2020.10.075. Epub 2020 Nov 26.

  PMID: 33249205 RESULT

MeSH Terms

Conditions

Peripheral Arterial Disease; Arterial Occlusive Diseases; Atherosclerosis; Arteriosclerosis; Cardiovascular Diseases; Peripheral Vascular Diseases; Plaque, Atherosclerotic; Chronic Limb-Threatening Ischemia; Plaque, Amyloid

Condition Hierarchy (Ancestors)

Vascular Diseases; Pathological Conditions, Anatomical; Pathological Conditions, Signs and Symptoms; Chronic Disease; Disease Attributes; Pathologic Processes; Ischemia

Study Officials

• BRUNO L ALMEIDA, MD

  Instituto Dante Pazzanese de Cardiologia

  PRINCIPAL INVESTIGATOR

• FABIO H ROSSI, MD, PHD

  Instituto Dante Pazzanese de Cardiologia

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD, PHD

Model Details: Prospective, randomized, single-center, single-blind, non-inferiority, clinical trial

Study Record Dates

• First Submitted: August 6, 2014
• First Posted: August 8, 2014
• Study Start: July 1, 2014
• Primary Completion: December 1, 2018
• Study Completion: October 1, 2019
• Last Updated: June 10, 2021

Record last verified: 2021-06

Locations

BR (1)