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Peripheral Vascular DiseasePhase 2/3PADINCT00471289

PTA and Drug Eluting Stents for Infrapopliteal Lesions in Critical Limb Ischemia

A Phase 2/3 study testing PTA with placement of paclitaxel-eluting stent and PTA in people with Peripheral Vascular Disease, run by Netherlands Society for Interventional Radiology at 3 sites in Netherlands.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The purpose of this study is to investigate the performance of paclitaxel-coated balloon expandable stainless steel coronary stent for the treatment of infrapopliteal stenoses and occlusions in patients with critical limb ischemia compared to percutaneous transluminal balloon angioplasty (PTA). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Peripheral Vascular Disease
What is being tested?
PTA with placement of paclitaxel-eluting stent and PTA
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
144 participants
Where
3 sitesNetherlands
Study dates
Aug 2007to Mar 2023
Phase
Phase 2/3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Written informed consent
  • Age > 18 years
  • If female patient with child bearing potential, patient may not be pregnant at the study entry and must utilize reliable birth control for the duration of her participation into the study
  • Patient is willing and able to comply with the specified follow-up evaluation
  • Critical Limb Ischaemia, this is Fontaine stage III (ischaemic rest pain) and IV (ischaemic ulcers or gangrene) or Rutherford category 4 (ischaemic rest pain), 5 (minor tissue loss) or 6 (major tissue loss)
  • Stenotic (>50% luminal loss) or occluded infrapopliteal artery, including the tibiofibular trunk, the anterior tibial artery, the posterior tibial artery and the peroneal artery, with a lesion length ≤ 60 mm
Show all 9Show fewer
  • Artery to be treated with a diameter more tham or equal to 2mm and less than or equal to 4mm
  • Patent common iliac, external iliac, superficial femoral and popliteal artery on the ipsilateral side prior to randomisation, possibly after treatment during the same session
  • At least one patent crural (anterior tibial, posterior tibial or peroneal) artery with expected unobstructed runoff to ankle level after treatment

Who cannot join

  • Acute limb ischaemia
  • Subacute limb ischaemia which requires thrombolysis as first treatment modality
  • Active bleeding or bleeding diathesis
  • Recent (less than 3 months) hemorrhagic stroke or other any other CNS abnormality with increased risk of haemorrhage, such as intracranial neoplasm, arteriovenous malformation, intracranial aneurysm or aneurysm repair
  • Gastrointestinal or genitourinary bleeding of clinical significance within the previous 6 weeks before treatment
  • Aneurysm in common femoral, superficial femoral or popliteal artery on the ipsilateral side
Show all 20Show fewer
  • Revascularization involving the same limb within 30 days prior to the index procedure or planned revascularization of the same limb within 30 days of the index procedure
  • Previous implanted stent at the index site
  • Life expectancy of less than 6 months or other factors making clinical follow-up difficult
  • Known allergy to acetylsalicylic acid (aspirin), clopidogrel, heparin or paclitaxel
  • Known allergy to contrast media
  • Known heparin induced thrombocytopenia (HIT type 2)
  • Patient unable or unwilling to tolerate anticoagulant, anti-platelet therapy or contrast media
  • Creatinine clearance < 20 ml/min (as derived from Cockcroft-Gault or MDRD formula)unless patient is on hemodialysis
  • Aneurysm in common femoral, superficial femoral or popliteal artery on the ipsilateral side
  • Severely calcified lesions with expected resistance to stenting
  • Poor inflow due to ipsilateral stenoses or occlusions of the iliac or femoropopliteal arteries that cannot be treated during the same session
  • Significant vessel tortuosity or other parameters prohibiting access to the lesions and/or delivery of the stent
  • Patients without (expected) distal runoff to the index site
  • Previous implanted stent at the index site

Trial locations and contacts

3 sites in 1 country.

Netherlands3 sites
  • Sint Antonius Ziekenhuis

    Nieuwegein, Utrecht

  • HagaZiekenhuis, location Leyweg

    The Hague, South Holland, 2545CH

  • University Medical Center Utrecht (UMCU)

    Utrecht, 3584 CX

Other trials in Netherlands

About this study

Official title: Percutaneous Transluminal Balloon Angioplasty (PTA) and Drug Eluting Stents for Infrapopliteal Lesions in Critical Limb Ischemia

The purpose of this study is to investigate the performance of paclitaxel-coated balloon expandable stainless steel coronary stent for the treatment of infrapopliteal stenoses and occlusions in patients with critical limb ischemia compared to percutaneous transluminal balloon angioplasty (PTA).

Read the detailed description

Critical limb ischemia (CLI) is a serious condition that is becoming more and more common in the western world due to the growing percentage of elderly in the population and the rising incidence of diabetes. In about 40% of patients a stenosis or occlusion in the arteries below the level of the knee will be present. Restoration of blood flow is imperative to allow pain relief and tissue healing. Without revascularization patients with CLI are at risk for limb loss and potentially fatal complications such as sepsis.

In patients treated with percutaneous transluminal balloon angioplasty (PTA)significant restenosis is found in approximately 50% after 6 months.

In interventional cardiology a significant reduction in restenosis rates in coronary arteries has been found using drug eluting stents (DES), including the paclitaxel eluting stent (TAXUS, Boston Scientific). DES locally deliver drugs (e.g. paclitaxel) that interfere with the restenosis process.

Using DES in treating below the knee (infrapopliteal) arterial lesions in patients with CLI may improve patency and clinical outcome.

Comparison:

Treatment of below the knee arterial lesions in patients with CLI with PTA and DES compared to only PTA.

Being tested
PTA with placement of paclitaxel-eluting stent, PTA
Keywords
Critical Limb Ischemia, Stents, Drug Eluting Stents, Peripheral arterial disease, PAD, Paclitaxel, TAXUS, Infrapopliteal, Infragenicular, Interventional Radiology, CLI, DES
Medical subject headings
Peripheral Vascular Diseases, Chronic Limb-Threatening Ischemia, Peripheral Arterial Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PTA with placement of paclitaxel-eluting stentDevice

    PTA with placement of paclitaxel-eluting stent

  • PTADevice

    PTA

Study groups in NCT00471289
Study groupRoleWhat they receive
1ExperimentalPTA with primary placement of Drug (paclitaxel) Eluting Stent
Receives: Device: PTA with placement of paclitaxel-eluting stent
2Active comparatorPTA
Receives: Device: PTA

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The primary endpoint will be primary patency of the treated site at 6 months. Primary patency is defined as <50% loss of luminal diameter at the treated site on CT arteriography (CTA) without re-intervention in the interim.

    Measured: 6 months

Secondary outcomes (13)
  1. Primary patency of the treated sites at 3, 6 and 12 months after intervention assessed by duplex sonography (binary patency, <50% stenosis defined as PSV ratio <2.0)

    Measured: 3, 6, 12 months

  2. Clinical evaluation of the treated ischemic leg at 3, 6 and 12 months.

    Measured: 3, 6, 12 months

  3. Major amputation (at or above the ankle) of the trial leg at 3, 6 and 12 months

    Measured: 3, 6, 12 months

  4. Minor amputation (below the ankle excluding the toes) of the trial leg at 3, 6 and 12 months.

    Measured: 3, 6, 12 months

  5. Infrapopliteal surgical bypass of the trial leg at 3, 6 and 12 months.

    Measured: 3, 6, 12 months

  6. Infrapopliteal endovascular re-intervention of the trial leg at 3, 6 and 12 months.

    Measured: 3, 6, 12 months

  7. Peri-procedural (within 30 days) complications.

    Measured: 30 days

  8. Death.

    Measured: 3, 6, 12 months

  9. Clinical assessment primarily by Rutherford score for peripheral arterial disease

    Clinical assessment outpatient clinic

    Measured: 2, 3, 4 and 5 years after treatment

  10. Target lesion patency by means of duplex sonography

    During outpatient clinic visits

    Measured: 2, 3, 4 and 5 years after treatment

  11. Major amputation (at or above the ankle) of treated limb

    Assessment up to 5 years after treatment during outpatient clinic visits From 5 to 10 years by means of yearly evaluation of patient charts

    Measured: yearly up to 10 years after treatment

  12. Minor amputation (below the ankle excluding the toes) of the trial leg at 3, 6 and 12 months.

    From 2 to 5 years during outpatient clinic visits From 5 to 10 years yearly evaluation of patient charts

    Measured: yearly up to 10 years after treatment

  13. Endovascular or surgical re-intervention of target lesion

    Follow-up until first re-intervention of target lesion

    Measured: 3, 6, 12 months, 2,3,4 and 5 years after inclusion

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 May 2007 (estimated)
  2. Study startAug 2007
  3. Primary completionSep 2013
  4. Study completionMar 2023 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
144 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00471289
Sponsor's protocol ID
PADI/200601
Acronym
PADI
Status last verified
Sep 2020
First submitted
7 May 2007
Last updated
16 Sep 2020
Results posted
No
Data monitoring committee
No

Publications

  • Management of peripheral arterial disease (PAD). TransAtlantic Inter-Society Consensus (TASC). Section D: chronic critical limb ischaemia. Eur J Vasc Endovasc Surg. 2000 Jun;19 Suppl A:S144-243. No abstract available.

    PubMed 10957907
  • Adam DJ, Beard JD, Cleveland T, Bell J, Bradbury AW, Forbes JF, Fowkes FG, Gillepsie I, Ruckley CV, Raab G, Storkey H; BASIL trial participants. Bypass versus angioplasty in severe ischaemia of the leg (BASIL): multicentre, randomised controlled trial. Lancet. 2005 Dec 3;366(9501):1925-34. doi: 10.1016/S0140-6736(05)67704-5.

    PubMed 16325694
  • Jensen SA, Vatten LJ, Myhre HO. The prevalence of chronic critical lower limb ischaemia in a population of 20,000 subjects 40-69 years of age. Eur J Vasc Endovasc Surg. 2006 Jul;32(1):60-5. doi: 10.1016/j.ejvs.2005.12.022. Epub 2006 Mar 2.

    PubMed 16513377
  • Black JH 3rd, LaMuraglia GM, Kwolek CJ, Brewster DC, Watkins MT, Cambria RP. Contemporary results of angioplasty-based infrainguinal percutaneous interventions. J Vasc Surg. 2005 Nov;42(5):932-9. doi: 10.1016/j.jvs.2005.06.024.

    PubMed 16275450
  • Sigala F, Menenakos Ch, Sigalas P, Baunach Ch, Langer S, Papalambros E, Hepp W. Transluminal angioplasty of isolated crural arterial lesions in diabetics with critical limb ischemia. Vasa. 2005 Aug;34(3):186-91. doi: 10.1024/0301-1526.34.3.186.

    PubMed 16184838
  • Hynes N, Mahendran B, Manning B, Andrews E, Courtney D, Sultan S. The influence of subintimal angioplasty on level of amputation and limb salvage rates in lower limb critical ischaemia: a 15-year experience. Eur J Vasc Endovasc Surg. 2005 Sep;30(3):291-9. doi: 10.1016/j.ejvs.2005.04.020.

    PubMed 15939635
  • Eskelinen E, Alback A, Roth WD, Lappalainen K, Keto P, Railo M, Eskelinen A, Lepantalo M. Infra-inguinal percutaneous transluminal angioplasty for limb salvage: a retrospective analysis in a single center. Acta Radiol. 2005 Apr;46(2):155-62. doi: 10.1080/02841850510022705.

    PubMed 15902890
  • Kudo T, Chandra FA, Ahn SS. The effectiveness of percutaneous transluminal angioplasty for the treatment of critical limb ischemia: a 10-year experience. J Vasc Surg. 2005 Mar;41(3):423-35; discussion 435. doi: 10.1016/j.jvs.2004.11.041.

    PubMed 15838475
  • Atar E, Siegel Y, Avrahami R, Bartal G, Bachar GN, Belenky A. Balloon angioplasty of popliteal and crural arteries in elderly with critical chronic limb ischemia. Eur J Radiol. 2005 Feb;53(2):287-92. doi: 10.1016/j.ejrad.2004.02.016.

    PubMed 15664294
  • Tsetis D, Belli AM. The role of infrapopliteal angioplasty. Br J Radiol. 2004 Dec;77(924):1007-15. doi: 10.1259/bjr/97382129.

    PubMed 15569642
  • Matsagas MI, Rivera MA, Tran T, Mitchell A, Robless P, Davies AH, Geroulakos G. Clinical outcome following infra-inguinal percutaneous transluminal angioplasty for critical limb ischemia. Cardiovasc Intervent Radiol. 2003 May-Jun;26(3):251-5. doi: 10.1007/s00270-003-0007-z.

    PubMed 14562973
  • Molloy KJ, Nasim A, London NJ, Naylor AR, Bell PR, Fishwick G, Bolia A, Thompson MM. Percutaneous transluminal angioplasty in the treatment of critical limb ischemia. J Endovasc Ther. 2003 Apr;10(2):298-303. doi: 10.1177/152660280301000220.

    PubMed 12877613
  • Haider SN, Kavanagh EG, Forlee M, Colgan MP, Madhavan P, Moore DJ, Shanik GD. Two-year outcome with preferential use of infrainguinal angioplasty for critical ischemia. J Vasc Surg. 2006 Mar;43(3):504-512. doi: 10.1016/j.jvs.2005.11.016.

    PubMed 16520164
  • Wiskirchen J, Schober W, Schart N, Kehlbach R, Wersebe A, Tepe G, Claussen CD, Duda SH. The effects of paclitaxel on the three phases of restenosis: smooth muscle cell proliferation, migration, and matrix formation: an in vitro study. Invest Radiol. 2004 Sep;39(9):565-71. doi: 10.1097/01.rli.0000133815.22434.55.

    PubMed 15308939
  • 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.

    PubMed 16452560

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing PTA with placement of paclitaxel-eluting stent and PTA in people with Peripheral Vascular Disease, run by Netherlands Society for Interventional Radiology at 3 sites in Netherlands.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 20 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 16 Sep 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in Netherlands. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The primary endpoint will be primary patency of the treated site at 6 months. Primary patency is defined as <50% loss of luminal diameter at the treated site on CT arteriography (CTA) without re-intervention in the interim. (time frame: 6 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00471289, which also lists 19 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Sep 2020.

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