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Popliteal Artery Stenosis Above the KneeSTAR-PAKNCT06734221

STAR-PAK Study: Evaluating the Safety and Efficacy of PAK® (Paclitaxel Coated Balloon) in Treating Atherosclerotic Femoro-Popliteal Lesions

A study testing Paclitaxel Coated Peripheral Angioplasty Balloon Catheter in people with Popliteal Artery Stenosis Above the Knee and Peripheral Artery Disease, run by Balton Sp.zo.o. at 3 sites in 2 countries.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

The primary objective of the study is to evaluate the performance and the safety of the PAK® DCB Catheter in the treatment of de novo and restenotic atherosclerotic lesions in the superficial femoral and/or popliteal arteries (SFA/PA) of patients with symptomatic peripheral artery disease (PAD). Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Paclitaxel Coated Peripheral Angioplasty Balloon Catheter
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
120 participants
Where
3 sitesin 2 countries
Study dates
15 Sep 2024to 15 Sep 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

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

  • Age ≥ 18 years.
  • Written informed consent of the patient to participate in the study.
  • Symptoms of lower limb ischemia defined by Rutherford classification from 2 to 4.
  • At least one de novo or restenotic lesion, in SFA and/or PA defined as a lesion with a proximal origin >10mm from SFA origin and a distal end above the knee joint (at least 3 cm above bottom of the femur- P1).
  • Target Lesion >60% stenosis in the SFA or PA (based on angio-CT and/or confirmed in angiography).
  • Target Lesion <150 mm that consists of no more than two adjacent lesions ≤ 25mm apart and is able to be completely covered with inflation of single investigated PAK DCB (with minimum of >5mm proximal and distal margin.
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  • Note: Adjacent or tandem lesions must be treated as a single lesion.
  • Reference Vessel Diameter (RVD) between 4.0 and 8.0mm and within treatment range of PAK® DCB to be used 1:1 at the target lesion.
  • Angiographic evidence of distal run-off demonstrated by at least one patent tibial vessel without evidence of significant ≥50% angiographic stenosis from origin to ankle.
  • In-flow vessel (both iliac and femoral) without significant ≥50% angiographic stenosis or successful treatment (≤30% residual stenosis with no complications) of a diseased in-flow vessel at least 30 days prior to the index procedure.
  • Note: treatment of contralateral iliac arteries is allowed.

Who cannot join

  • Life expectancy less than 2 years.
  • Suspected or detected malignancy without completed treatment (not considered cured).
  • Planned surgical or interventional procedures within 30 days after the study procedure.
  • Known impaired renal function with GFR ≤30 mL/min per 1.73 m2 and/or elevated serum creatinine > 2.5mg/dL or on dialysis.
  • Active inflammatory process at the site of the planned puncture.
  • Acute lower limb ischemia.
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  • Non-atherosclerotic lesion (e.g. vasculitis, dysplasia).
  • Necessary concurrent non-target lesion interventions involving a re-entry device, atherectomy, laser, or ablation procedures, the use of a drug eluting stent, or treatment with any other drug coated balloon.
  • Massive calcifications of the treated lesion (defined as angiographic evidence of dense calcification present on both sides of the vessel wall on two orthogonal views and that extends >50 continuous mm in length; reflective 3 or 4 on the PACSS scale https://doi.org/10.1002%2Fccd.25387).
  • Angiographically confirmed presence of a thrombus in the target lesion.
  • The target lesion requiring primary stenting.
  • Presence of perforation, dissection (Type D or worse) or other injury in target vessel at time of enrollment.
  • Previous bypass graft or stent at target vessel (must be greater than 20mm from target lesion), or iliac stent that cannot permit crossing by the treatment balloon within the introducer sheath Note: In-stent restenosis is not allowed.
  • Gastrointestinal or any other major bleeding in the past three months.
  • Known bleeding disorder or uncontrolled hypercoagulable disorder.
  • Myocardial infarction or any stroke within 30 days prior to the procedure.
  • Known intolerance to required medications (especially antiplatelets and heparin), contrast media (that cannot be adequately pre-medicated), nitinol or paclitaxel.
  • Pregnant and childbearing age women not using effective contraception.
  • Participation in another investigational study (before completing primary endpoint analysis) or previous enrollment to this study.

Trial locations and contacts

3 sites in 2 countries. Contact the study team or a site near you to ask about taking part.

3 sites in 2 countries

Poland2 sites, 2 recruiting
  • Department of Vascular Surgery; Malopolska Cardiovascular Center; Polish-American Heart Clinics

    Chrzanów, Malopolska, 32-500

    Przemysław Nowakowski, Prof., (+48) 32 758 69 19, nowakowski.mcsn@gmail.com

    Recruiting
  • University Hospital Clinical Hospital No. 2 PUM in Szczecin, Department of General, Dental and Interventional Radiology

    Szczecin, West Pomeranian Voivodeship, 70-111

    Aleksander Falkowski, Prof., (+48) 603945465, bakhis@hot.pl

    Recruiting

Other trials in Poland

Spain1 site, 1 recruiting
  • Vascular Surgery Teaching Unit CardioVascular Institute Hospital Clinic University of Barcelona

    Barcelona, Barcelona, 08036

    Vincent Riambau, MD, PhD, (+34) 607958090, vriambau@clinic.cat

    Not yet recruiting

Other trials in Spain

About this study

The primary objective of the study is to evaluate the performance and the safety of the PAK® DCB Catheter in the treatment of de novo and restenotic atherosclerotic lesions in the superficial femoral and/or popliteal arteries (SFA/PA) of patients with symptomatic peripheral artery disease (PAD).

The study enrolls patients who have been diagnosed with peripheral artery disease with stenosis of the superficial femoral or popliteal artery and are qualified for endovascular revascularization.

Read more

Lower extremity peripheral artery disease may be asymptomatic or may be accompanied by clinical symptoms due to restricted blood flow to the lower extremities.

The management of a patient diagnosed with peripheral arteriosclerosis is primarily aimed at reducing symptoms of limb ischemia and improving blood supply to the limb, as well as seeking to halt the progression of the disease.

Treatment of lower extremity atherosclerosis with percutaneous methods is a well-known minimally invasive and recommended treatment for lower extremity ischemia.

A maximum of 120 patients will be included in the study. All patients included in the study will receive treatment with the investigational device.

The study will use the PAK balloon catheter, which is CE certified and approved for the treatment of patients with peripheral vascular disease. That is, it is also used as standard outside the study. The test procedure with the study device is in accordance with its registration and instructions for use.

Being tested
Paclitaxel Coated Peripheral Angioplasty Balloon Catheter
Keywords
Peripheral Artery Disease, Drug Coated Balloon
Medical subject headings
Peripheral Arterial Disease

What participants receive

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

  • Paclitaxel Coated Peripheral Angioplasty Balloon CatheterDevice

    Also called PAK®

    Paclitaxel coated peripheral angioplasty balloon catheters are catheters of "over the wire" (OTW) type. Distal part of the catheter consists of two channels. External channel is used for inflating the balloon, and internal channel is the guide wire. Catheter has two markers enabling precise determination of balloon position in the vessel. The balloon is covered with a coating POLIGRADE® and drug paclitaxel an amount to 2.5 µg/mm2 , which is eluting during balloon inflation. Paclitaxel belongs to alkaloids group from taxanes group. It is cytostatic and it inhibits the cell cycle in G2/M phase. By inhibiting division of cells and their migration, paclitaxel allows for limiting restenosis phenomenon. Paclitaxel selectively inhibits smooth myocytes proliferation, while the endothelium cells show higher resistance to its action. In addition, paclitaxel restricts inflammatory conditions in walls of the arteries after balloon angioplasty.

Study groups in NCT06734221
Study groupRoleWhat they receive
PAK DCB catheterExperimentalPeripheral revascularization procedure using a PAK DCB catheter covered with paclitaxel.
Receives: Device: Paclitaxel Coated Peripheral Angioplasty Balloon Catheter

What is being measured

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

  1. Safety - MAEs at 12 months

    Major Adverse Events (MAEs) at 12 months defined as the composite of: target-limb-related death, major amputation of the target limb and, re-intervention of the target limb.

    Measured: 12 months

  2. Efficacy-PAK DCB Success at 12 months, defined as primary patency (PP)

    PAK DCB Success at 12 months, defined as primary patency (PP) in the absence of clinically driven bail-out stenting (CDBOS), as defined below.

    Subjects with no CDBOS will be assessed for PP for the purposes of determining True DCB Success. Clinically Driven Bail-Out Stenting (CDBOS): Stents are considered clinically driven when the angiographic core lab determines that a stent was placed after DCB use during the index procedure under the following conditions that were not resolved by prolonged balloon inflation: •Unresolved flow limiting dissection (Type E or F), OR •Residual lumen diameter stenosis > 50% A subject with a CDBOS fails the True DCB success endpoint regardless of patency outcomes.

    Measured: 12 months

  3. Primary Patency: Subjects who will achieve primary patency by a combination of duplex ultrasound review and no evidence of clinically driven target lesion revascularization (CD-TLR) prior to the study required 12-month DUS as defined below:

    Duplex Ultrasound Review: A patent target lesion shows a Peak Systolic Velocity Ratio (PSVR) less than 2.5 by the Duplex Ultrasound DUS core lab or Clinically Driven Target Lesion Revascularization CD-TLR: any repeat percutaneous intervention of the target lesion or bypass surgery of the target vessel performed that was considered clinically driven when both of the following conditions were met: Worsening clinical based on an ankle-brachial index (ABI) decrease≥20%or>0.15 compared to maximum early postprocedure ABI or documented increase in Rutherford by at least one class if ABI change was unattainable. Angiographic core lab adjudication of the revascularization angiogram confirming that the target lesion prior to re-intervention demonstrated diameter stenosis >50%.

    Measured: 12 Month

Secondary outcomes (21)
  1. Technical success rate.

    Technical success rate defined as successful balloon insertion, balloon inflation and removal.

    Measured: During procedure

  2. Device success defined.

    Device success defined as ability to achieve optimal percutaneoustransluminal angioplasty (PTA) outcome (≤30% residual diameter stenosis in post-procedural angiography with no flow-limiting dissection at the target lesion).

    Measured: During procedure

  3. Procedural success.

    Procedural success defined as device success with no major complications. (death, myocardial infarction, amputation, stroke).

    Measured: Up to 3 days after index procedure

  4. Rate of CDBOS.

    Rate of Clinically Driven Bail-Out Stenting

    Measured: Up to 3 days after index procedure

  5. Primary Patency at 12 months.

    Primary Patency at 12 months, defined as target lesion restenosis as determined by DUS (PSVR < 2.5) and freedom from CD-TLR.

    Measured: 12 months

  6. Secondary Patency at 12 months.

    Secondary Patency at 12 months defined by a PSVR less than 2.5 on DUS regardless of the need for TLR.

    Measured: 12 months

  7. Freedom from clinically driven TLR at 30-day follow-up.

    Measured: 30 days

  8. Freedom from clinically driven TLR at 6-month follow-up.

    Measured: 6 months

  9. Freedom from clinically driven TLR at 12-month follow-up.

    Measured: 12 months

  10. Freedom from TVR at 30-day follow-up.

    Measured: 30 days

  11. Freedom from TVR at 6-month follow-up.

    Measured: 6 months

  12. Freedom from TVR at 12-month follow-up.

    Measured: 12 months

  13. All-cause mortality at 30-day follow-up.

    Measured: 30 days

  14. All-cause mortality at 6-month follow-up.

    Measured: 6 months

  15. All-cause mortality at 12-month follow-up.

    Measured: 12 months

  16. Major amputation rate at 30-day follow-up.

    Measured: 30 days

  17. Major amputation rate at 6-month follow-up.

    Measured: 6 months

  18. Major amputation rate at 12-month follow-up.

    Measured: 12 months

  19. Clinical improvement at 30-day follow-up.

    Clinical improvement at 30-day follow-up compared to the baseline, defined by Rutherford classification improved by at least one category if ABI improved by at least 20% or 0.15.

    Measured: 30 days

  20. Clinical improvement at 6-month follow-up.

    Clinical improvement at 6-month follow-up compared to the baseline, defined by Rutherford classification improved by at least one category if ABI improved by at least 20% or 0.15.

    Measured: 6 months

  21. Clinical improvement at 12-month follow-up.

    Clinical improvement at 12-month follow-up compared to the baseline, defined by Rutherford classification improved by at least one category if ABI improved by at least 20% or 0.15.

    Measured: 12 months

Timeline

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

  1. First posted16 Dec 2024
  2. Study start15 Sep 2024
  3. Primary completion15 Sep 2026 (estimated)
  4. Study completion15 Sep 2026 (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 N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
120 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06734221
Sponsor's protocol ID
24-BAL-0001
Acronym
STAR-PAK
Status last verified
Dec 2024
First submitted
3 Dec 2024
Last updated
16 Dec 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Buszman PP, Nowakowski P, Milewski K, Orlik B, Zurakowski A, Ludyga T, Polczyk F, Debinski M, Jelonek M, Kachel M, Gasior M, Granada JF, Kiesz RS, Buszman PE. Clinical Randomized Trial Evaluating Novel, Microcrystalline, and Biocompatible Polymer Paclitaxel-Coated Balloon for the Treatment of Femoropopliteal Occlusive Disease: The BIOPAC Trial. JACC Cardiovasc Interv. 2018 Dec 10;11(23):2436-2438. doi: 10.1016/j.jcin.2018.07.029. No abstract available.

    PubMed 30522679

Questions about this trial

What is this clinical trial studying?

A study testing Paclitaxel Coated Peripheral Angioplasty Balloon Catheter in people with Popliteal Artery Stenosis Above the Knee and Peripheral Artery Disease, run by Balton Sp.zo.o. at 3 sites in 2 countries.

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 11 inclusion and 19 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: looking for participants now, as of the sponsor's last update on 16 Dec 2024. 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 Poland, Spain. 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.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

Contact Elżbieta Sojka ((+48) 22 597 44 43, elzbieta.sojka@balton.pl), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Safety - MAEs at 12 months (time frame: 12 months). The study lists 3 primary outcomes in all. 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 NCT06734221, which also lists 1 linked publication.

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 Dec 2024.

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