Chronic Limb Threatening IschemiaNCT07175129
Transverse Tibial Transport for Chronic Limb-Threatening Ischemia (CLTI)
A study testing Transverse Tibial Bone Transport and TrueLok Elevate in people with Chronic Limb Threatening Ischemia, run by University Hospitals Cleveland Medical Center at 1 site in United States.
Trial summary
Chronic limb-threatening ischemia (CLTI) is a serious condition that happens when blood flow to the legs or feet is severely reduced. This can lead to constant pain, wounds that don't heal, infections, and in some cases, the need for amputation. Read more about this study
- Who is it for?
- Ages 18 to 95 years
- Conditions the study is for
- Chronic Limb Threatening Ischemia
- What is being tested?
- Transverse Tibial Bone Transport and TrueLok Elevate
- Type of treatment
- Medical device, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 0 participants
- Where
- 1 siteUnited States
- Study dates
- 5 Jan 2026to Jun 2027
- Phase
- Interventional
- 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 to 95 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age above 18 years and under 95 years
- History of diabetes mellitus with stable glycemic control (HbA1C<10)
- Clinical diagnosis of chronic limb-threatening ischemia
- Stable Rutherford Classification 5 or 6 ischemic ulcer on foot
- Subjects who are determined by an independent multidisciplinary team of surgical and endovascular experts to have no feasible conventional distal bypass surgical or endovascular therapy for limb salvage.
- Subjects who are enrolled in an appropriate wound care network and have a sufficient support system to ensure compliance with medication regimens and follow-up study visits.
- Subjects who are willing and able to provide informed consent
Who cannot join
- Frailty or severe comorbidities including significantly reduced cardiac, hepatic, renal and respiratory insufficiency making the subject not fit for surgery
- Active malignancy or immunodeficiency disorder
- Previous major amputation of the target limb or presence of a wound requiring a free flap
- Life expectancy less than 12 months
- Active infection at the time of the index procedure
- Any significant concurrent medical, psychological, or social condition that, in the opinion of the investigator, may substantially interfere with the subject's optimal participation in the study.
Show all 9Show fewer
- Pregnancy at the time of enrolment
- The subject participating in another investigational drug or device study that has not completed its primary endpoint or clinically interferes with the endpoints of this study.
- The subject is unwilling or unable to comply with any protocol or follow-up requirements.
Trial locations and contacts
1 site in 1 country.
United States1 site
University Hospitals Cleveland Medical Center
Cleveland, Ohio, 44106
About this study
Official title: Transverse Tibial Bone Transport in "No Option" Patients With Chronic Limb-Threatening Ischemia: A Pilot Study
Chronic limb-threatening ischemia (CLTI) is a serious condition that happens when blood flow to the legs or feet is severely reduced. This can lead to constant pain, wounds that don't heal, infections, and in some cases, the need for amputation.
Some people with CLTI have such severe artery disease that doctors are unable to restore blood flow using standard treatments like surgery or stents. For these patients, major amputation may be the only remaining option.
This study aims to test a new surgical technique called transverse tibial bone transport, which has been shown in some previous small studies to help improve blood flow and promote healing of wounds in the legs and feet. These early studies suggest that the procedure may help wounds heal better and reduce the need for amputation in people with severe circulation problems. This research will help us learn more about how safe and effective this technique is for patients who have no other treatment options other than amputation.
- Conditions
- Chronic Limb Threatening Ischemia
- Being tested
- Transverse Tibial Bone Transport, TrueLok Elevate
- Keywords
- peripheral artery disease, Diabetic Foot
- Medical subject headings
- Chronic Limb-Threatening Ischemia, Peripheral Arterial Disease, Diabetic Foot
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Transverse Tibial Bone TransportProcedure or surgery
Tibial tibial bone transport is a novel surgical procedure that involves the gradual movement of a bone segment in order to improve perfusion and tissue healing.
TrueLok ElevateDevice
This device is used to move the bone segment as a part of the tibial bone transport surgery.
| Study group | Role | What they receive |
|---|---|---|
| Transverse Tibial Bone Transport Patients | Experimental | Patients in this arm will undergo transverse tibial bone transport Receives: Procedure: Transverse Tibial Bone Transport; Device: TrueLok Elevate |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of patients avoiding major amputation
major amputation refers to the surgical removal of a limb anywhere above the ankle joint
Measured: Up to 6 months post surgery
Percentage of patients achieving complete wound healing as measured by the direct wound observation
Measured: Up to 6 months post surgery
Percentage of patients achieving a decrease in the Rutherford classification measured by direct observation
The Rutherford wound classification is an observational technique to assess the severity of peripheral artery disease of the lower limb on a scale of 0 being asymptomatic to 6 being major tissue loss.
Measured: Up to 6 months post surgery
Changes in lower extremity arterial perfusion measured by ankle-brachial index and toe-brachial index
The Ankle-Brachial Index (ABI) and Toe-Brachial Index (TBI) are noninvasive measures of lower-extremity arterial perfusion, calculated as the ratio of the highest systolic blood pressure at the ankle or great toe, respectively, to the highest systolic blood pressure at the brachial artery. Lower ABI and TBI values on indicate greater arterial obstruction.
Measured: 1 month, 3 months, and 6 months post surgery
Secondary outcomes (4)
Changes in pain measured by the Visual Analog Scale
The Visual Analogue Scale (VAS) is a simple tool used to measure the intensity of pain. It typically consists of a 100 mm horizontal line anchored by two extremes, such as "No pain" on the left and "Worst imaginable pain" on the right.
Participants mark a point along the line that best represents their experience, and the distance from the "no pain" end to the mark is measured in millimeters to produce a score from 0 to 100.
Measured: 1 week, 2 weeks, 1 month, 2 months, 3 months, and 6 months post surgery
Changes in lower extremity neuropathy measured by Semmes-Weinstein Monofilament Test
The Semmes-Weinstein Monofilament Test is a standardized assessment of light touch and protective sensation using calibrated nylon filaments, with inability to perceive the 10-gram (5.07) monofilament at specified sites indicating loss of protective sensation.
Measured: 1 week, 2 weeks, 1 month, 2 months, 3 months, and 6 months post surgery
Changes in quality of life measured by the Short Form-36 (SF-36) scores
The Short Form-36 (SF-36) Health Survey is a validated 36-item questionnaire assessing eight domains of health-related quality of life, with scores for each domain ranging from 0 to 100, where higher scores indicate better perceived health status.
Measured: 1 month, 2 months, 3 months, and 6 months post surgery
Percentage of patients experiencing adverse outcomes
All adverse outcomes and complications directly attributable to the transverse tibial bone transport procedure.
Measured: Up to 6 months post surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Sep 2025
- Study start5 Jan 2026
- Primary completionJun 2027 (estimated)
- Study completionJun 2027 (estimated)
Why it stopped: Closed due to slow enrollment.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (7)Papers the sponsor has linked to this study.
- Other trials for Chronic Limb Threatening IschemiaStudies of the same condition, open and under way.
- More trials run by University Hospitals Cleveland Medical CenterThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Device feasibility
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 0 participants (actual)
Sponsor and investigators
- Lead sponsor
- University Hospitals Cleveland Medical Center
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07175129
- Sponsor's protocol ID
- STUDY20250771
- Status last verified
- May 2026
- First submitted
- 14 Sep 2025
- Last updated
- 29 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- Yes
- Individual data sharing
- No
Publications
Yang AA, Park N, Gazes MI, Samchukov M, Frumberg DB. Transverse tibial bone transport for non-healing heel wound: A case report. Int J Surg Case Rep. 2024 Nov;124:110400. doi: 10.1016/j.ijscr.2024.110400. Epub 2024 Oct 2.
PubMed 39369454Wen R, Cheng X, Cao H, Zhang L, Luo F, Shang W. Transverse Tibial Bone Transfer in the Treatment of Diabetes Foot Ulcer: A Pilot Study. Diabetes Metab Syndr Obes. 2023 Jul 3;16:2005-2012. doi: 10.2147/DMSO.S413884. eCollection 2023.
PubMed 37427081Yu L, Zhang D, Yin Y, Li X, Bai C, Zhou Q, Liu X, Tian X, Xu D, Yu X, Zhao S, Hu R, Guo F, Yang Y, Ren Y, Chen G, Zeng J, Feng J. Tibial cortex transverse transport surgery improves wound healing in patients with severe type 2 DFUs by activating a systemic immune response: a cross-sectional study. Int J Surg. 2025 Jan 1;111(1):257-272. doi: 10.1097/JS9.0000000000001897.
PubMed 38954658Zuo Q, Gao F, Song H, Zhou J. Application of Ilizarov transverse tibial bone transport and microcirculation reconstruction in the treatment of chronic ischemic diseases in lower limbs. Exp Ther Med. 2018 Aug;16(2):1355-1359. doi: 10.3892/etm.2018.6321. Epub 2018 Jun 18.
PubMed 30116386Ou S, Xu C, Yang Y, Chen Y, Li W, Lu H, Li G, Sun H, Qi Y. Transverse Tibial Bone Transport Enhances Distraction Osteogenesis and Vascularization in the Treatment of Diabetic Foot. Orthop Surg. 2022 Sep;14(9):2170-2179. doi: 10.1111/os.13416. Epub 2022 Aug 10.
PubMed 35946439Hu XX, Xiu ZZ, Li GC, Zhang JY, Shu LJ, Chen Z, Li H, Zou QF, Zhou Q. Effectiveness of transverse tibial bone transport in treatment of diabetic foot ulcer: A systematic review and meta-analysis. Front Endocrinol (Lausanne). 2023 Jan 4;13:1095361. doi: 10.3389/fendo.2022.1095361. eCollection 2022.
PubMed 36686461Liu J, Yao X, Xu Z, Wu Y, Pei F, Zhang L, Li M, Shi M, Du X, Zhao H. Modified tibial cortex transverse transport for diabetic foot ulcers with Wagner grade >/= II: a study of 98 patients. Front Endocrinol (Lausanne). 2024 Jan 22;15:1334414. doi: 10.3389/fendo.2024.1334414. eCollection 2024.
PubMed 38318295
Study at a glance
From the registry record, last updated by the sponsor on 29 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Transverse Tibial Bone Transport in "No Option" Patients With Chronic Limb-Threatening Ischemia: A Pilot Study
- ClinicalTrials.gov ID
- NCT07175129
- Acronym / sponsor ID
- STUDY20250771
- Conditions
- Chronic Limb Threatening Ischemia
- Keywords
- peripheral artery disease, Diabetic Foot
- Study type
- Interventional
- Recruitment status
- WithdrawnReason stopped: Closed due to slow enrollment.
- Enrolment
- 0 participants (actual)
- Lead sponsor
- University Hospitals Cleveland Medical CenterUniversity, hospital or other
- Study start
- 5 Jan 2026 (actual)
- Primary completion
- Jun 2027 (estimated)
- Study completion
- Jun 2027 (estimated)
- First posted
- 16 Sep 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Chronic limb-threatening ischemia (CLTI) is a serious condition that happens when blood flow to the legs or feet is severely reduced. This can lead to constant pain, wounds that don't heal, infections, and in some cases, the need for amputation.
Some people with CLTI have such severe artery disease that doctors are unable to restore blood flow using standard treatments like surgery or stents. For these patients, major amputation may be the only remaining option.
This study aims to test a new surgical technique called transverse tibial bone transport, which has been shown in some previous small studies to help improve blood flow and promote healing of wounds in the legs and feet. These early studies suggest that the procedure may help wounds heal better and reduce the need for amputation in people with severe circulation problems. This research will help us learn more about how safe and effective this technique is for patients who have no other treatment options other than amputation.
Study design
- Primary purpose
- Device feasibility
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Transverse Tibial Bone Transport Patients | Experimental | Procedure: Transverse Tibial Bone Transport, Device: TrueLok ElevatePatients in this arm will undergo transverse tibial bone transport |
Who may qualify
- Ages
- 18 to 95 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- Age above 18 years and under 95 years
- History of diabetes mellitus with stable glycemic control (HbA1C<10)
- Clinical diagnosis of chronic limb-threatening ischemia
- Stable Rutherford Classification 5 or 6 ischemic ulcer on foot
- Subjects who are determined by an independent multidisciplinary team of surgical and endovascular experts to have no feasible conventional distal bypass surgical or endovascular therapy for limb salvage.
Key exclusion criteria (9 listed)
- Frailty or severe comorbidities including significantly reduced cardiac, hepatic, renal and respiratory insufficiency making the subject not fit for surgery
- Active malignancy or immunodeficiency disorder
- Previous major amputation of the target limb or presence of a wound requiring a free flap
- Life expectancy less than 12 months
- Active infection at the time of the index procedure
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Transverse Tibial Bone TransportTibial tibial bone transport is a novel surgical procedure that involves the gradual movement of a bone segment in order to improve perfusion and tissue healing. | Procedure or surgery | Transverse Tibial Bone Transport Patients |
| TrueLok ElevateThis device is used to move the bone segment as a part of the tibial bone transport surgery. | Device | Transverse Tibial Bone Transport Patients |
Primary outcome
Percentage of patients avoiding major amputation
Time frame: Up to 6 months post surgery
major amputation refers to the surgical removal of a limb anywhere above the ankle joint
Percentage of patients achieving complete wound healing as measured by the direct wound observation
Time frame: Up to 6 months post surgery
Percentage of patients achieving a decrease in the Rutherford classification measured by direct observation
Time frame: Up to 6 months post surgery
The Rutherford wound classification is an observational technique to assess the severity of peripheral artery disease of the lower limb on a scale of 0 being asymptomatic to 6 being major tissue loss.
Changes in lower extremity arterial perfusion measured by ankle-brachial index and toe-brachial index
Time frame: 1 month, 3 months, and 6 months post surgery
The Ankle-Brachial Index (ABI) and Toe-Brachial Index (TBI) are noninvasive measures of lower-extremity arterial perfusion, calculated as the ratio of the highest systolic blood pressure at the ankle or great toe, respectively, to the highest systolic blood pressure at the brachial artery. Lower ABI and TBI values on indicate greater arterial obstruction.
4 secondary outcomes
Changes in pain measured by the Visual Analog Scale
Time frame: 1 week, 2 weeks, 1 month, 2 months, 3 months, and 6 months post surgery
Changes in lower extremity neuropathy measured by Semmes-Weinstein Monofilament Test
Time frame: 1 week, 2 weeks, 1 month, 2 months, 3 months, and 6 months post surgery
Changes in quality of life measured by the Short Form-36 (SF-36) scores
Time frame: 1 month, 2 months, 3 months, and 6 months post surgery
Percentage of patients experiencing adverse outcomes
Time frame: Up to 6 months post surgery
Results and safety
The study was withdrawn before enrolling participants, so there are no results.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 May 2026.
- Background: PubMed 39369454Yang AA, Park N, Gazes MI, Samchukov M, Frumberg DB. Transverse tibial bone transport for non-healing heel wound: A case report. Int J Surg Case Rep. 2024 Nov;124:110400. doi: 10.1016/j.ijscr.2024.110400. Epub 2024 Oct 2.
- Background: PubMed 37427081Wen R, Cheng X, Cao H, Zhang L, Luo F, Shang W. Transverse Tibial Bone Transfer in the Treatment of Diabetes Foot Ulcer: A Pilot Study. Diabetes Metab Syndr Obes. 2023 Jul 3;16:2005-2012. doi: 10.2147/DMSO.S413884. eCollection 2023.
- Background: PubMed 38954658Yu L, Zhang D, Yin Y, Li X, Bai C, Zhou Q, Liu X, Tian X, Xu D, Yu X, Zhao S, Hu R, Guo F, Yang Y, Ren Y, Chen G, Zeng J, Feng J. Tibial cortex transverse transport surgery improves wound healing in patients with severe type 2 DFUs by activating a systemic immune response: a cross-sectional study. Int J Surg. 2025 Jan 1;111(1):257-272. doi: 10.1097/JS9.0000000000001897.
- Background: PubMed 30116386Zuo Q, Gao F, Song H, Zhou J. Application of Ilizarov transverse tibial bone transport and microcirculation reconstruction in the treatment of chronic ischemic diseases in lower limbs. Exp Ther Med. 2018 Aug;16(2):1355-1359. doi: 10.3892/etm.2018.6321. Epub 2018 Jun 18.
- Background: PubMed 35946439Ou S, Xu C, Yang Y, Chen Y, Li W, Lu H, Li G, Sun H, Qi Y. Transverse Tibial Bone Transport Enhances Distraction Osteogenesis and Vascularization in the Treatment of Diabetic Foot. Orthop Surg. 2022 Sep;14(9):2170-2179. doi: 10.1111/os.13416. Epub 2022 Aug 10.
- Background: PubMed 36686461Hu XX, Xiu ZZ, Li GC, Zhang JY, Shu LJ, Chen Z, Li H, Zou QF, Zhou Q. Effectiveness of transverse tibial bone transport in treatment of diabetic foot ulcer: A systematic review and meta-analysis. Front Endocrinol (Lausanne). 2023 Jan 4;13:1095361. doi: 10.3389/fendo.2022.1095361. eCollection 2022.
- Background: PubMed 38318295Liu J, Yao X, Xu Z, Wu Y, Pei F, Zhang L, Li M, Shi M, Du X, Zhao H. Modified tibial cortex transverse transport for diabetic foot ulcers with Wagner grade >/= II: a study of 98 patients. Front Endocrinol (Lausanne). 2024 Jan 22;15:1334414. doi: 10.3389/fendo.2024.1334414. eCollection 2024.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Transverse Tibial Bone Transport and TrueLok Elevate in people with Chronic Limb Threatening Ischemia, run by University Hospitals Cleveland Medical Center at 1 site in United States.
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 7 inclusion and 9 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: withdrawn, as of the sponsor's last update on 29 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. 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?
The study was withdrawn before enrolling participants, so there are no results.
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?
Percentage of patients avoiding major amputation (time frame: Up to 6 months post surgery). The study lists 4 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 NCT07175129, which also lists 7 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 29 May 2026.