Endovascular Treatment of Peripheral Artery Disease

Study Overview
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Brief Summary
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The purpose of this observational study is to evaluate the performance and safety of endovascular treatment with stenting (Optimed Sinus Superflex 635) or balloon angioplasty (Cardionovum Legflow or Optimed Nylotrack .035 + .018) according to current practice. The goal of the study will be achieved by assessing binary restenosis with duplex ultrasound, peri- and postoperative complications, technical success, target lesion revascularization, amputation and clinical outcome.

Official Title
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Endovascular Treatment of Peripheral Artery Disease

Conditions
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Peripheral Arterial Disease, Iliac Artery Disease, Below-the-knee Obstruction, Femoropopliteal Occlusive Disease

Intervention / Treatment
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* Device: stent or balloon


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient must sign the informed consent form prior to the index-procedure. Patient is older than 18 years. Patient is compliant with the requested follow-up visits at week 6 and month 12 and the treatment regime. Patient suffers from intermittent claudication (Rutherford 2-3) or critical limb ischemia (Rutherford 4-5). Target lesion is an occlusion or diameter stenosis is ≥70% by visual estimate. Target lesion is located in the common and external iliac artery, in the common and superficial femoral artery, popliteal artery and/or the below-the-knee (BTK) arteries (anterior tibial artery, posterior tibial artery or peroneal artery) . Exclusion Criteria: Patients with Rutherford 0, 1 and 6. Patient is pregnant. Patients with serum creatinine >2.0 mg/dL or renal dialysis. Patient has an acute thrombus or aneurysm in the target arteries. Patient has a life expectancy of <12 months. Patient with bypass that involves the target arteries. Patient has a target lesion that cannot be crossed with a guidewire. Patient suffers from acute limb ischemia defined as any sudden decrease in limb perfusion causing a potential threat to limb viability. Patient has scheduled elective non-vascular procedures within 3 months after index-procedure. Vascular procedures are allowed within 3 months after the index-procedure if it is guaranteed that acetylic salicylic acid and clopidogrel intake is not interrupted. Contraindication for anti-thrombotic therapy (coagulopathy, …). Patient has a known intolerance to anti-thrombotic medication or contrast agents.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients with peripheral artery disease<br>located in the common and external iliac artery, the common and superficial femoral artery, the popliteal artery and/or the below-the-knee (BTK) arteries (anterior tibial artery, posterior tibial artery or peroneal artery). | Device: stent or balloon<br>* Endovascular treatment with stent or balloon according to current practice<br>* Other names: Optimed Nylotrack .035 + .018 balloons;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Binary restenosis | Binary restenosis defined as ≥ 50% re-obstruction of the target lesion will be assessed by duplex ultrasound (peak systolic ratio >2.4) | at 12 months follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Device-related complications | Registration of peri- and early/late postoperative complications | up to 12 months follow-up | 
| Immediate procedural outcome | The combination of technical success defined as a successful access and deployment of the device and achievement of a final residual diameter stenosis of <30% of the treated target lesion on the procedural completion angiography. and procedural success defined as a combination of technical success and absence of procedural complications. | up to 12 months follow-up | 
| Clinical outcome | Rutherford classification | at baseline | 
| Clinical outcome | Rutherford classification | at 6 weeks follow-up | 
| Clinical outcome | Rutherford classification | at 12 months follow-up | 
| Primary sustained clinical improvement | defined as sustained upward shift of ≥ 1 category on Rutherford classification without the need for repeated TLR in surviving patients. | at 12 months follow-up | 
| Secondary sustained clinical improvement | defined as sustained upward shift of ≥ 1 category on Rutherford classification including the need for repeated TLR in surviving patients. | at 12 months follow-up | 
| Target lesion revascularization (TLR) | defined as an endovascular or surgical treatment due to a problem arising from the lesion (+1cm proximally and distally to include edge phenomena). | up to 12 months follow-up | 
| Mortality | Procedure-related and all-cause mortality. | up to 12 months follow-up | 
| Amputation | minor amputation defined as below the ankle and major defined as above the ankle. | up to 12 months follow-up | 
| Stent fracture | Only if restenosis occurs, stent fracture will be examined (when Optimed Sinus Superflex 635 stent is used). | up to 12 months follow-up |