Clinical trial NCT02648620: Safety and Feasibility of SurModics SurVeil (TM) Drug Coated Balloon
Official title: A Prospective, Multi-Center, Single-Arm Trial to Assess the Safety and Feasibility of the SurModics Drug Coated Balloon in the Treatment of Subjects With De Novo Lesions of the Femoropopliteal Artery
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Peripheral Arterial Disease
Peripheral Vascular Diseases
Keywords: Paclitaxel
Percutaneous Transluminal Angioplasty
PAD
Peripheral Artery Disease
Pharmacokinetics
Lead sponsor: SurModics, Inc.
Sponsor class: INDUSTRY
First posted: 2016-01-07
Enrollment: 13
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: PREVEIL is a prospective, multi-center, single-arm clinical trial to assess the safety and functionality of the SurModics drug coated balloon (DCB) in the treatment of subjects with symptomatic peripheral artery disease (PAD) due to de novo stenoses of the femoral and popliteal arteries. The trial will enroll up to 15 subjects.

Detailed description: PREVEIL will enroll patients presenting with angiographic evidence of significant stenosis in the femoral or popliteal arteries. All enrolled subjects will be treated with the SurVeil DCB.

Eligibility criteria: Inclusion Criteria:

Subjects must meet all of the following criteria to participate in the trial:

* Subject is ≥ 18 years.
* Subject has lifestyle-limiting claudication or rest pain with Rutherford classification 2, 3 or 4.
* Subject has provided written informed consent.
* Subject is willing to comply with study follow-up requirements.
* A de novo target lesion in the femoral or popliteal arteries.
* Target lesion must have angiographic evidence of ≥ 50% stenosis by operator visual estimate.
* Target lesion must be ≤ 90 mm in length (one long lesion or multiple serial lesions) by operator visual estimate. Note: Multiple serial lesions are allowed provided that they can be treated as a single lesion with one balloon.
* Target vessel must have an reference vessel diameter (RVD) of 4 mm to 6 mm by operator visual estimate.
* After pre-dilatation, the target lesion is ≤ 70% residual stenosis, absence of a flow limiting dissection and treatable with a single balloon (lesion length ≤90 mm, limited to 100-mm balloon in EFS).
* A patent inflow artery free from significant stenosis (≥ 50% stenosis) as confirmed by angiography.
* At least one patent native outflow artery to the ankle or foot, free from significant stenosis (≥ 50% stenosis) as confirmed by angiography.

Exclusion Criteria:

Subjects will be excluded from the trial if any of the following criteria are met:

* Subject has acute limb ischemia.
* Subject has Rutherford classification of 0, 1, 5 or 6.
* Subject previously underwent any lower extremity percutaneous transluminal angioplasty (PTA) using a DCB within 3 months.
* Subject has had prior vascular intervention within 2 weeks before the planned study index procedure or subject has planned vascular intervention within 30 days after the study index procedure.
* Subject is pregnant and/or breast-feeding or intends to become pregnant during the time of the study OR subject is a male intending to father children within 60 days of index procedure.
* Life expectancy less than 2 years.
* Subject has a known allergy to contrast medium that cannot be adequately pre-medicated.
* Subject is allergic to ALL antiplatelet treatments.
* Subject has impaired renal function (i.e. serum creatinine level ≥ 2.5 mg/dl).
* Subject is dialysis dependent.
* Subject is receiving immunosuppressant therapy.
* Subject has known or suspected active infection at the time of the index procedure.
* Subject has platelet count \< 100,000/mm3 or \> 700,000/mm3.
* Subject has white blood cell (WBC) count \< 3,000/mm3.
* Subject has history of gastrointestinal hemorrhage requiring a transfusion within 3 months prior to the index procedure.
* Subject is diagnosed with coagulopathy that precludes treatment with systemic anticoagulation and/or dual antiplatelet therapy (DAPT).
* Subject is unable to tolerate blood transfusions because of religious beliefs or other reasons.
* Subject is unwilling or unable to comply with procedures specified in the protocol or has difficulty or inability to return for follow-up visits as specified by the protocol.
* Subject is known to be incarcerated, mentally incompetent and/or an alcohol or drug abuser.
* Subject is participating in another investigational drug or medical device study that has not completed primary endpoint(s) evaluation or that clinically interferes with the endpoints from this study, or subject is planning to participate in such studies prior to the completion of this study.
* Subject has had major surgical or interventional procedures unrelated to this study within 30 days prior to this study or has planned surgical or interventional procedures within 30 days of entry into this study.
* Previous intervention at the lesion site including previous stenting within 3 cm of the target lesion or previous bypass surgery of the target lesion.
* Previous treatment of the target vessel with thrombolysis or surgery.
* Severe concentric calcification of the target lesion.
* Target lesion involves an aneurysm or is adjacent to an aneurysm.
* Target lesion requires treatment with alternative therapy such as stenting, laser, atherectomy, cryoplasty, brachytherapy or re-entry devices.
* Significant vessel tortuosity or other parameters prohibiting access to the target lesion.
* Presence of thrombus in the target vessel.
* Iliac inflow disease requiring treatment , unless the iliac artery disease is successfully treated first during the index procedure. Success is defined as ≤ 30% residual diameter stenosis without death or major complications.
* Absence of at least one patent native outflow artery.
* Presence of an aortic, iliac or femoral artificial graft.
* Failure to cross the target lesion with a guide wire. Successful crossing of the target lesion occurs when the tip of the guide wire is distal to the target lesion without the occurrence of flow-limiting dissection or perforation.
* Failure to successfully pre-dilate the target lesion. Successful pre-dilatation is defined as residual stenosis ≤ 70% with no flow-limiting dissection.

Primary outcomes:
measure: Peak paclitaxel plasma concentration
timeFrame: Up to 30 days
Secondary outcomes:
measure: Area under the drug concentration time curve
timeFrame: Up to 30 days
measure: Technical success
timeFrame: At procedure
measure: Device success
timeFrame: At procedure
measure: Procedure success
timeFrame: At procedure up to 12 hours
measure: Resting ankle brachial index
timeFrame: within 90 days of index procedure, and at 6, 12, 24 and 36 months post-index procedure
measure: Change in Rutherford classification
timeFrame: baseline, 30 days, 6, 12, 24, and 36 months
measure: Change in 6-minute walk test
timeFrame: baseline, 30 days, 6, 12, 24, and 36 months
measure: Primary patency
timeFrame: 6 months
measure: Continuous DUS Peak systolic velocity ratio (PSVR) as measured by Duplex ultrasound
timeFrame: 30 days, 6, 12, 24, and 36 months
measure: Late lumen loss
timeFrame: baseline, 6 months
measure: Quality of life
timeFrame: baseline, 30 days, 6, 12, 24, and 36 months
measure: Evidence of Paclitaxel toxicity
timeFrame: At hospital discharge, 30 days
measure: Major vascular complications
timeFrame: At hospital discharge, 30 days
measure: Thrombolysis in Myocardial Infarction (TIMI)-defined major and minor bleeding
timeFrame: At hospital discharge, 30 days
measure: Major adverse events
timeFrame: 30 days, 6, 12, 24, and 36 months
measure: All-cause death
timeFrame: 30 days, 6, 12, 24, and 36 months
measure: Index limb above the ankle amputation
timeFrame: 30 days, 6, 12, 24, and 36 months
measure: Index limb below the ankle amputation
timeFrame: 30 days, 6, 12, 24, and 36 months
measure: Clinically-driven TLR
timeFrame: 30 days, 6, 12, 24, and 36 months
measure: Clinically-driven target vessel revascularization (TVR)
timeFrame: 30 days, 6, 12, 24, and 36 months
measure: Arterial thrombosis of the treated segment on angiography
timeFrame: 30 days, 6, 12, 24, and 36 months
measure: Embolic events of the index limb
timeFrame: 30 days, 6, 12, 24, and 36 months
Other outcomes:
Locations:
city: Raleigh
country: United States
facility: NC Heart and Vascular Research
state: North Carolina
city: Columbus
country: United States
facility: OhioHealth Research Institute
state: Ohio
city: Kingsport
country: United States
facility: Wellmont Health System
state: Tennessee
Study officials:
affiliation: Wellmont CVA Heart Institute
name: Christopher Metzger, MD, FACC, FSCAI
role: PRINCIPAL_INVESTIGATOR
References: