4-EVER : a Trial Investigating the Safety of 4F Endovascular Treatment of Infra-Inguinal Arterial Stenotic Disease
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Purpose
The objective of this clinical investigation is to evaluate puncture site complication rate as well as the short- and long-term (up to 24 months) outcome of treatment by means of Astron Pulsar / Astron Pulsar-18 stent implantation in symptomatic (Rutherford 2-4) femoro-popliteal arterial stenotic or occlusive lesions, using 4F compatible devices of BIOTRONIK and without the use of a closure device.
The hypothesis is that the primary patency at 12 months is non-inferior to the primary patency obtained in the Durability study (72.2%).
| Condition | Intervention | Phase |
|---|---|---|
|
Peripheral Vascular Disease Claudication |
Device: 4F portfolio products from Biotronik |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | 4-EVER Study - Physician-Initiated Trial Investigating the Safety of the Full 4F Endovascular Treatment Approach of Infra-Inguinal Arterial Stenotic Disease |
- Primary patency at 12 months as indicated by an independently verified duplex ultrasound peak systolic velocity ratio (PSVR) <2.5 in the target vessel with no reintervention [ Time Frame: 12 months ] [ Designated as safety issue: No ]Primary patency at 12 months, defined as freedom from >50% restenosis
- Technical success [ Time Frame: procedure (day 0) ] [ Designated as safety issue: No ]Technical success, defined as the ability to cross and stent the lesion to achieve residual angiographic stenosis no greater than 30% and residual stenosis less than 50% by duplex imaging.
- Puncture site complications [ Time Frame: 10 days ] [ Designated as safety issue: No ]Number of puncture site complications in the absence of a closure device after intervention
- Primary patency [ Time Frame: 6- & 24-month follow-up ] [ Designated as safety issue: No ]Primary patency rate at 6- & 24-month follow-up, defined as freedom from >50% restenosis at 6 & 24 months as indicated by an independently verified duplex ultrasound peak systolic velocity ratio (PSVR) <2.5 in the target vessel with no reintervention.
- Clinical success [ Time Frame: 6-, 12- & 24-month follow-up ] [ Designated as safety issue: No ]Clinical success at follow-up is defined as an improvement of Rutherford classification at 6-, 12- & 24-month follow-up of one class or more as compared to the pre-procedure
- Stent fracture rate at 12- & 24-month follow-up [ Time Frame: 12- & 24-month follow-up ] [ Designated as safety issue: No ]
Stent fracture rate at 12- & 24-month follow-up (in patient who were treated with stentplacement), as determined according the following classification on x-ray:
- Class 0 : no strut factures
- Class I : single tine fracture
- Class II : multiple tine factures
- Class III : Stent fracture(s) with preserved alignment of the components
- Class IV : Stent fracture(s) with mal-alignment of the components
- Class V : Stent fracture(s) in a trans-axial spiral configuration
| Estimated Enrollment: | 120 |
| Study Start Date: | July 2010 |
| Estimated Study Completion Date: | May 2013 |
| Primary Completion Date: | May 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
4F portfolio products from Biotronik
The devices under investigation are the 4F portfolio products from Biotronik: Astron pulsar / Astron Pulsar-18, Fortress, Passeo-18 and Cruiser-18.
|
Device: 4F portfolio products from Biotronik
4F portfolio products from Biotronik: Astron pulsar / Astron Pulsar-18, Fortress, Passeo-18, Cruiser-18
Other Names:
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- De novo, restenotic or reoccluded lesion located in the femoropopliteal arteries suitable for endovascular treatment
- Patient presenting with a score from 2 to 4 according to the Rutherford classification
- Patient is willing to comply with specified follow-up evaluations at the predefined time intervals times
- Patient is >18 years old
- Patient understands the nature of the procedure and provides written informed consent, prior to enrollment in the study
- Prior to enrollment, the target lesion was crossed with standard guidewire manipulation
- Patient is eligible for treatment with 4F compatible devices
Angiographic Inclusion Criteria:
- The target lesions are located within the native superficial femoral artery: Distal point 3 cm above knee joint and 1 cm below the origin of the profunda femoralis.
- The target lesion has angiographic evidence of stenosis or restenosis > 50% or occlusion
- Length of the target lesion is =20 cm by visual estimation and can be covered with one stent
- Target vessel diameter visually estimated is =4 mm and =6.5 mm
- There is angiographic evidence of at least one-vessel-runoff to the foot
Exclusion Criteria:
- Presence of another stent in the target vessel that was placed during a previous procedure
- Presence of an aortic thrombosis or significant common femoral ipsilateral stenosis
- Previous bypass surgery in the same limb
- Patients contraindicated for antiplatelet therapy, anticoagulants or thrombolytics
- Patients who exhibit persistent acute intraluminal thrombus at the target lesion site
- Perforation at the angioplasty site evidenced by extravasation of contrast medium
- Patients with known hypersensitivity to nickel-titanium
- Patients with uncorrected bleeding disorders
- Female patient with child bearing potential not taking adequate contraceptives or currently breastfeeding
- Life expectancy of less than 12 months
- Ipsilateral iliac artery treatment before target lesion treatment with a residual stenosis > 30%
- Use of thrombectomy, atherectomy or laser devices during procedure
- Any planned surgical intervention/procedure 30 days after the study procedure
- Any patient considered to be hemodynamically unstable at onset of procedure
- Patient is currently participating in another investigational drug or device study that has not reached the primary endpoint
Contacts and Locations| Belgium | |
| Imelda hospital | |
| Bonheiden, Antwerpen, Belgium, 2820 | |
| Universitair ziekenhuis antwerpen | |
| Edegem, Antwerpen, Belgium, 2650 | |
| AZ Sint Blasius | |
| Dendermonde, Oost-Vlaanderen, Belgium, 9200 | |
| Germany | |
| Park-Krankenhaus Leipzig | |
| Leipzig, Germany, 04289 | |
| St Fransiskus hospital | |
| Münster, Germany, 48145 | |
| Principal Investigator: | Marc Bosiers, MD | AZ Sint Blasius, Dendermonde, Belgium |
More Information
No publications provided
| Responsible Party: | Flanders Medical Research Program |
| ClinicalTrials.gov Identifier: | NCT01413139 History of Changes |
| Other Study ID Numbers: | FMRP-100701 |
| Study First Received: | July 1, 2010 |
| Last Updated: | June 18, 2012 |
| Health Authority: | Belgium: Institutional Review Board Belgium: Federal Agency for Medicinal Products and Health Products |
Keywords provided by Flanders Medical Research Program:
|
peripheral Vascular Disease claudication rest pain |
Additional relevant MeSH terms:
|
Vascular Diseases Peripheral Vascular Diseases Peripheral Arterial Disease Cardiovascular Diseases |
Atherosclerosis Arteriosclerosis Arterial Occlusive Diseases |
ClinicalTrials.gov processed this record on May 16, 2013