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The objective of this study is to evaluate the safety and efficacy of the CLiRpath® Photoablation Atherectomy System consisting of the Bias Sheath guiding catheter, in combination with the available CLiRpath® Excimer Laser Catheters ≤ 2.0 mm, to create larger lumens for treatment within the superficial femoral and popliteal arteries above the knee.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Laser Treatment | Experimental | CLiRpath Photoablation Atherectomy System |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CLiRpath Photoablation System | Device | Use of CLiRpath Laser Catheter to improve vessel lumen diameter. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Laser Success | The primary efficacy endpoint is laser success, defined as achieving >/= 20% average reduction in the percent (%) diameter stenosis, post-laser and prior to adjunctive therapy, based on angiographic core laboratory assessment. | Measured at time of procedure |
| Major Adverse Events | The primary safety endpoint is the occurrence of major adverse events defined as clinical perforation, major dissection requiring surgery, major amputation, cerebrovascular accidents (CVA), myocardial infarction, and death. | From discharge through the 6 month follow-up |
| Measure | Description | Time Frame |
|---|---|---|
| Procedural Success | Acute procedural success, defined as achievement of \ | measured at time of procedure |
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Inclusion Criteria:
General Inclusion Criteria
Angiographic Inclusion Criteria
Reference vessel diameter >/= 4.0 mm and ≤ 7.0 mm as determined by physician visual angiographic assessment of the most normally appearing vessel segment within 10 mm proximal AND 10 mm distal to the target segment.
Stenosis within the SFA and/or popliteal artery above the knee of >/= 70% and </= 100% DS (occlusion), as determined by visual angiographic assessment by the investigator at the time of the procedure and documented by angiography in at least two (2) orthogonal views.
At least 1.0 cm of visible SFA stump beyond the origin of the profunda artery.
Total lesion length >/= 1.0 cm and ≤ 15.0 cm as determined by visual angiographic assessment at the time of the procedure, separate multiple lesions can be combined as two separate treatment areas as long as the sum total of all lesion lengths and/or treatment areas does not exceed 1.0 cm to 15.0 cm.
Patency (< 50% DS) of at least one (1) infrapopliteal artery in continuity with the native femoropopliteal artery.
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Exclusion Criteria:
General Exclusion Criteria
1.
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| Name | Affiliation | Role |
|---|---|---|
| Thomas M Rasmussen | Spectranetics Corp. | Study Director |
| Rajesh Dave, MD | Pinnacle Health Hospital, Central Pennsylvania Research Foundation | Principal Investigator |
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Patients were screened for inclusion/exclusion criteria
Patients were recruited from investigator patient referral base. Recruitment occurred between November 2006 and March 2007
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| ID | Title | Description |
|---|---|---|
| FG000 | Laser Treatment | CLiRpath Photoablation Atherectomy System |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Laser Treatment | CLiRpath Photoablation Atherectomy System |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Laser Success | The primary efficacy endpoint is laser success, defined as achieving >/= 20% average reduction in the percent (%) diameter stenosis, post-laser and prior to adjunctive therapy, based on angiographic core laboratory assessment. | Per protocol | Posted | Mean | Standard Deviation | percent reduction | Measured at time of procedure |
|
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Laser Treatment | CLiRpath Photoablation Atherectomy System |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Worsening coronary artery disease | Cardiac disorders | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Hematoma at access site | Surgical and medical procedures | Systematic Assessment |
Non-randomized study
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Thomas M. Rasmussen V.P. Clinical Affairs | Spectranetics Inc | 719-447-2471 | thomas.rasmussen@spnc.com |
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| ID | Term |
|---|---|
| D058729 | Peripheral Arterial Disease |
| ID | Term |
|---|---|
| D050197 | Atherosclerosis |
| D001161 | Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
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| Minimum and Maximum Lumen Diameters |
Minimum and maximum lumen diameters immediately after treatment with the CLiRpath® Photoablation Atherectomy System as determined by Intravascular Ultrasound (IVUS). |
| measured at time of procedure |
| Clinical Success | Clinical success, defined as primary patency (≤ 50% stenosis at the treatment site), as assessed by duplex Doppler ultrasound at 30 days, six (6) months and 12 months post-procedure | measured post discharge thorugh 12 Months follow-up |
| Assisted Primary Patency | Incidence of freedom from assisted primary patency at 30 days, six (6) and 12 months post-procedure, defined as a re-intervention of a stenosis (patent vessel) at the treatment site to prevent reocclusion | Through 12 Months |
| Assisted Secondary Patency | Incidence of freedom from assisted secondary patency at 30 days, six (6) and 12 months post-procedure, defined as a re-intervention of a reocclusion (non-patent vessel) at the treatment site | Through 12 Month |
| Patients With >50% Stenosis Measured by Duplex Ultrasound | Percentage of patients with >50% stenosis at each follow-up (30 days, six months, and 12 months post-procedure). | Through 12 Month |
| Rutherford Classification | Rutherford Classification at 30 days, six (6) and 12 months post-procedure. Physician assessed based on ankle pressures and treadmill testing. Rutherford scale: 0=best, 6=worst | Through 12 Months |
| Adverse Events | Adverse events during procedure and prior to release from the hospital, at 30 days, six (6) months, and 12 months post-procedure. | Through 12 Months |
| Volumetric Plaque Reduction | Volumetric plaque reduction immediately after treatment with the CLiRpath® Photoablation Atherectomy System as determined by IVUS. Actual volume of plaque present is presented for each measurement point. | measured at time of procedure |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
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| Race/Ethnicity | Number | participants |
|
|
|
| Primary | Major Adverse Events | The primary safety endpoint is the occurrence of major adverse events defined as clinical perforation, major dissection requiring surgery, major amputation, cerebrovascular accidents (CVA), myocardial infarction, and death. | Posted | Number | events | From discharge through the 6 month follow-up |
|
|
|
| Secondary | Procedural Success | Acute procedural success, defined as achievement of \ | Per protocol. All enrolled patients | Posted | Number | percent with </=30% RS | measured at time of procedure |
|
|
|
| Secondary | Minimum and Maximum Lumen Diameters | Minimum and maximum lumen diameters immediately after treatment with the CLiRpath® Photoablation Atherectomy System as determined by Intravascular Ultrasound (IVUS). | Analysis per protocol | Posted | Mean | Standard Deviation | millimeters | measured at time of procedure |
|
|
|
| Secondary | Clinical Success | Clinical success, defined as primary patency (≤ 50% stenosis at the treatment site), as assessed by duplex Doppler ultrasound at 30 days, six (6) months and 12 months post-procedure | 65 patients at 30 days; 59 at 6 months; 46 at 12 months | Posted | Number | percent of patients | measured post discharge thorugh 12 Months follow-up |
|
|
|
| Secondary | Assisted Primary Patency | Incidence of freedom from assisted primary patency at 30 days, six (6) and 12 months post-procedure, defined as a re-intervention of a stenosis (patent vessel) at the treatment site to prevent reocclusion | 65 at 30 days; 64 at 6 months; 63 at 12 months | Posted | Number | % pts free from assisted primary patency | Through 12 Months |
|
|
|
| Secondary | Assisted Secondary Patency | Incidence of freedom from assisted secondary patency at 30 days, six (6) and 12 months post-procedure, defined as a re-intervention of a reocclusion (non-patent vessel) at the treatment site | 65 at 30 days; 64 at 6 months; 63 at 12 months | Posted | Number | % pts free from secondary patency | Through 12 Month |
|
|
|
| Secondary | Patients With >50% Stenosis Measured by Duplex Ultrasound | Percentage of patients with >50% stenosis at each follow-up (30 days, six months, and 12 months post-procedure). | per protocol; 65 patients at 30 days; 59 at 6 months and 46 at 12 months | Posted | Number | percent of patients | Through 12 Month |
|
|
|
| Post-Hoc | Walking Impairment Questionare (WIQ) | Measures difficulty in walking before and after treatment. Defined by comparing the responses to a WIQ at pre-treatment with the responses at 30 days, six (6) months and 12 months post-procedure. Higher score is better (scale 0-100). | 65 patients at baseline and 30 days; 64 at 6 mo; 63 at 12 mo | Posted | Mean | Standard Deviation | units on a scale 0-100 | measured at each follow-up period |
|
|
|
| Secondary | Rutherford Classification | Rutherford Classification at 30 days, six (6) and 12 months post-procedure. Physician assessed based on ankle pressures and treadmill testing. Rutherford scale: 0=best, 6=worst | 63 at baseline; 62 at 30days and 6 months; 63 at 12 months | Posted | Mean | Standard Deviation | units on a scale of 0-6 | Through 12 Months |
|
|
|
| Secondary | Adverse Events | Adverse events during procedure and prior to release from the hospital, at 30 days, six (6) months, and 12 months post-procedure. | Posted | Number | events | Through 12 Months |
|
|
|
| Secondary | Volumetric Plaque Reduction | Volumetric plaque reduction immediately after treatment with the CLiRpath® Photoablation Atherectomy System as determined by IVUS. Actual volume of plaque present is presented for each measurement point. | Per protocol | Posted | Mean | Standard Deviation | millimeters cubed | measured at time of procedure |
|
|
|
| 11 |
| 65 |
| 8 |
| 65 |
| Right renal artery and non-treated leg stenosis | Vascular disorders | Systematic Assessment |
|
| Coronary artery bypass graft | Cardiac disorders | Systematic Assessment |
|
| Congestive heart failure | Cardiac disorders | Systematic Assessment |
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| Vessel occlusion | Vascular disorders | Systematic Assessment |
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| Lung cancer | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| Neck, back and shoulder pain | General disorders | Systematic Assessment |
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| Sternum infection | Infections and infestations | Systematic Assessment |
|
| Cerebrovascular accident | Vascular disorders | Systematic Assessment |
|
| Occlusion to treated leg other than at lesion site | Vascular disorders | Systematic Assessment |
|
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| D002318 |
| Cardiovascular Diseases |
| D016491 | Peripheral Vascular Diseases |
| Title | Measurements |
|---|---|
|
| Post Turbo-Booster min lumen diameter |
|
| Measurements |
|---|
|
| Measurements |
|---|
|
| Measurements |
|---|
|
| Measurements |
|---|
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| Title | Measurements |
|---|---|
|
| 12 months; n=63 |
|
| Title |
|---|
| Measurements |
|---|
|
| 12 months; n=63 |
|