Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
The purpose of the study is to evaluate the intermediate and long-term effectiveness of stand-alone atherectomy treatment of peripheral arterial disease in the legs.
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Atherectomy | Other | All patients enrolled in this single-arm study were treated with directional atherectomy. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| SilverHawk & TurboHawk Peripheral Plaque Excision System | Device | Removal of atherosclerotic plaque from artery walls. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Primary Patency Rate (in Patients Treated for Claudication RCC 1-3) | The primary endpoint analysis for claudication subjects was primary patency rate at one year, defined by duplex ultrasound measurement of peak systolic velocity ratio ≤ 3.5 at the target lesion(s) with no clinically-driven reintervention within the treated segment in subjects who had claudication (RCC of 1 - 3) at time of enrollment. | One year |
| Amputation-Free Survival at 1 Year (in Patients Treated for Critical Limb Ischemia RCC 4-6) | The primary endpoint for CLI was amputation-free survival at one year, defined as freedom from a major, unplanned amputation of the target limb through the 1-year visit in subjects who have CLI (RCC 4 - 6) at time of enrollment. | One Year |
| Measure | Description | Time Frame |
|---|---|---|
| Device Success (in All Patients Enrolled) | Device success was defined as ≤ 30% residual stenosis following use of the SilverHawk device, as measured by angiography, without adjunctive endovascular interventions or periprocedural complications. | Immediately following use of the SilverHawk device |
| Procedural Success (in All Patients Enrolled) |
Not provided
Inclusion Criteria
Exclusion Criteria
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Lawrence Garcia, MD | St. Elizabeth's Medical Center, Tuft's University School of Medicine | Principal Investigator |
| James McKinsey, MD | The New York Presbyterian/Columbia University | Principal Investigator |
| Professor Thomas Zeller | Herz-Zentrum Bad Krozingen Germany | Principal Investigator |
Not provided
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25147039 | Background | McKinsey JF, Zeller T, Rocha-Singh KJ, Jaff MR, Garcia LA; DEFINITIVE LE Investigators. Lower extremity revascularization using directional atherectomy: 12-month prospective results of the DEFINITIVE LE study. JACC Cardiovasc Interv. 2014 Aug;7(8):923-33. doi: 10.1016/j.jcin.2014.05.006. |
Not provided
Not provided
800 subjects were enrolled. One subject was excluded from all data analyses due to an invalid informed consent and was not considered started.
Subjects with all severities of peripheral arterial disease were recruited for this single-arm study. Outcome measures may apply to all subjects or be specific to level of disease severity (ie subjects w/claudication RCC1-3, subjects w/critical limb ischemia RCC4 (no wounds) or RCC5-6 (with wounds)). These are specified in the Arm/Group titles.
Not provided
| ID | Title | Description |
|---|---|---|
| FG000 | Atherectomy | All patients enrolled in this single-arm study were treated with directional atherectomy. SilverHawk Peripheral Plaque Excision System: Removal of atherosclerotic plaque from artery walls. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
800 patients were enrolled, but 1 subject's data were excluded from all analyses due to an invalid informed consent, yielding a cohort of 799 analyzable subjects.
Not provided
| ID | Title | Description |
|---|---|---|
| BG000 | Atherectomy | All patients enrolled in this single-arm study were treated with directional atherectomy. SilverHawk Peripheral Plaque Excision System: Removal of atherosclerotic plaque from artery walls. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| 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 | Primary Patency Rate (in Patients Treated for Claudication RCC 1-3) | The primary endpoint analysis for claudication subjects was primary patency rate at one year, defined by duplex ultrasound measurement of peak systolic velocity ratio ≤ 3.5 at the target lesion(s) with no clinically-driven reintervention within the treated segment in subjects who had claudication (RCC of 1 - 3) at time of enrollment. | Kaplan-Meier estimate of the freedom from loss of primary patency in lesions (N=743 lesions) | Posted | Number | percentage of lesions by Kaplan Meier | One year | Number of Lesions Analyzed | Number of Lesions Analyzed |
|
Adverse events were collected throughout the 12 month follow-up of the study.
Adverse events were reviewed and classified by a third party clinical events committee. AEs were classified as device-related and/or procedure-related, as well as Serious Adverse Events (SAEs) and Major Adverse Events (MAEs).
Not provided
| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | All Patients | All patients enrolled in this single-arm study were treated with directional atherectomy. SilverHawk Peripheral Plaque Excision System: Removal of atherosclerotic plaque from artery walls. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Abrupt closure | Vascular disorders | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Arterial perforation | Vascular disorders | Systematic Assessment |
The study's principal limitations include a lack of randomization and follow-up beyond 12 months.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Clinical Program Manager | Medtronic | 763-398-7000 | michael.p.swierzewski@medtronic.com |
| ID | Term |
|---|---|
| D058729 | Peripheral Arterial Disease |
| D007383 | Intermittent Claudication |
| D000089802 | Chronic Limb-Threatening Ischemia |
| ID | Term |
|---|---|
| D050197 | Atherosclerosis |
| D001161 | Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
Not provided
Not provided
| ID | Term |
|---|---|
| D017073 | Atherectomy |
| ID | Term |
|---|---|
| D017130 | Angioplasty |
| D002404 | Catheterization |
| D013812 | Therapeutics |
| D057510 | Endovascular Procedures |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Procedure success was defined as ≤ 30% residual stenosis following use of SilverHawk device and adjunctive endovascular interventions (if required) as measured by angiography without periprocedural complications. |
| Immediately following use of the SilverHawk and adjunctive devices |
| Major Adverse Event Rate (in All Patients Enrolled) | Major Adverse Event Rate (MAE) at 30 Days was defined as clinically-driven target vessel revascularization (TVR), major unplanned amputation of treated limb, or all-cause mortality within 30 days post procedure, as classified by the Clinical Events Committee (CEC). | 30 Days |
| Major Adverse Event Rate (in All Patients Enrolled) | Major Adverse Event Rate at One Year was defined as clinically-driven target vessel revascularization, major unplanned amputation of the treated limb, or all-cause mortality within one year, as classified by the Clinical Events Committee (CEC). | One Year |
| Improvement in Walking Impairment Questionnaire Score (in Patients Treated for Claudication RCC 1-3) | WIQ includes a measurement for walking distance, walking speed, and climbing stairs collected at baseline and one year, presented for subjects who have claudication. The Walking Improvement Questionnaire (WIQ) is a validated method to assess objective improvement in functional walking ability of subjects with intermittent claudication. Difficulty walking a distance was self-assessed at baseline by the patient (prior to treatment) and at the one year follow up visit. Speed and stair climbing ability were assessed by the treating physician. Scale ranges from 0 (minimum) to 100 (maximum), with larger numbers representing better outcomes. An increase in WIQ scores at 1 year represents an improvement over baseline. | Baseline and 1 Year |
| Improvement in Rutherford Clinical Category (in All Patients Enrolled) | Change in RCC at One Year was assessed and percentage of subjects with an improvement in clinical status indicated by a decrease of one or more in RCC at one year compared to baseline, that is attributable to the treated limb (in cases of bilateral disease), was calculated. | 1 Year |
| Ankle-Brachial Index (in All Patients Enrolled) | Change in Ankle-Brachial Index at One Year was calculated and percentage of subjects with an increase (improvement) in the ankle-brachial index (ABI) at one year compared to baseline in subjects with compressible arteries and baseline ABI < 0.9 was calculated. | 1 Year |
| Secondary Patency (in Patients Treated for Claudication RCC 1-3) | Secondary patency was defined as measured by duplex ultrasound peak systolic velocity ratio ≤ 3.5 maintained by repeat percutaneous intervention in subjects who have claudication; estimated as freedom from loss of patency by the Kaplan-Meier method at one year. | One Year |
| Primary Patency (in Patients Treated for Critical Limb Ischemia RCC 4-6) | The primary patency for CLI was defined by duplex ultrasound measurement of peak systolic velocity ratio ≤ 3.5 at the target lesion(s) with no clinically-driven reintervention within the treated segment in subjects who have CLI at time of enrollment | One Year |
| Amputation-Free Survival (in Patients Treated for Claudication RCC 1-3) | Amputation-Free Survival in Claudicants at One Year was defined as freedom from a major, unplanned amputation of the target limb through the one year visit in subjects who have claudication at time of enrollment. | One Year |
| Improvement in Wound Healing (in Patients Treated for Critical Limb Ischemia and With Wounds RCC 5-6) | Wound healing at three months was defined as a decrease of at least one Wagner Classification grade of the wound at three months compared to baseline in subjects who have Rutherford Clinical Category score of 5 or 6 at the time of enrollment. | 3 months |
| Alternative Patency Rate (Peak Systolic Velocity ≤ 2.4) at 1 Year (in Patients Treated for Claudication RCC 1-3) | Defined by the duplex ultrasound measurement of peak systolic velocity ration ≤ 2.4 at the target lesion (s) with no clinically-driven re- intervention with the treated segment in subjects who have claudication at time of enrollment. | 1 year |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Diabetes | Number | participants |
|
| Units | Counts |
|---|---|
| Participants |
|
| Number of Lesions Analyzed |
|
|
| Primary | Amputation-Free Survival at 1 Year (in Patients Treated for Critical Limb Ischemia RCC 4-6) | The primary endpoint for CLI was amputation-free survival at one year, defined as freedom from a major, unplanned amputation of the target limb through the 1-year visit in subjects who have CLI (RCC 4 - 6) at time of enrollment. | Posted | Number | percentage of subjects by Kaplan-Meier | One Year |
|
|
|
| Secondary | Device Success (in All Patients Enrolled) | Device success was defined as ≤ 30% residual stenosis following use of the SilverHawk device, as measured by angiography, without adjunctive endovascular interventions or periprocedural complications. | Lesions with core angiographic laboratory measurements of residual stenosis | Posted | Number | percentage of Lesions | Immediately following use of the SilverHawk device | Number of Lesions Analyzed | Number of Lesions Analyzed |
|
|
|
| Secondary | Procedural Success (in All Patients Enrolled) | Procedure success was defined as ≤ 30% residual stenosis following use of SilverHawk device and adjunctive endovascular interventions (if required) as measured by angiography without periprocedural complications. | All lesions with angiographic core lab assessment of residual stenosis at the end of the procedure were included | Posted | Number | percentage of lesions | Immediately following use of the SilverHawk and adjunctive devices | Number of Lesions Analyzed | Number of Lesions Analyzed |
|
|
|
| Secondary | Major Adverse Event Rate (in All Patients Enrolled) | Major Adverse Event Rate (MAE) at 30 Days was defined as clinically-driven target vessel revascularization (TVR), major unplanned amputation of treated limb, or all-cause mortality within 30 days post procedure, as classified by the Clinical Events Committee (CEC). | Posted | Number | percentage of patients | 30 Days |
|
|
|
| Secondary | Major Adverse Event Rate (in All Patients Enrolled) | Major Adverse Event Rate at One Year was defined as clinically-driven target vessel revascularization, major unplanned amputation of the treated limb, or all-cause mortality within one year, as classified by the Clinical Events Committee (CEC). | Posted | Number | percentage of patients | One Year |
|
|
|
| Secondary | Improvement in Walking Impairment Questionnaire Score (in Patients Treated for Claudication RCC 1-3) | WIQ includes a measurement for walking distance, walking speed, and climbing stairs collected at baseline and one year, presented for subjects who have claudication. The Walking Improvement Questionnaire (WIQ) is a validated method to assess objective improvement in functional walking ability of subjects with intermittent claudication. Difficulty walking a distance was self-assessed at baseline by the patient (prior to treatment) and at the one year follow up visit. Speed and stair climbing ability were assessed by the treating physician. Scale ranges from 0 (minimum) to 100 (maximum), with larger numbers representing better outcomes. An increase in WIQ scores at 1 year represents an improvement over baseline. | All subjects treated for claudication RCC 1-3 with completed WIQ forms | Posted | Mean | Standard Deviation | units on a scale | Baseline and 1 Year |
|
|
|
| Secondary | Improvement in Rutherford Clinical Category (in All Patients Enrolled) | Change in RCC at One Year was assessed and percentage of subjects with an improvement in clinical status indicated by a decrease of one or more in RCC at one year compared to baseline, that is attributable to the treated limb (in cases of bilateral disease), was calculated. | All patients with RCC data at baseline and 1 year | Posted | Number | percentage of patients | 1 Year |
|
|
|
| Secondary | Ankle-Brachial Index (in All Patients Enrolled) | Change in Ankle-Brachial Index at One Year was calculated and percentage of subjects with an increase (improvement) in the ankle-brachial index (ABI) at one year compared to baseline in subjects with compressible arteries and baseline ABI < 0.9 was calculated. | All patients with compressible arteries and a baseline ABI < 0.9. | Posted | Number | percentage of patients improved | 1 Year |
|
|
|
| Secondary | Secondary Patency (in Patients Treated for Claudication RCC 1-3) | Secondary patency was defined as measured by duplex ultrasound peak systolic velocity ratio ≤ 3.5 maintained by repeat percutaneous intervention in subjects who have claudication; estimated as freedom from loss of patency by the Kaplan-Meier method at one year. | All claudicants. | Posted | Number | percentage of lesions | One Year | Number of Lesions Analyzed | Number of Lesions Analyzed |
|
|
|
| Secondary | Primary Patency (in Patients Treated for Critical Limb Ischemia RCC 4-6) | The primary patency for CLI was defined by duplex ultrasound measurement of peak systolic velocity ratio ≤ 3.5 at the target lesion(s) with no clinically-driven reintervention within the treated segment in subjects who have CLI at time of enrollment | All patients with CLI. | Posted | Number | percentage of lesions | One Year | Number of Lesions Analyzed | Number of Lesions Analyzed |
|
|
|
| Secondary | Amputation-Free Survival (in Patients Treated for Claudication RCC 1-3) | Amputation-Free Survival in Claudicants at One Year was defined as freedom from a major, unplanned amputation of the target limb through the one year visit in subjects who have claudication at time of enrollment. | All claudicants. | Posted | Number | percentage of patients by Kaplan-Meier | One Year |
|
|
|
| Secondary | Improvement in Wound Healing (in Patients Treated for Critical Limb Ischemia and With Wounds RCC 5-6) | Wound healing at three months was defined as a decrease of at least one Wagner Classification grade of the wound at three months compared to baseline in subjects who have Rutherford Clinical Category score of 5 or 6 at the time of enrollment. | Patients with wounds at baseline who had wound assessment scores at baseline and at 3 months. | Posted | Number | percentage of patients | 3 months |
|
|
|
| Secondary | Alternative Patency Rate (Peak Systolic Velocity ≤ 2.4) at 1 Year (in Patients Treated for Claudication RCC 1-3) | Defined by the duplex ultrasound measurement of peak systolic velocity ration ≤ 2.4 at the target lesion (s) with no clinically-driven re- intervention with the treated segment in subjects who have claudication at time of enrollment. | Lesions in patients with claudication at baseline | Posted | Number | percentage of lesions by Kaplan-Meier | 1 year | Number of Lesions Analyzed | Number of Lesions Analyzed |
|
|
|
| 4 |
| 799 |
| 410 |
| 799 |
| 41 |
| 799 |
| Access site complication | Vascular disorders | Systematic Assessment |
|
| Arterial dissection (Grade D or greater) | Vascular disorders | Systematic Assessment |
|
| Arterial Spasm | Vascular disorders | Systematic Assessment |
|
| Arterial thrombosis | Vascular disorders | Systematic Assessment |
|
| Arterio-venous fistula | Vascular disorders | Systematic Assessment |
|
| Bleeding complications | Vascular disorders | Systematic Assessment |
|
| Cellulitis | Vascular disorders | Systematic Assessment |
|
| Hypertension | Vascular disorders | Systematic Assessment |
|
| Hypotention | Vascular disorders | Systematic Assessment |
|
| Infection (not at access site) | Infections and infestations | Systematic Assessment |
|
| Myocardial Infarction | Vascular disorders | Systematic Assessment |
|
| Other | Vascular disorders | Systematic Assessment | Other" included events such as acute coronary syndrome, back pain, fractures, cancers, non-target lesions revascularizations, heart failure, pneumonia, etc. |
|
| Pseudoaneurysm not at the access site | Vascular disorders | Systematic Assessment |
|
| renal failure | Renal and urinary disorders | Systematic Assessment |
|
| Renal Insufficiency | Renal and urinary disorders | Systematic Assessment |
|
| Restenosis | Vascular disorders | Systematic Assessment |
|
| Sepsis | Infections and infestations | Systematic Assessment |
|
| stroke | Vascular disorders | Systematic Assessment |
|
| Sub-acute Closure | Vascular disorders | Systematic Assessment |
|
| Tansient ischemic attack | Vascular disorders | Systematic Assessment |
|
| Wound abscess | Infections and infestations | Systematic Assessment |
|
| wound debridement | Surgical and medical procedures | Systematic Assessment |
|
Not provided
| D002318 |
| Cardiovascular Diseases |
| D016491 | Peripheral Vascular Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D007511 | Ischemia |
| D014656 |
| Vascular Surgical Procedures |
| D013504 | Cardiovascular Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
| D019060 | Minimally Invasive Surgical Procedures |
| D008919 | Investigative Techniques |
| Walking Speed Score |
|
|
| Stair Climbins Score |
|
|