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The primary objective of this study is to confirm the safety and efficacy of the RenzanTM Peripheral Stent System when used for treatment of superficial femoral (SFA) and/or popliteal (POP) artery disease.
This trial plans to include 135 patients in (up to) 10 locations around in Europe.
PRIZER Study is a prospective, multicenter, post-market, single arm study with plan to include approximately 135 patients eligible to be treated with RenzanTM Peripheral Stent System stratified in 2 groups: 90 FEM-POP patients (From superficial femoral Artery to the Proximal edge of patella) and 45 Isolated POP patients (From Hunter's canal to the Origin of anterior tibial artery).
The sponsor will work in accordance with standard operating procedures (SOP) and the Monitoring Plan in order to ensure adherence to the CIP and applicable regulations at the investigational sites.
The Monitoring Plan is built according to a risk-based monitoring approach and describes the level of source data verification to be performed by the monitors.
Risk-based monitoring approach uses all available means to supervise the trial (central monitoring, remote monitoring and on-site monitoring), focusing in critical data points and issues ensuring that adequate monitoring (central, remote and on-site) at each site is completed to ensure protection of the rights and safety of the subjects and the quality and integrity of the data collected and submitted.
The sponsor shall provide training and the necessary guidelines to assist each investigational site on the data collection in the eCRF. Each site is responsible to report the available data requested by the CIP. In order to ensure data quality and avoid missing information in the eCRF, edit checks are designed during database development. In addition, Sponsor's CRA and Data Management team will be responsible to review the data and raise queries accordingly into the eCRF. An audit trail logging all data entered and edited is available within the EDC system. All source documents are maintained in the hospital files ready for inspection by the Sponsor and regulatory authorities upon request. The Sponsor will inform the investigator of the time period for retaining these records as per applicable regulatory requirements.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Single Arm | Other | 135 patients stratified into 2 groups:
It is expected the majority of enrolled patients to be FEM-POP category. In case sufficient Isolated POP patients are enrolled, a sub-analysis will be performed on this group of patients. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Stent implantation | Device | Procedure can be conducted via either contralateral or antegrade approach. After a successful target lesion crossing, predilate the lesion using either plain old balloon angioplasty (POBA) or (if necessary) any available specialty balloon. The inflated diameter of the balloon should approximate the diameter of the vessel just distal to the lesion. Proper vessel preparation should achieve diameter of 1:1 to healthy vessel (with ≤20% residual stenosis, as per operator's assessment). Adjunctive debulking devices are prohibited. Final stent selection should be confirmed after a proper vessel preparation, considering the reference vessel diameter (RVD) for the optimal 1:1 stent-to-vessel sizing. The implanted dual layer length would encompass the entire lesion with the micromesh, covering it from healthy to healthy tissue. Post-dilatation of the stent for more optimal placement may be done at operator's discretion, using standard angioplasty with uncoated balloon. |
| Measure | Description | Time Frame |
|---|---|---|
| Primary safety endpoint - Death | Freedom from death. | 30 days |
| Primary efficacy endpoint - TLR | Freedom from Target Lesion Revascularization (TLR). | 30 days |
| Primary efficacy endpoint - Amputation | Freedom from any amputation of the index limb. | 30 days |
| Primary efficacy endpoint | Primary patency of the artery at 12 months, defined as no evidence of restenosis or occlusion within the originally treated lesion based on a centrally-read Color Flow Doppler ultrasound in the absence of target lesion revascularization (TLR) (excluding TLR due to thrombosis within 30 days) | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Device Success | Defined as a successful device deployment according to IFU. | Intraoperative |
| Technical Success | Defined as achievement of a final target lesion residual diameter stenosis of <30% based on angiography. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Koen Deloose, Dr | AZ Sint-Blasius Dendermonde | Principal Investigator |
| Torsten Fuss, Dr | Elblandhospital Radebeul | Principal Investigator |
| Michael Lichtenberg, Dr | Karolinen-Hospital: Klinikum Arnsberg | Principal Investigator |
| Jérôme Brunet, Dr. | Clinique Rhône-Durance | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| AZ Sint-Blasius | Dendermonde | Oost-Vlaanderen | 9200 | Belgium | ||
| Onze Lieve Vrouw (OLV) Ziekenhuis |
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Peripheral Stent placement at the location of the initially stenosed or occluded femoropopliteal lesion after proper (1:1 to the reference vessel diameter) vessel preparation without the use of adjunctive debulking devices. Proper vessel preparation should result in ≤20% residual stenosis (as per operator's assessment).
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|
| Intraoperative |
| Procedural Success | Defined as technical and device success without procedural complication. | Intraoperative |
| Any death | Cardiovascular death and Non-cardiovascular death | at 1, 6, 12, 24, 36 months |
| Ankle-brachial Index (ABI) on target limb | Defined as a ratio of the highest ankle systolic blood pressure in one leg, usually measured with a 10 cm cuff at the ankle and using a continuous wave Doppler to detect return of blood flow in the anterior tibial and posterior tibial arteries, to the highest of either arm systolic blood pressure. Performed at rest with subject in supine position. | at baseline, 1, 6, 12, 24 and 36 months |
| Clinically-driven Target Lesion Revascularization (CD-TLR) | Defined as any TLR associated with deterioration of patient's Rutherford category and/or increase in size of pre-existing ischemic wounds and/or occurrence of new wounds. | at 1, 6, 12, 24 and 36 months |
| Target Lesion Revascularization (TLR) | Defined as any repeat percutaneous intervention or bypass surgery performed on the target lesion (including 5mm proximal and distal from the implanted stent). | at 1, 6, 12, 24 and 36 months |
| Target Vessel Revascularization (TVR) | Defined as any repeat percutaneous intervention or bypass surgery performed on the target vessel. | at 1, 6, 12, 24 and 36 months |
| Patency of the target lesion | Defined as no evidence of restenosis or occlusion within the originally treated lesion based on a centrally-read Color Flow Doppler ultrasound in the absence of target lesion revascularization (TLR) (excluding TLR due to thrombosis within 30 days). Occlusion and restenosis were defined as no color flow or an increase in peak systolic velocity ratio (PSVR) of ≥ 2.4 when compared to the proximal normal segment, respectively. | at 6, 24 and 36 months |
| Limb Ischemia Improvement | Defined as an improvement in the Rutherford-Becker Clinical Improvement Scale of greater than or equal to 1. | at 1, 6, 12, 24 and 36 months |
| Major Adverse Events (MAE) | Defined as a composite rate of:
| at 1, 6, 12, 24 and 36 months |
| Index Limb Amputations | Defined as the surgical removal of tissue anywhere from the toe to hip. | at 1, 6, 12, 24 and 36 months |
| Quality of Life (QoL) | Quality of Life (QoL) assessed as per EQ-5D questionnaire | at baseline, 1, 6, 12, 24 and 36 months |
| Walking performance | Walking performance assessed as per Walking Impairment Questionnaire (WIQ) | at baseline, 1, 6, 12, 24 and 36 months |
| Rutherford-Becker Scale | Category 0 = Asymptomatic, no hemodynamically significant occlusive disease, Category 1 = Mild claudication, Category 2 = Moderate claudication, Category 3 = Severe claudication, Category 4 = Ischemic rest pain, Category 5 = Minor tissue loss, non-healing ulcer, or focal gangrene with diffuse pedal ischemia, Category 6 = Major tissue loss, extending above trans metatarsal level, functional foot no longer salvageable. | at baseline, 1, 6, 12, 24 and 36 months |
| Clinical Improvement | Clinical Improvement compared with baseline as per Rutherford-Becker Clinical Improvement Scale | at 1, 6, 12, 24 and 36 months |
| Aalst |
| 9300 |
| Belgium |
| Imelda ziekenhuis | Bonheiden | 2820 | Belgium |
| Ziekenhuis Oost Limburg | Genk | 3600 | Belgium |
| Clinique Rhône-Durance | Avignon | 84000 | France |
| Hôpital Paris Saint-Joseph | Paris | 75014 | France |
| Clinique Saint Jean - Sud de France | Saint-Jean-de-Védas | 34433 | France |
| Klinikum Hochsauerland Karolinen-Hospital Hüsten | Arnsberg | 59759 | Germany |
| CCB MVZ Frankfurt und Main-Taunus GbR | Frankfurt | 60389 | Germany |
| Elblandklinikum Radebeul | Radebeul | Germany |
| Diakonessenhuis | Utrecht | 3582 | Netherlands |
| Hospital Germans Trias i Pujol | Badalona | 08916 | Spain |
| Hospital Universitario Cruces | Bilbao | 48903 | Spain |