Limited recruiting

The goal of this clinical trial is to compare plain old balloon angioplasty with sirolimus-coated balloon angioplasty in patients with an infrainguinal venous bypass stenosis. The main question we aim to answer is, how patency is affected by each of the randomised treatment options.

This clinical trial will be conducted at our Division of Vascular Surgery and Endovascular Surgery at the University Hospital of Salzburg. Patients will be randomized into one of the two treatment options (plain old ballon angioplasty versus sirolimus coated balloon angioplasty). The recruitment phase is calculated for two years with a planned follow-up of 2 years. Follow-up data will be collected to answer the endpoints and will include all available follow-ups to monitor the bypass up to 2 years after the procedure. Typically, follow-up visits will be conducted at 6 weeks, 3 months, 6 months, 12 months, and 24 months after the procedure.

Inclusion Criteria

• Age at least 18 years
• Informed consent with signature
• Rutherford category 2 or 3 (in terms of lifestyle-limiting moderate or severe claudication symptomatology) or chronic critical ischemia (Rutherford 4-6)
• Venous bypass stenosis requiring intervention
• Confirmed inflow
• At least 1 crural outflow vessel

Exclusion Criteria:

• Pregnant or lactating women
• Active infection or sepsis
• Patients currently participating in another clinical trial
• Unconfirmed inflow
• Intolerance to sirolimus
• Coagulopathy
• Radiotherapy
• Patients on immunosuppressive therapy
• Non-dialysis renal insufficiency (eGFR < 45 ml/min/1.73m2)
• Use of potent CYP3A4 and/or P-gp inhibitors (such as ketoconazole, Voriconazole, itraconazole, erythromycin, telithromycin, or clarithromycin) or strong CYP3A4 and/or P-gp inducers (such as rifampin or rifabutin).