Chronic Limb-Threatening Ischemia Treated With Intravascular Lithotripsy Observational Study (CALCIO)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Claire Poulet, PhD
- Phone Number: +41 79 385 16 78
- Email: calcio@cirse.org
Study Contact Backup
- Name: Dhwani S. Korde, PhD
- Phone Number: +4367762942469
- Email: calcio@cirse.org
Study Locations
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Eisenstadt, Austria, 7000
- Krankenhaus der Barmherzigen Brüder
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Graz, Austria, 8036
- Medizinische Universität Graz
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Linz, Austria, 4020
- Krankenhaus Barmherzige Brüder Linz
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Vienna, Austria, 1130
- Klinik Hietzing
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Vienna, Austria, 1210
- Klinik Florisdorf
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Montreal, Canada, H4J 1C5
- Hôpital Sacré Coeur de Montréal
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Dijon, France, 21000
- CHU François Mitterrand
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Paris, France, 75014
- Institute Mutualiste Montsouris
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Strasbourg, France, 67000
- Rhéna Clinique de Strasbourg
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Cologne, Germany, 50937
- Universitätsklinikum Köln
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Essen, Germany, 45147
- Universitätsmedizin Essen
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Hanover, Germany, 30989
- KRH Klinikum Robert Koch Gehrden
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Heilbronn, Germany, 74078
- SLK-Heilbronn
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Karlsruhe, Germany, 76133
- Städtisches Klinikum
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Mülheim, Germany, 45468
- Evangelisches Krankenhaus
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Neumünster, Germany, 24534
- Friedrich Ebert Krankenhaus
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Rendsburg, Germany, 24768
- Schön Klinik Rendsburg
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Siegen, Germany, 57072
- St Marien-Krankenhaus
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Tübingen, Germany, 72076
- Universitatsklinikum Tubingen
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Budapest, Hungary, 1085
- Semmelweis University
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Alicante, Spain, 03010
- Hospital General Universitario Dr. Balmis
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Granollers, Spain, 08402
- Hospital General de Granollers
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Pamplona, Spain, 31006
- University of Navarra
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Lugano, Switzerland, 6500
- Ente Ospedaliero Cantonale
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Winterthur, Switzerland, 8400
- Kantonsspital Winterthur
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Bedford, United Kingdom, MK42 9DJ
- Bedfordshire Hospitals NHS Foundation Trust
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Frimley, United Kingdom, GU16 7UJ
- Frimley Health NHS Foundation Trust
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Hull, United Kingdom, HU3 2JZ
- Hull University Teaching Hospitals NHS Trust
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Leeds, United Kingdom, LS1 3EX
- Leeds Teaching Hospitals NHS Trust
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Liverpool, United Kingdom, L7 8XP
- Liverpool University Hospitals NHS Foundation Trust
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London, United Kingdom, NW3 2QG
- Royal Free London NHS Foundation Trust
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London, United Kingdom, NW1 2PG
- University College London Hospitals Nhs Foundation Trust
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London, United Kingdom, W2 1NY
- Imperial College Healthcare NHS Trust
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London, United Kingdom, SW17 0QT
- St George's University Hospitals NHS Foundation Trust
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Manchester, United Kingdom, M13 9WL
- Manchester University NHS Foundation Trust
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Newcastle, United Kingdom, NE1 4LP
- Newcastle upon Tyne Hospitals NHS Foundation Trust
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Oxford, United Kingdom, OX3 9DU
- Oxford University Hospitals NHS Foundation Trust
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Plymouth, United Kingdom, PL6 8DH
- University Hospitals Plymouth NHS Trust
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Sheffield, United Kingdom, S10 2JF
- Sheffield Teaching Hospitals NHS FT
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patient with chronic limb-threatening ischemia (Rutherford Category ≥4)
- Femoropopliteal and/or crural calcified lesions visible on fluoroscopy;
- Treatment with IVl using the Shockwave Medical IVL System.
Exclusion Criteria:
- < 18 years old;
- Incapacity or refusal to give informed consent;
- Ongoing pregnancy;
- Endovascular procedure(s) on the treatment site within 4 weeks before the planned IVL treatment.
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
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Full cohort
Intravascular lithotripsy of femoropopliteal and crural lesions as per standard of care
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Comprehensive system consisting of generator, a connector cable and a single-use sterile catheter with integrated balloon for intravascular lithotripsy of peripheral artery calcification.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Wound healing and freedom from amputation
Time Frame: 12 months
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Composite of wound healing defined as the healing status of the dominant ischemic wound of the target limb (complete, partial, unchanged, worsening) and freedom from amputation defined as the absence of any amputation of the treated limb: minor (digital, metatarsal), major below the knee or major above the knee (excluding any amputation planned before the IVL procedure).
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12 months
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Wound healing
Time Frame: 24 months
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Healing status of the dominant ischemic wound of the target limb (complete, partial, unchanged, worsening)
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24 months
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Freedom from amputation
Time Frame: 24 months
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Absence of any amputation of the treated limb: minor (digital, metatarsal), major below the knee or major above the knee (excluding any amputation planned before the IVL procedure).
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24 months
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Amputation-free survival
Time Frame: through study completion, approximately 2 years
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time between IVL treatment and amputation of the target limb, minor (digital, metatarsal), major below the knee or major above the knee (excluding any amputation planned before the IVL procedure)
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through study completion, approximately 2 years
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Change in Rutherford classification category
Time Frame: 12 and 24 months
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Seven classification categories, from 0 (asymptomatic) to 6 (Major tissue loss)
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12 and 24 months
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Change in foot ischemia
Time Frame: 12 and 24 months
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Change in ankle-brachial index or toe pressure, depending on which data is available
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12 and 24 months
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Change in WIfi score
Time Frame: 12 and 24 months
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Three-digit score for comprehensive assessment of wound, ischemia and foot infection
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12 and 24 months
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CD-TLR-free survival
Time Frame: through study completion, approximately 2 years
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time between IVL treatment and any endovascular re-intervention to the target lesion (± 10 mm)
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through study completion, approximately 2 years
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Primary patency rate
Time Frame: 12 and 24 months
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freedom from total occlusion without any endovascular or surgical re-intervention to the target lesion (± 10 mm)
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12 and 24 months
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Assisted primary patency rate
Time Frame: 12 and 24 months
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freedom from total occlusion following additional endovascular or surgical intervention(s) due to restenosis of the target lesion
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12 and 24 months
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Secondary patency rate
Time Frame: 12 and 24 months
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freedom from total occlusion following additional endovascular or surgical intervention(s) due to occlusion of the target lesion
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12 and 24 months
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Technical success of IVL
Time Frame: on the day of the procedure
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residual diameter stenosis ≤30% after IVL and before any potential adjunctive intervention
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on the day of the procedure
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Overall procedural success
Time Frame: on the day of the procedure
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residual stenosis ≤30% by the end of the complete procedure
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on the day of the procedure
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Patient-reported health-related quality-of-life
Time Frame: at 6, 12 and 24 months
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EuroQol questionnaire EQ-5D-5L
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at 6, 12 and 24 months
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Freedom from clinically-driven target lesion revascularization (CD-TLR)
Time Frame: 12 and 24 months
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freedom from any endovascular re-intervention to the target lesion (± 10 mm) or surgical bypass performed because of restenosis or occlusion of the target lesion.
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12 and 24 months
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Frequency and severity of procedural complications and other adverse events
Time Frame: Within 30 days after the procedure
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Grading according to the classification system of the Cardiovascular and Interventional Radiological Society of Europe
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Within 30 days after the procedure
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Chair: Raman Uberoi, Dr, Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom
- Study Chair: Christoph Binkert, Prof. Dr, Cantonal Hospital Winterthur, Winterthur, Switzerland
- Study Chair: Peter Reimer, Prof. Dr, Municipal Clinic Karlsruhe, Karlsruhe, Germany
Publications and helpful links
General Publications
- Filippiadis DK, Binkert C, Pellerin O, Hoffmann RT, Krajina A, Pereira PL. Cirse Quality Assurance Document and Standards for Classification of Complications: The Cirse Classification System. Cardiovasc Intervent Radiol. 2017 Aug;40(8):1141-1146. doi: 10.1007/s00270-017-1703-4. Epub 2017 Jun 5.
- Uberoi R, Reimer P, Chun JY, Goyault G, Kashef E, Loffroy R, Rand T, Ruffino MA, von Stempel C, Lange T, Zeka B, Poulet C, Kaufmann N, Binkert C. Intravascular Lithotripsy for Patients with Chronic Limb-Threatening Ischemia: Study Protocol for CALCIO, a Prospective Multicenter Observational Investigation. Cardiovasc Intervent Radiol. 2026 Jun;49(6):1219-1226. doi: 10.1007/s00270-025-04335-w. Epub 2026 Feb 17.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Vascular Diseases
- Cardiovascular Diseases
- Pathologic Processes
- Chronic Disease
- Disease Attributes
- Atherosclerosis
- Arteriosclerosis
- Arterial Occlusive Diseases
- Peripheral Vascular Diseases
- Ischemia
- Peripheral Arterial Disease
- Pathological Conditions, Signs and Symptoms
- Chronic Limb-Threatening Ischemia
Other Study ID Numbers
Other Study ID Numbers
- CALCIO
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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