Comparison of the Ranger™ Paclitaxel-Coated PTA Balloon Catheter and Uncoated PTA Balloons in Femoropopliteal Arteries (RANGER-SFA)

Prospective, Randomized, Multicentre Clinical Study of the Hemoteq Ranger™ Paclitaxel-Coated PTA Balloon Catheter (Ranger DCB) in Comparison to Uncoated PTA Balloons in Femoropopliteal Lesions

The primary objective of this study is to prove the superior performance of the Ranger™ paclitaxel-coated PTA balloon catheter for angioplasty for femoropopliteal artery lesions when compared to non-coated balloons at six months post-procedure when comparing Late Lumen Loss (LLL). Study statistical hypothesis: The %-mean loss of luminal diameter as assessed by angiography at six months follow-up after treatment of the femoropopliteal artery with Ranger DCB study devices is lower than the %-mean loss of luminal diameter after treatment with uncoated PTA balloon control devices.

Study Overview

• Status: Completed
• Conditions: Arteriosclerosis; Atherosclerosis; Peripheral Artery Disease; Claudication
• Intervention / Treatment: Device: Ranger DCB; Device: uncoated PTA balloon

• Study Type: Interventional
• Enrollment (Actual): 105
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Austria
  • Vienna, Austria, 1090
    • Medical University, AKH
• France
  • Caen, France, 14000
    • CHU Caen Côte de Nacre
  • Paris, France, 75908
    • Hôpital Européen Georges-Pompidou (HEGP)
  • Toulouse, France, 31076
    • Clinique Pasteur Toulouse
• Germany
  • Arnsberg, Germany, 59759
    • Klinikum Arnsberg
  • Bad Segeberg, Germany, 23795
    • Segeberger Kliniken
  • Darmstadt, Germany, 64283
    • Klinikum Darmstadt GmbH
  • Frankfurt, Germany, 60389
    • Cardiovascular Center
  • Leipzig, Germany, 04103
    • Universitätsklinikum Leipzig
  • Leipzig, Germany, 04289
    • Park-Krankenhaus
  • Marburg, Germany, 35043
    • Universitätsklinikum

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Subjects must be age 18 or older
• Subject is willing and able to provide informed consent
• Subject is available to attend all required follow-up visits
• Subject has a clinically significant symptomatic leg ischemia requiring treatment
• Subject has a Rutherford clinical category of 2-4
• If the index lesion is restenotic, the prior PTA must have been >30 days prior to treatment in the current study
• Only one lesion per limb can be treated under this protocol.
• Successful intraluminal wire crossing of the target lesion
• Index lesion is a clinically and hemodynamically significant stenotic or restenotic lesion located in the native nonstented superficial femoral artery or proximal popliteal artery
• Degree of stenosis 70% or more, by visual assessment
• Lesion length between 20 mm and 150 mm
• At least one patent infrapopliteal artery to the foot of the index limb

Exclusion Criteria:

• Subjects who have undergone prior vascular surgery of the femoropopliteal artery in the index limb to treat atherosclerotic disease
• History of major amputation in the same limb as the target lesion
• Presence of aneurysm in the target vessel
• Acute ischemia and/or acute thrombosis in any artery of the lower limbs
• Acute Myocardial Infarction within 30 days before the index procedure
• Persistent, intraluminal thrombus of the proposed target lesion post-thrombolytic therapy
• Known hypersensitivity or contraindication to contrast dye that cannot be adequately pre-medicated
• Known allergies against Paclitaxel or other components of the used medical devices
• Intolerance to antiplatelet, anticoagulant, or thrombolytic medications that would be administered during the trial
• Platelet count <100,000 mm3 or >600,000 mm3
• Concomitant renal failure with a serum creatinine >2.0 mg/dL
• Receiving dialysis or immunosuppressant therapy
• Life expectancy of less than one year
• Women of child-bearing potential must agree to use a reliable method of contraception from the time of screening through 12 months after the index procedure.
• Woman who is pregnant or nursing.
• Previously planned stenting of the index lesion
• Use of adjunctive therapies (debulking, laser, cryoplasty, re-entry devices)
• Planned or expected procedures (cardiac, aorta, peripheral) within 30 days after the index procedure
• Presence of outflow lesions requiring intervention within 30 days of the index procedure
• Perforated vessel as evidenced by extravasation of contrast media
• Heavily calcified target lesions resistant to PTA
• Current participation in another drug or device trial that has not completed the primary endpoint, that may potentially confound the results of this trial, or that would limit the subject's compliance with the follow-up requirements
• Current participation in any study using drug-coated/drug-eluting technologies
• Current participation in any study using drug-coated/drug-eluting technologies
• Target lesion with in-stent restenosis (any stent or stent-graft)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Ranger(TM) Paclitaxel-coated balloon; Index lesion treated with Ranger(TM) Paclitaxel-coated PTA balloon catheter (Ranger DCB)	Device: Ranger DCB; After successful pre-dilatation the index lesion is treated with one or two Ranger DCB devices that completely cover the lesion. If two devices are deployed, overlap shall be minimal.
Active Comparator: uncoated PTA balloon; Index lesion treated with an uncoated standard PTA dilatation balloon catheter selected upon investigator´s discretion	Device: uncoated PTA balloon; The index lesion is treated with one or more uncoated standard PTA balloons that completely cover the lesion.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
in-segment late lumen loss	In-segment late lumen loss (LLL) of the treated segment after PTA using the Ranger™ paclitaxel-coated PTA balloon, in comparison to the LLL after PTA using an uncoated balloon, as observed by angiography at six months post-index procedure.	six months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
technical success	The ability to cross and dilate the lesion to achieve residual angiographic stenosis no greater than 30%.	during index procedure, less 1 hour
procedural success	Technical success with no MAE noted within 24 hours of the index procedure.	within 24 hours of index procedure
primary patency	Percentage of lesions that reach endpoint without a hemodynamically significant stenosis on duplex ultrasound (DUS) and without target lesion revascularization (TLR) or bypass of the target lesion to maintain or restore patency.	six months
primary patency	Percentage of lesions that reach endpoint without a hemodynamically significant stenosis on DUS and without TLR or bypass of the target lesion to maintain or restore patency.	twelve months
assisted primary patency	Percentage of lesions without TLR and those with TLR (not due to complete occlusion or bypass) that reach endpoint without restenosis.	six months
assisted primary patency	Percentage of lesions without TLR and those with TLR (not due to complete occlusion or bypass) that reach endpoint without restenosis.	twelve months
secondary patency	Percentage of lesions with TLR for occlusion that reach endpoint without restenosis.	six months
secondary patency	Percentage of lesions with TLR for occlusion that reach endpoint without restenosis.	twelve months
binary restenosis rate	Binary restenosis defined as > 50% diameter stenosis via peak systolic velocity ratio (PSVR) > 2.4 via duplex ultrasound and assessed by the core lab.	six months
binary restenosis rate	Binary restenosis defined as > 50% diameter stenosis via peak systolic velocity ratio (PSVR) > 2.4 via duplex ultrasound and assessed by the core lab.	twelve months
clinical success	Positive change (by +1 or more) of Rutherford category at pre-discharge post-index-procedure as compared to baseline.	pre-discharge, estim. 1-2 days post-index procedure
clinical success	Positive change (by +1 or more) of Rutherford category at six months (plus or minus 30 days) post-index-procedure as compared to baseline.	six months
clinical success	Positive change (by +1 or more) of Rutherford category at twelve months (plus or minus 30 days) post-index-procedure as compared to baseline.	twelve months
hemodynamic success	positive change in Ankle-Brachial Index (ABI) at pre-discharge as compared to baseline	pre-discharge, estim. 1-2 days post-index procedure
hemodynamic success	positive change in ABI at six months (plus or minus 30 days) as compared to baseline	six months
hemodynamic success	positive change in ABI at twelve months (plus or minus 30 days) as compared to baseline	twelve months
change in quality of life	Change in functional status measured by changes in the Walking Impairment Questionnaire (WiQ) and general health-related quality of life measured by changes in SF-12 and EQ5D scores at six months (plus or minus 30 days) as compared to baseline.	six months
change in quality of life	Change in functional status measured by changes in the Walking Impairment Questionnaire (WiQ) and general health-related quality of life measured by changes in SF-12 and EQ5D scores at twelve months (plus or minus 30 days) as compared to baseline.	twelve months
change in quality of life	Change in general health-related quality of life measured by changes in SF-12 and EQ5D scores at 24 months (plus or minus 30 days) as compared to baseline.	24 months
change in quality of life	Change in general health-related quality of life measured by changes in SF-12 and EQ5D scores at 36 months (plus or minus 30 days) as compared to baseline.	36 months

Collaborators and Investigators

• Sponsor: Hemoteq AG
• Collaborators: CERES GmbH; coreLab Black Forest GmbH
• Investigators: Principal Investigator: Dierk Scheinert, M.D., University Leipzig

Publications and helpful links

General Publications

• Bausback Y, Willfort-Ehringer A, Sievert H, Geist V, Lichtenberg M, Del Giudice C, Sauguet A, Diaz-Cartelle J, Marx C, Strobel A, Schult I, Scheinert D; RANGER SFA Investigators. Six-Month Results From the Initial Randomized Study of the Ranger Paclitaxel-Coated Balloon in the Femoropopliteal Segment. J Endovasc Ther. 2017 Aug;24(4):459-467. doi: 10.1177/1526602817710770. Epub 2017 May 31.

Study record dates

Study Major Dates

• Study Start (Actual): January 7, 2014
• Primary Completion (Actual): June 16, 2016
• Study Completion (Actual): March 15, 2019

Study Registration Dates

• First Submitted: December 11, 2013
• First Submitted That Met QC Criteria: December 16, 2013
• First Posted (Estimate): December 17, 2013

Study Record Updates

• Last Update Posted (Actual): December 23, 2019
• Last Update Submitted That Met QC Criteria: December 20, 2019
• Last Verified: December 1, 2019

More Information

Terms related to this study

• Keywords: drug-coated balloon; claudication; peripheral artery disease; drug-eluting balloon
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Arterial Occlusive Diseases; Peripheral Vascular Diseases; Peripheral Arterial Disease; Intermittent Claudication; Arteriosclerosis; Atherosclerosis
• Other Study ID Numbers: HTQ001-RangerSFA; CIV-13-07-011514 (Other Identifier: EUDAMED)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No