- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02944071
Ranger™ and Ranger™ SL (OTW) DCB) in China
Prospective, Non-randomized, Multicenter Clinical Study of the Boston Scientific Paclitaxel-Coated PTA Balloon Catheter (Ranger™ and Ranger™ SL (OTW) DCB) in China
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
study objectives: The primary objective of this study is to demonstrate acceptable safety and performance of the Ranger™(Ranger & Ranger LE) and Ranger™ SL (OTW) paclitaxel-coated PTA balloon catheter used for angioplasty of femoropopliteal artery lesions.
Primary endpoints: The primary safety endpoint is the rate of following major adverse events through 30 days post-procedure:
- all device and/or procedure related mortality
- target limb major amputation at
- Clinically-driven Target Lesion Revascularization (TLR)
The primary efficacy endpoint is primary lesion patency of the treated segment(s) as assessed by computed tomography angiography (CTA) at 12 months post-procedure without clinically-driven TLR.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Changsha, China
- Xiangya Hospital Central South University
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Shanghai, China
- Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine
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Tianjin, China
- Tianjin Medical University General Hospital
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Beijing Municipality
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Beijing, Beijing Municipality, China
- Beijing Tongren Hospital, Capital Medical University
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Henan
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Zhengzhou, Henan, China
- The first affiliated hospital of Zhengzhou university
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Jiangsu
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Nanjing, Jiangsu, China
- Jiangsu Province Hospital
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Jilin
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Harbin, Jilin, China
- The First Affiliated Hospital of Harbin Medicial University
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Shanghai Municipality
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Shanghai, Shanghai Municipality, China
- Zhongshan Hospital Affiliated to Fudan University
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Sichuan
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Chengdu, Sichuan, China
- West China Hospital, Sichuan University
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Subjects must be age 18 or older
- Subject is willing and able to provide informed consent
- Subject is available and willing to attend all required follow-up visits
- Subject has a clinically significant symptomatic leg ischemia
- Subject has a Rutherford clinical category of 2 - 4
- If the index lesion is restenotic, the prior PTA must have been > 90 days prior to treatment in the current study
- Only one lesion per limb can be treated under this protocol, which means that one index lesion, on one index limb will be "in treatment". However, both limbs may be treated during either the index procedure and/or subsequent procedures
- Successful intraluminal wire crossing of the target lesion
Angiographic Inclusion Criteria:
Al1.The index lesion is a clinically and hemodynamically de novo stenotic or restenotic lesion located in the native nonstented superficial femoral artery or proximal popliteal artery between the Hunter's Canal and the popliteal fossa (i.e. within the P1 segment), with the following characteristics by visual assessment:
- Degree of stenosis ≥ 70%
- Target vessel diameter ≥ 2.0 mm and ≤ 8.0 mm
- Lesion length ≥ 20 mm and ≤ 200 mm, to be covered by one or two balloon(s) (with minimal overlap)
- For diffuse lesion or multiple lesions in the same target vessel, the total lesion length, including the distance between lesions, must be ≤ 200 mm
- AI2. The subject has at least one patent infrapopliteal artery (< 50% stenosis) to the foot prior to index procedure
Exclusion Criteria:
- Subjects who have undergone prior vascular surgery of the SFA/PPA(Superficial Femoral Artery / Proximal Popliteal 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(s)
- Acute ischemia and/or acute thrombosis in any artery of the lower limbs
- Acute Myocardial Infarction within 30 days before the index procedure
- History of hemorrhagic stroke within 3 months
- History of thrombolysis or angina within 2 weeks of enrollment
- Persistent, intraluminal thrombus of the proposed target lesion post thrombolytic therapy
- Known hypersensitivity or contraindication to contrast dye that, in the opinion of the investigator, 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 < 80,000 mm3 or > 700,000 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 cannot use a reliable method of contraception from the time of screening through 12 months after the index procedure.
- Woman who is pregnant or nursing. (Pregnancy test must be performed within 72 hours prior to the index procedure, except for women who definitely do not have child-bearing potential).
- Previously planned stenting of the index lesion (stents will be allowed for bailout situations like flow-limiting dissection)
- Use of adjunctive therapies (debulking, laser, cryoplasty, re-entry devices)
- Subjects who had any major procedures (cardiac, aorta, peripheral) within 30 days prior to the index procedure
- Planned or expected procedures (cardiac, aorta, peripheral) within 30 days post 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, including any clinical study using drug-coated or drug-eluting technology, that may potentially confound the results of this trial, or that would limit the subject's compliance with the follow-up requirements
- Current or past intervention using drug-coated/drug-eluting technologies in the index limb
- Target lesion with in-stent restenosis (any stent or stent-graft)
Angiographic Exclusion Criteria:
- AE1. Subjects with ipsilateral iliac inflow lesions , and unsuccessful treatment prior to the index procedure (i.e., residual stenosis ≥ 30% post treatment
- AE2. Subjects with no patent infrapopliteal artery (i.e., ≥ 50% stenosis) to the foot prior to index procedure
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
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Experimental: (Ranger & Ranger LE) and Ranger DCB
The working length is 80cm and 135cm for Ranger DCB catheter and 90 cm and 150cm for Ranger SL and Ranger LE DCB catheter. Multiple interventions: Prior to or during Index Procedure:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Major Adverse Events Through 30 Days Post-procedure
Time Frame: Within 30 days after treatment
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Within 30 days after treatment
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Primary Vessel Patency of the Treated Segment(s)
Time Frame: Within 12 months after treatment
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Assessed by computed tomography angiography (CTA) at 12 months post-procedure without Target Lesion Revascularization.
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Within 12 months after treatment
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Technical Success
Time Frame: within 24 hours of the index procedure
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defined as ability to cross and dilate the lesion to achieve residual angiographic stenosis no greater than 30%
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within 24 hours of the index procedure
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Procedural Success
Time Frame: within 24 hours of the index procedure
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defined as technical success with no Major Adverse Events (including all-cause death, clinically-driven Target Lesion Revascularization, target limb major amputation or thrombosis at target lesion)
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within 24 hours of the index procedure
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Target Vessel Patency Assessed by Duplex Ultrasound Sonography
Time Frame: at 3 month post index procedure
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access the target vessel patency at 3 month visit by duplex ultrasound sonography
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at 3 month post index procedure
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All-cause Death at 30 Days, 3, 6 and 12 Months
Time Frame: Within 12 months after treatment
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calculate the rate of all-cause death at 30 days, 3, 6 and 12 months after treatment
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Within 12 months after treatment
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Clinically-driven Target Lesion Revascularization at 3, 6 and 12 Months
Time Frame: Within 12 months after treatment
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calculate the rate of Target Lesion Revascularization at 30 days, 3, 6 and 12 months after treatment
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Within 12 months after treatment
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Clinical Success
Time Frame: Within 12 months after treatment
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defined as improved Rutherford classification by at least +1 class at pre-discharge, 3 and 12 months as compared to baseline. RUTHERFORD / BECKER CLASSIFICATION Category Objective Criteria 0 Normal Treadmill /stress test
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Within 12 months after treatment
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Hemodynamic Success
Time Frame: Within 12 months after treatment
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defined as positive change in Ankle-Brachial Index at pre-discharge, 3 months, 12 months as compared to baseline. The ratio between the systolic pressure measured at the ankle and the systolic pressure measured in the arm as follows:
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Within 12 months after treatment
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Major Adverse Events Through 12 Months
Time Frame: Within 12 months after treatment
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Major Adverse Events , including all-cause death, clinically-driven Target Lesion Revascularization, target limb major amputation or thrombosis at target lesion
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Within 12 months after treatment
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Zhong Chen, dr., Beijing Anzehn hospital
Publications and helpful links
General Publications
- Criqui MH, Fronek A, Barrett-Connor E, Klauber MR, Gabriel S, Goodman D. The prevalence of peripheral arterial disease in a defined population. Circulation. 1985 Mar;71(3):510-5. doi: 10.1161/01.cir.71.3.510.
- Hiatt WR, Hoag S, Hamman RF. Effect of diagnostic criteria on the prevalence of peripheral arterial disease. The San Luis Valley Diabetes Study. Circulation. 1995 Mar 1;91(5):1472-9. doi: 10.1161/01.cir.91.5.1472.
- Selvin E, Erlinger TP. Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey, 1999-2000. Circulation. 2004 Aug 10;110(6):738-43. doi: 10.1161/01.CIR.0000137913.26087.F0. Epub 2004 Jul 19.
- Garcia LA. Epidemiology and pathophysiology of lower extremity peripheral arterial disease. J Endovasc Ther. 2006 Feb;13 Suppl 2:II3-9. doi: 10.1177/15266028060130S204.
- Kasapis C, Gurm HS. Current approach to the diagnosis and treatment of femoral-popliteal arterial disease. A systematic review. Curr Cardiol Rev. 2009 Nov;5(4):296-311. doi: 10.2174/157340309789317823.
- Rooke TW, Hirsch AT, Misra S, Sidawy AN, Beckman JA, Findeiss LK, Golzarian J, Gornik HL, Halperin JL, Jaff MR, Moneta GL, Olin JW, Stanley JC, White CJ, White JV, Zierler RE; American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines; Society for Cardiovascular Angiography and Interventions; Society of Interventional Radiology; Society for Vascular Medicine; Society for Vascular Surgery. 2011 ACCF/AHA focused update of the guideline for the management of patients with peripheral artery disease (updating the 2005 guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society for Vascular Medicine, and Society for Vascular Surgery. J Vasc Surg. 2011 Nov;54(5):e32-58. doi: 10.1016/j.jvs.2011.09.001. Epub 2011 Sep 29. No abstract available.
- Rocha-Singh KJ, Jaff MR, Crabtree TR, Bloch DA, Ansel G; VIVA Physicians, Inc. Performance goals and endpoint assessments for clinical trials of femoropopliteal bare nitinol stents in patients with symptomatic peripheral arterial disease. Catheter Cardiovasc Interv. 2007 May 1;69(6):910-9. doi: 10.1002/ccd.21104.
- Laird JR, Katzen BT, Scheinert D, Lammer J, Carpenter J, Buchbinder M, Dave R, Ansel G, Lansky A, Cristea E, Collins TJ, Goldstein J, Jaff MR; RESILIENT Investigators. Nitinol stent implantation versus balloon angioplasty for lesions in the superficial femoral artery and proximal popliteal artery: twelve-month results from the RESILIENT randomized trial. Circ Cardiovasc Interv. 2010 Jun 1;3(3):267-76. doi: 10.1161/CIRCINTERVENTIONS.109.903468. Epub 2010 May 18.
- Waksman R, Pakala R. Drug-eluting balloon: the comeback kid? Circ Cardiovasc Interv. 2009 Aug;2(4):352-8. doi: 10.1161/CIRCINTERVENTIONS.109.873703. No abstract available.
- Stone GW, Ellis SG, Cannon L, Mann JT, Greenberg JD, Spriggs D, O'Shaughnessy CD, DeMaio S, Hall P, Popma JJ, Koglin J, Russell ME; TAXUS V Investigators. Comparison of a polymer-based paclitaxel-eluting stent with a bare metal stent in patients with complex coronary artery disease: a randomized controlled trial. JAMA. 2005 Sep 14;294(10):1215-23. doi: 10.1001/jama.294.10.1215.
- Tepe G, Zeller T, Albrecht T, Heller S, Schwarzwalder U, Beregi JP, Claussen CD, Oldenburg A, Scheller B, Speck U. Local delivery of paclitaxel to inhibit restenosis during angioplasty of the leg. N Engl J Med. 2008 Feb 14;358(7):689-99. doi: 10.1056/NEJMoa0706356.
- Tenaglia AN, Fortin DF, Califf RM, Frid DJ, Nelson CL, Gardner L, Miller M, Navetta FI, Smith JE, Tcheng JE, et al. Predicting the risk of abrupt vessel closure after angioplasty in an individual patient. J Am Coll Cardiol. 1994 Oct;24(4):1004-11. doi: 10.1016/0735-1097(94)90862-1.
- Lincoff AM, Popma JJ, Ellis SG, Hacker JA, Topol EJ. Abrupt vessel closure complicating coronary angioplasty: clinical, angiographic and therapeutic profile. J Am Coll Cardiol. 1992 Apr;19(5):926-35. doi: 10.1016/0735-1097(92)90272-o.
- Post MJ, Borst C, Kuntz RE. The relative importance of arterial remodeling compared with intimal hyperplasia in lumen renarrowing after balloon angioplasty. A study in the normal rabbit and the hypercholesterolemic Yucatan micropig. Circulation. 1994 Jun;89(6):2816-21. doi: 10.1161/01.cir.89.6.2816.
- Leiner T, Kessels AG, Nelemans PJ, Vasbinder GB, de Haan MW, Kitslaar PE, Ho KY, Tordoir JH, van Engelshoven JM. Peripheral arterial disease: comparison of color duplex US and contrast-enhanced MR angiography for diagnosis. Radiology. 2005 May;235(2):699-708. doi: 10.1148/radiol.2352040089.
- Klein WM, van der Graaf Y, Seegers J, Spithoven JH, Buskens E, van Baal JG, Buth J, Moll FL, Overtoom TT, van Sambeek MR, Mali WP. Dutch iliac stent trial: long-term results in patients randomized for primary or selective stent placement. Radiology. 2006 Feb;238(2):734-44. doi: 10.1148/radiol.2382041053. Epub 2005 Dec 21.
- Lutonix 2014 Panel Presentation Summary of Safety and Effectiveness Data (SSED) http://www.fda.gov/downloads/advisorycommittees/committeesmeetingmaterials/medicaldevices/medicaldevicesadvisorycommittee/circulatorysystemdevicespanel/ucm400421.pdf.
- Cutlip DE, Windecker S, Mehran R, Boam A, Cohen DJ, van Es GA, Steg PG, Morel MA, Mauri L, Vranckx P, McFadden E, Lansky A, Hamon M, Krucoff MW, Serruys PW; Academic Research Consortium. Clinical end points in coronary stent trials: a case for standardized definitions. Circulation. 2007 May 1;115(17):2344-51. doi: 10.1161/CIRCULATIONAHA.106.685313.
- Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG; TASC II Working Group; Bell K, Caporusso J, Durand-Zaleski I, Komori K, Lammer J, Liapis C, Novo S, Razavi M, Robbs J, Schaper N, Shigematsu H, Sapoval M, White C, White J, Clement D, Creager M, Jaff M, Mohler E 3rd, Rutherford RB, Sheehan P, Sillesen H, Rosenfield K. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). Eur J Vasc Endovasc Surg. 2007;33 Suppl 1:S1-75. doi: 10.1016/j.ejvs.2006.09.024. Epub 2006 Nov 29. No abstract available.
- Werk M, Langner S, Reinkensmeier B, Boettcher HF, Tepe G, Dietz U, Hosten N, Hamm B, Speck U, Ricke J. Inhibition of restenosis in femoropopliteal arteries: paclitaxel-coated versus uncoated balloon: femoral paclitaxel randomized pilot trial. Circulation. 2008 Sep 23;118(13):1358-65. doi: 10.1161/CIRCULATIONAHA.107.735985. Epub 2008 Sep 8.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimated)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Vascular Diseases
- Cardiovascular Diseases
- Atherosclerosis
- Arteriosclerosis
- Arterial Occlusive Diseases
- Peripheral Vascular Diseases
- Peripheral Arterial Disease
- Antineoplastic Agents
- Molecular Mechanisms of Pharmacological Action
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Antineoplastic Agents, Phytogenic
- Paclitaxel
Other Study ID Numbers
- S6052
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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