Outcome of Endovascular Therapies in Chronic Femoropopliteal Occlusive Disease With Severe Calcification

February 20, 2023 updated by: First Affiliated Hospital of Zhejiang University

Clinical and Economic Outcome of Endovascular Therapies in Chronic Femoropopliteal Occlusive Disease With Severe Calcification (The Evolution Study): a Prospective, Multi-center，Observational Study

This study is a prospective, multicenter, real world, observational study, which aims at evaluating the safety, efficacy and economic cost of endovascular treatments for endovascular therapies in chronic femoropopliteal occlusive disease with severe calcification. It is estimated that 400 subjects diagnosed with chronic femoropopliteal occlusive disease with severe calcification and receive endovascular treatments will be enrolled in eight centers nationwide from January 2021 to December 2022. All the subjects will be under follow-up for two years. There is no restriction on the endovascular techniques. The primary outcomes include the technical success rate of each endovascular techniques and the reintervention rate driven by lesions' clinical symptoms.

Study Overview

Status

Recruiting

Conditions

Detailed Description

Arteriosclerosis obliterans (ASO) is a common disease in middle-aged and elderly people, which affects up to 30% people who are over 70 years in the general population. Its symptoms include claudication, rest pain and ischemic tissue loss depending on its severity. Nowadays, endovascular treatments have become the first-line therapy. If ASO is combined with severe calcification, the treatment will be much more challenging. The efficacy of plain old balloon angioplasty is limited. New devices including drug-coated balloon, intravascular Lithotripsy, directional atherectomy, Supera stent and drug-eluting stent offer another chance and better prognosis. The data of these new devices, however, are mainly from low quality evidence. Therefore, we start this prospective, multicenter, real world, observational study, providing new data on the safety, efficacy and health economics evaluation of endovascular treatments for endovascular therapies in chronic femoropopliteal occlusive disease with severe calcification.

Study Type

Observational

Enrollment (Anticipated)

600

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • China
    • Zhejiang
      • Hangzhou, Zhejiang, China, 310000
        • Recruiting
        • The First Affliated Hospital, Zhejiang University, School of Medicine
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Chronic femoropopliteal occlusive disease with severe calcification

Description

Inclusion Criteria:

  1. Rutherford stages 2-6
  2. The target vessel (femoral and/or popliteal artery) has at least ≥90% stenosis or occlusion with the moderate to severe calcification (defined as >5 cm continuous calcification)
  3. For patients with both lower limbs to be treated, the side with severer calcification is selected. If the calcification is similar in the two sides, the first one to be treated is selected.
  4. At least one outflow artery (which is patent in > 1/3 length) in the calf connects the popliteal artery.
  5. Patients who failed the first treatment because the guide wire could not pass through the lesion can still be selected if the second endovascular treatment succeeds.
  6. There is no restriction on the types of endovascular techniques and devices.

Exclusion Criteria:

Exclusion Criteria:

  1. Life expectation less than one year
  2. There is several infection and/or major tissue loss in the leg. Even if after revascularization, patient still need amputation.
  3. The quality of patients' life cannot be assessed by vascular quality of life questionnaire due to difficulties in communication.
  4. Chronic femoropopliteal occlusive disease without calcification.
  5. Patients with acute arterial thrombosis.
  6. Limbs that have been treated with the femoral and popliteal artery bypass surgery.
  7. Pregnant women
  8. Allergic to contrast medium
  9. Participating in other drug or device studies currently.
  10. Systematic infection and/or coagulation disorders 14 days before the enrollment.
  11. Patients have severe systematic disease that cannot be controlled currently such as severe heart, lung disease, live function disorder, end stage cancer, etc
  12. Stroke, myocardial infarction, bleeding in the past 6 month

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Technical success rate
Time Frame: 1 week
Successfully revascularize the target vessel. The residual stenosis is <30% and there is no acute thrombosis occurred in the target vessel within 1 week post-operation.
1 week
The clinically driven target lesion revascularization(CD-TLR) rate at post-interventional
Time Frame: 1 month
Any reintervention within the target lesion due to symptoms or drop of ≥20% ABI compared to baseline.
1 month
The clinically driven target lesion revascularization(CD-TLR) rate at post-interventional
Time Frame: 6 months
Any reintervention within the target lesion due to symptoms or drop of ≥20% ABI compared to baseline.
6 months
The clinically driven target lesion revascularization(CD-TLR) rate at post-interventional
Time Frame: 12 months
Any reintervention within the target lesion due to symptoms or drop of ≥20% ABI compared to baseline.
12 months
The clinically driven target lesion revascularization(CD-TLR) rate at post-interventional
Time Frame: 18 months
Any reintervention within the target lesion due to symptoms or drop of ≥20% ABI compared to baseline.
18 months
The clinically driven target lesion revascularization(CD-TLR) rate at post-interventional
Time Frame: 24 months
Any reintervention within the target lesion due to symptoms or drop of ≥20% ABI compared to baseline.
24 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Vascular quality of life questionnaire(VascuQol)
Time Frame: 1 month,6 months,12 months,18 months and 24 months
The VascuQol was designed as a questionnaire containing five domains: pain (4 items), symptoms (4 items), activities (8 items), social (2 items), and emotional (7 items) to evaluate Health related quality of life (HRQL). Every item has seven response options, with scores ranging from 1 to 7. A total score is the sum of all 25 item scores divided by 25.And both the total score as well as the domain scores range from 1 (worst HRQL) to 7 (best HRQL).The lower the value, the poorer the quality of life.
1 month,6 months,12 months,18 months and 24 months
Incidence of severe adverse events
Time Frame: 1 month,6 months,12 months,18 months and 24 months
Severe adverse events include anyone of the following: Myocardial infarction, ischemic stroke, cardiovascular mortality, acute limb ischemia, and major amputation of a vascular etiology.
1 month,6 months,12 months,18 months and 24 months
Patency of the target vessel
Time Frame: Patency of the target vessel. [ Time Frame: 1 month,6 months,12 months,18 months and 24 months
The patency is assessed by the vascular ultrasound.
Patency of the target vessel. [ Time Frame: 1 month,6 months,12 months,18 months and 24 months
Health economics evaluation
Time Frame: 24 months
All the cost related to the target vessel and spent in the inpatient ward will be recorded and analyzed.
24 months
Wound, Ischemia, and foot infection(WIFI) classification system
Time Frame: 1 month,6 months,12 months,18 months and 24 months
The Wound, Ischemia, and foot Infection (WIfI) classification system is a composite outcome measure encompassing demographic changes and expanding techniques of revascularization to perform meaningful analyses of outcomes in the treatment of the threatened limb, including wound, ischemia and foot infection. Each index was evaluated by very low, low, moderate and high, the very low represents no risk, the high reveals high risk of amputation.
1 month,6 months,12 months,18 months and 24 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

First Affiliated Hospital of Zhejiang University

Investigators

  • Principal Investigator: Ziheng Wu, M.D., First Affiliated Hospital of Zhejiang University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 10, 2020

Primary Completion (Anticipated)

June 30, 2023

Study Completion (Anticipated)

December 31, 2024

Study Registration Dates

First Submitted

January 10, 2021

First Submitted That Met QC Criteria

January 18, 2021

First Posted (Actual)

January 20, 2021

Study Record Updates

Last Update Posted (Estimate)

February 22, 2023

Last Update Submitted That Met QC Criteria

February 20, 2023

Last Verified

February 1, 2023

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • IIT20200011B

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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