POWER: Pulse Intravascular Lithotripsy (Pulse IVL) to Open Vessels With Calcific Walls and Enhance Vascular Compliance and Remodeling (POWER-PAD-1)

A Prospective, Single-Arm, Multicenter, Feasibility Study to Evaluate Safety and Performance of the Amplitude Vascular System (AVS) Pulse Peripheral Intravascular Lithotripsy (IVL) for Treating Subjects With Calcific Femoropopliteal Arteries in Conjunction With Adjunctive Therapy

The POWER-PAD-1 Study is a first-in-human evaluation of the safety and performance of the Pulse Peripheral Intravascular Lithotripsy (IVL) Balloon Catheter to enroll up to twenty (20) subjects.

Study Overview

• Status: Active, not recruiting
• Conditions: Peripheral Arterial Disease
• Intervention / Treatment: Device: Pulse Intravascular Lithotripsy System

Detailed Description

Amplitude Vascular System intendeds to conduct a first-in-human evaluation of the safety and performance of the Pulse Peripheral Intravascular Lithotripsy (IVL) Balloon Catheter in subjects with stenotic lesions of the superficial femoral and/or popliteal arteries (Rutherford Category 2 to 4 of the target limb) with a reference vessel diameter (RVD) of 4mm to 6mm and a total length of <60mm. Up to twenty subjects will be enrolled and treated with the Pulse IVL lithotripsy and followed for 6 months. The Pulse Intravascular Lithotripsy Catheter is intended for the pulsatile lithotripsy-enhanced balloon dilation of lesions, including calcified and fibro-calcific lesions in the peripheral vasculature, such as the superficial femoral and popliteal arteries.

• Study Type: Interventional
• Enrollment (Actual): 9
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Australia
  • Western Australia
    • Perth, Western Australia, Australia, 6000
      • Royal Perth Hospital
• Dominican Republic
  • Santo Domingo, Dominican Republic
    • Centro Medico Moderno
• New Zealand
  • Auckland, New Zealand, 1023
    • Auckland City Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Subject is ≥18 years.
2. Subject is able and willing to comply with all assessments in the study.
3. Subject or subject's legal representative have been informed of the nature of the study, agrees to participate, and has signed the approved consent form approved by the local Ethics Committee.
4. Rutherford clinical category 2, 3, or 4 of the target limb.
5. Resting ankle-brachial index (ABI) of ≤0.90, or ≤0.75 after exercise, of the target leg.
6. Moderate to severe calcification of target lesion(s) per pre-procedure CT scan. (Calcification must be: ≥180 degrees circumferential at some point in the lesion AND extend ≥50% length of lesion or absolute length ≥20mm.)
7. Flow-limiting target lesion reference vessel diameter is between 4.0mm and 6.5mm as determined by investigator
8. Target lesion length is ≤150mm
9. Subject life expectancy >1 year
10. Subject is intended to undergo angiographic and endovascular intervention in the opinion of the investigator(s) and/or per hospital protocols.
11. Subject agrees to undergo treatment with Pulse Peripheral Intravascular Lithotripsy.

Exclusion Criteria:

1. Rutherford Category 0, 1, 5, and 6.
2. Subject has active infection in the target leg requiring antibiotic therapy.
3. Planned major amputation of the target leg (transmetatarsal or higher).
4. In-stent restenosis within the target lesion(s).
5. Significant target vessel tortuosity (bends >30 degrees over the arc length of the balloon) or other parameters prohibiting access to the target lesion.
6. Chronic total occlusion of the target lesion(s) > 40mm.
7. Target lesion(s) within native or synthetic vessel grafts.
8. Chronic total occlusion of inflow vessel.
9. Lesion in contralateral limb requiring intervention within the next 30 days.
10. Subject has had any major (e.g., cardiac, peripheral, abdominal) surgical procedure or intervention unrelated to this study within 30 days prior to the index procedure or has planned major surgical procedure or intervention within 30 days of the index procedure.
11. Subject has significant stenosis (>50% stenosis) or occlusion of inflow tract (upstream disease) not successfully treated with percutaneous transluminal angioplasty (PTA) or percutaneous stent.
12. Deep heel ulcers or any evidence of osteomyelitis.
13. Subject requires treatment of a peripheral lesion on the ipsilateral limb distal to the target lesion(s) at the time of the enrollment / index procedure.
14. Subject has a known coagulopathy or has a bleeding diathesis, thrombocytopenia with platelet counts <100,000/microliter, or international normalized ratio >1.5.
15. Subject in whom antiplatelet, anticoagulant, or thrombolytic therapy is contraindicated.
16. Subject has known allergy to contrast agents or medications used to perform endovascular intervention that cannot be adequately pre-treated.
17. Subject has known allergy to urethane, nylon, or silicone.
18. Myocardial infarction within 60 days prior to enrollment.
19. History of stroke within 60 days prior to enrollment.
20. Subjects that are non-ambulatory and confined to bed.
21. Subject has life expectancy <12 months.
22. History of unstable coronary artery disease or other uncontrollable comorbidity resulting in hospitalization within the last 60 days prior to enrollment.
23. History of thrombolytic therapy within 2 weeks of enrollment.
24. Subject has acute or chronic renal disease (e.g., as measured by a serum creatinine of >2.5 mg/dL or >220 µmol/L or is on dialysis).
25. Women who are pregnant, breast-feeding, or intend to become pregnant
26. Subject is participating in another investigational drug, biological, or medical device study that has not completed primary endpoint(s) evaluation or that clinically interferes with the endpoints of this study, or subject is planning to participate in such studies prior to the completion of this study.
27. Subject has any other condition that, at the discretion of the Investigator, would preclude them completing the study protocol.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Lithotripsy Treatment; Pulse Intravascular Lithotripsy System Device: Pulse Intravascular Lithotripsy Catheter	Device: Pulse Intravascular Lithotripsy System; Treatment with Pulse Intravascular Lithotripsy System

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Device Success	Defined as successful delivery, balloon inflation, deflation, and retrieval of the intact study device without bust below rated burst pressure	up to 24 hours
Technical Success	Defined as successful vascular access, completion of endovascular procedure with or without adjunctive therapy, and immediate achievement of less than or equal to 50% residual stenosis of the treated lesion on completion of angiography.	up to 24 hours
Procedural Success	Defined as Device Success or Technical Success and absence of procedural complications	up to 24 hours
Major Adverse Events	A composite of either unplanned major amputation (above the ankle) or major reintervention of target limb defined as new unplanned surgical bypass graft, the use of thrombectomy or thrombolysis, major surgical graft revision such as a jump graft or an interposition graft, or bail-out stenting at 30 days.	30 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Freedom from target limb revascularization	Freedom from clinically driven target lesion revascularization at 30-days and 6-months	30 days and 6 months
Clinical Success	Achievement of residual stenosis of the treated lesion on completion of angiography with or without adjunctive therapy	up to 24 hours
Rutherford Clinical Category	Improvement in Rutherford Class score at 6 months	6 months
Ankle-Brachial Index	Change in Ankle Brachial Index (ABI) of the target limb at 30 days	30 days
Quality of Life at 30 days and 6 months	Assessed by EUROQOL - EQ-5D-5L descriptive system (Mobility, Self-Care, Usual Activities, Pain/Discomfort, and Anxiety/Depression) questionnaire at 30 days and 6 months reported as a change from baseline. LEVEL 1: indicating no problem LEVEL 2: indicating slight problems LEVEL 3: indicating moderate problems LEVEL 4: indicating severe problems LEVEL 5: indicating unable to/extreme problems	30 days and 6 months
Walking Capacity	Assessed by the Walking Impairment Questionnaire (WIQ) at 30 days and 6 months reported as a change from baseline.	30 days and 6 months
VacuQol	Change in VascuQol score from pre-procedure to 30-days and 6-months	30 days and 6 months
Major Adverse Event	Major Adverse Limb event or procedure-related death at 30-days	30 days
Major Unplanned Amputation	Major Unplanned Amputation of the target limb at 6 months.	6 months

Collaborators and Investigators

• Sponsor: Amplitude Vascular Systems, Inc.
• Investigators: Principal Investigator: Andrew Holden, MD, Auckland City Hospital; Principal Investigator: Nelson Encanacion, MD, Centro Medico Moderno; Principal Investigator: Bibombe P Mwipatayi, MD, Royal Perth Hospital

Study record dates

Study Major Dates

• Study Start (Actual): June 28, 2022
• Primary Completion (Estimated): June 28, 2024
• Study Completion (Estimated): December 31, 2024

Study Registration Dates

• First Submitted: December 9, 2021
• First Submitted That Met QC Criteria: December 30, 2021
• First Posted (Actual): January 14, 2022

Study Record Updates

• Last Update Posted (Actual): August 4, 2023
• Last Update Submitted That Met QC Criteria: August 3, 2023
• Last Verified: August 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Atherosclerosis; Peripheral Arterial Disease; Peripheral Vascular Diseases
• Other Study ID Numbers: CPF-001

Plan for Individual participant data (IPD)

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

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No