Évaluation de l'innocuité et de l'efficacité du stent couvert par iCover pour le traitement de la maladie occlusive aorto-iliaque (iliCo)
Étude observationnelle prospective, multicentrique, non randomisée et à un seul bras pour évaluer l'innocuité et l'efficacité de l'endoprothèse couverte iCover pour le traitement de la maladie occlusive aorto-iliaque
The objective of this prospective, multi-center, non-randomized, single-arm observational study is to evaluate the safety and the efficacy of the iCover covered stent over a 24-month follow-up period for the treatment of de novo iliac occlusive lesions, defined by a significant vessel stenosis ≥70%, in patients with symptomatic arteriopathy of the lower limbs (Rutherford class 2 to 5).
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
This is a prospective, single-arm, multinational, and multicenter study conducted to evaluate the safety and efficacy of the iCover covered stent for the treatment of de novo iliac occlusive lesions (common and/or external iliac arteries) in patients with symptomatic lower limb arteriopathy. The primary endpoint of the study is primary patency, defined as the absence of restenosis in the target lesion over a 12-month follow-up period in patients who did not undergo a reintervention on the target lesion. Restenosis is defined as a reduction in the luminal diameter of more than 50%, assessed either by duplex ultrasound (considered as a peak systolic velocity index ≥ 2.4 at the target lesion) or by angio-CT (multiplanar reconstruction). Secondary endpoints include: technical and procedural success rate, freedom from all major adverse events, incidence of procedure- or device-related major local complications at the treated lesion, rate of SAEs, major amputation rate at the target limb, primary sustained clinical improvement (improvement in Rutherford classification), primary and secondary patency rates, TLR and TVR rates, and changes in ABI, the Walking Impairment Questionnaire, and the EQ-5D questionnaire from baseline.
Type d'étude
Inscription (Réel)
Contacts et emplacements
Lieux d'étude
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Berlin, Allemagne
- KEH Berlin
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Rendsburg, Allemagne
- Imland Klinik Rendsburg
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Baden-Wurttemberg
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Bad Krozingen, Baden-Wurttemberg, Allemagne, 79189
- Herzzentrum Bad Krozingen
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Rhineland-Palatinate
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Kaiserslautern, Rhineland-Palatinate, Allemagne, 67657
- MVZ Kaiserslautern
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Saxony
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Leipzig, Saxony, Allemagne, 04103
- Universitätsklinikum Leipzig
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Aalst, Belgique
- Onze Lieve Vrouw Aalst
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Bonheiden, Belgique
- Imelda Bonheiden
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Dendermonde, Belgique
- Az Sint Blasius Dendermonde
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Genk, Belgique
- ZOL Genk
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Barcelona, Espagne
- Hospital Universitari Germans Trias i Pujol
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Barcelona, Espagne
- Hospital de Santa Creu i Sant Pau
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Bilbao, Espagne
- Hospital de Cruces
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Sabadell, Espagne
- Hospital Parc Taulí
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Brest, France
- Centre Hospitalier Universitaire de Brest
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Paris, France
- Hôpital Paris Saint Joseph
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Paris, France
- CHU Pitié Salpêtrière
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Pessac, France
- Hôpital privé Saint-Martin
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Villeneuve-d'Ascq, France
- Hôpital privé Villeneuve d'Ascq
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
Méthode d'échantillonnage
Population étudiée
Patients with symptomatic arteriopathy of the lower limbs (Rutherford class 2 to 5). Patients with de novo atheromatous aorto-iliac lesions.
According to the incidence of TASC II lesions, approximately 70% of the patients will be classified as TASC II A or B lesions, while the other 30% will be classified as TASC II C or D lesions.
La description
Inclusion criteria
- ≥ 18 years of age
- Rutherford clinical stage 2 to 5
- Significant (≥70%) stenosis of atheromatous iliac lesions evidenced by duplex scan, MRI CT angiography or arteriography
- De novo atheromatous lesion of the aortoiliac segment
- Patient informed about the study and collection of the patient's informed consent agreement Exclusion criteria
Subjects will not be eligible to participate in the study if any of the following conditions are present in the subject:
- Protected adult patients, guardianship, curatorship, safeguard of justice
- Woman with possibility of pregnancy
- Patient with asymptomatic atheromatous lesions
- Patient with inflow lesion in the infrarenal aorta
- Patient treated with Covered endovascular reconstruction of aortic bifurcation (CERAB reconstruction)
- Acute ischemia or acute thrombosis
- Non-atherosclerotic disease
- History of coagulopathy
- Severe comorbidities with life expectancy <2 years
- Contraindication to taking antiplatelet aggregation therapy (aspirin or clopidogrel). The patient must be able to take an antiplatelet aggregation for at least 3 months after the procedure
- Patient participating in another clinical study which may interfere with the results
- Comorbidity or any reason which, according to the investigator, could limit the participation, the patient's adherence with the follow-up or the scientific integrity of the study
- Lesion near or adjacent to an aneurysm
- Inability to follow-up during the investigation
- Patient objection to participate in the investigation
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Modèles d'observation: COHORT
- Perspectives temporelles: PROSPECTIVE
Cohortes et interventions
Groupe / Cohorte |
Intervention / Traitement |
|---|---|
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iCover covered stent
Percutaneous transluminal angioplasty (PTA) |
Percutaneous transluminal angioplasty (PTA) with iCover covered stent for the treatment of de novo aorto-iliac occlusive lesions |
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Primary Patency
Délai: 12 months after index procedure.
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The primary patency, defined as the absence of restenosis in the target lesion over the 12-month follow-up period in patients who did not undergo a reintervention on the target lesion. |
12 months after index procedure.
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Technical success rate
Délai: Day 0.
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Technical success rate, defined as the ability to cross and dilate the lesion and achieve residual angiographic stenosis no greater than 30% after iCover stent graft insertion. Outcomes will be computed as the percentage of lesions treated at the end of the procedure. |
Day 0.
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Procedural success rate
Délai: Day 0.
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Procedural success rate, defined as technical success and no complications during the procedure including general and local complications as defined in the protocol. Outcomes will be computed as the percentage of patients at the end of the procedure. |
Day 0.
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Freedom from All Major Adverse Event (MAEs)
Délai: 1, 6, 12, 24 months after index procedure.
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MAEs are described as All-Cause Mortality post-procedure, Target Lesion Revascularization (TLR) post-procedure and Major Amputation of the Target Limb post-procedure (amputations above the ankle of the target leg). |
1, 6, 12, 24 months after index procedure.
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Incidence of Procedure- or Device- related Major Local Complications
Délai: Up to 30 days after index procedure.
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Incidence of Procedure- or Device- related Major Local Complications at the treated lesion or Puncture Site up to 30 days post-procedure. Major Local Complications include: Iliac arterial rupture, retroperitoneal hematoma, thrombosis of the iliac axis on the ipsilateral side, need for surgery to achieve hemostasis, bleeding with loss of more than 2 g/ dL of hemoglobin, false aneurysm at the puncture site, preventing resumption of walking at 24 hours or appearance of ischemia on the ipsilateral side. |
Up to 30 days after index procedure.
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Rates of Serious Adverse Events (SAEs)
Délai: 1, 6, 12, 24 months after index procedure.
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Rates of SAEs, including both related and unrelated events. SAEs will be categorized as related or unrelated to the procedure/device based on adjudication by an Independent Clinical Events Committee. |
1, 6, 12, 24 months after index procedure.
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Major amputation at target limb rate
Délai: 1, 6, 12, 24 months after index procedure.
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Percentage of patients with amputations above the ankle of the target leg will be counted. |
1, 6, 12, 24 months after index procedure.
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Primary sustained clinical improvement
Délai: 1, 6, 12, 24 months after index procedure.
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Primary sustained clinical improvement defined as a sustained upward shift of 1 category of the Rutherford classification for patients with claudication, and by wound healing and rest pain resolution for patients in critical limb ischemia, without the need for repeated target lesion revascularization in surviving patients. |
1, 6, 12, 24 months after index procedure.
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Primary patency rates
Délai: 6 and 24 months after index procedure.
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Primary patency rates, defined as the lack of restenosis without reintervention of the target lesion. Restenosis is defined as a reduction in the luminal diameter of more than 50%, determined by either, duplex ultrasound examination considered as a peak systolic velocity index ≥ 2.4 at the target lesion, or by angio-CT (multiplanar reconstruction). In case of death, the vessel is considered as patent as long as no restenosis was detected during the last visit before the patient died. Outcomes will be computed as the percentage of lesions (Time frame: 6, 24 months after index procedure). |
6 and 24 months after index procedure.
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Secondary patency rates
Délai: 6, 12, 24 months after index procedure.
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Secondary patency rates, defined as the patency of the stent following an endovascular or surgical reintervention due to significant in-stent restenosis or occlusion. Outcomes computed as percentage of lesions. |
6, 12, 24 months after index procedure.
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Target lesion revascularization (TLR) rate
Délai: 1, 6, 12, 24 months after index procedure.
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Target lesion revascularization (TLR) rate, defined as the need for repeated procedures (endovascular or surgical) due to a problem arising from the lesion initially treated in surviving patients with preserved limbs. Outcomes will be computed as the percentage of lesions. |
1, 6, 12, 24 months after index procedure.
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Target vessel revascularization (TVR) rate
Délai: 1, 6, 12, 24 months after index procedure.
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Target vessel revascularization (TVR) rate, defined as the need for repeated procedures (endovascular or surgical) due to a problem arising remote from the vessel initially treated in surviving patients with preserved limbs. Outcomes will be computed as the percentage of lesions. |
1, 6, 12, 24 months after index procedure.
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Change in Ankle-Brachial Index (ABI) from baseline
Délai: 1, 6, 12, 24 months post-procedure.
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Change in ABI from baseline. |
1, 6, 12, 24 months post-procedure.
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Change in Walking Impairment Questionnaire from baseline
Délai: 1, 6, 12, 24 months post-procedure.
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The Walking Impairment Questionnaire values will be recorded and compared to the baseline values. This questionnaire is a validated tool to assess walking capability in patients with Peripheral Arterial Disease in different situations. |
1, 6, 12, 24 months post-procedure.
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Change in quality of life from baseline
Délai: 1, 6, 12, 24 months post-procedure.
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Change in quality of life from baseline, as measured by EQ-5D. The EQ-5D Questionnaire values will be recorded and compared to the baseline values. It is a validated questionnaire to measure the quality of life based on 5 different parameters. Worst possible score in this study would be 0, best possible score would be 1. In addition, the patient indicates her/his current health on an analog scale from 0 (worst) to 100 (best). |
1, 6, 12, 24 months post-procedure.
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Collaborateurs et enquêteurs
Parrainer
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- iliCo Study
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Informations sur les médicaments et les dispositifs, documents d'étude
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