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DCB Outcomes After Non-Compliant Balloon Vessel Preparation With or Without Scoring in Patients With Femoropopliteal Arterial Disease (DASBAD-NC)

12 de agosto de 2026 atualizado por: Marc Sirvent

Drug-coated Balloon Angioplasty After Non-Compliant Balloon Vessel Preparation With or Without Scoring for Femoropopliteal Arterial Disease: A Randomized Controlled Trial

The aim of this clinical trial is to determine whether vessel preparation with a non-compliant scoring balloon before drug-coated balloon (DCB) angioplasty provides superior procedural and clinical outcomes compared with vessel preparation using a non-compliant plain balloon in patients with chronic limb-threatening ischaemia (CLTI) undergoing femoropopliteal endovascular intervention.

The main questions the study aims to answer are:

  • Does non-compliant scoring balloon vessel preparation reduce the need for bailout stenting during the index procedure?
  • Does it improve primary patency after DCB angioplasty?
  • Does it improve clinically relevant outcomes such as wound healing, freedom from clinically driven target lesion revascularisation, limb salvage and health-related quality of life?
  • Does it provide procedural and economic advantages compared with non-compliant plain balloon vessel preparation?

Participants will be randomly assigned to undergo vessel preparation using either a non-compliant plain balloon or the DKutting™ non-compliant scoring balloon, followed by angioplasty with the Legflow XP™ drug-coated balloon. Patients will undergo clinical, duplex ultrasound and quality-of-life follow-up for 24 months.

Visão geral do estudo

Descrição detalhada

The DASBAD-NC trial is a prospective, multicentre, randomised, patient-blinded, controlled clinical investigation designed to compare two vessel preparation strategies before drug-coated balloon (DCB) angioplasty for femoropopliteal arterial disease in patients with chronic limb-threatening ischaemia (Rutherford classification 4-5).

Eligible patients with significant atherosclerotic femoropopliteal disease (≥50% stenosis or chronic total occlusion) will be randomised in a 1:1 ratio, after successful guidewire crossing of the target lesion and confirmation of all eligibility criteria, to one of two treatment strategies:

  • Vessel preparation using a non-compliant plain balloon (PBA arm), followed by Legflow XP™ drug-coated balloon angioplasty.
  • Vessel preparation using the DKutting™ non-compliant scoring balloon (SB arm), followed by Legflow XP™ drug-coated balloon angioplasty.

Vessel preparation will be performed using a 1:1 balloon-to-reference vessel diameter ratio with a minimum inflation time of 180 seconds. Predilatation with a smaller balloon will only be permitted if the allocated study balloon cannot cross the lesion. Drug-coated balloon angioplasty will subsequently be performed using the Legflow XP™ drug-coated balloon according to the study protocol. Bailout stenting will only be permitted in the presence of residual stenosis ≥30% and/or flow-limiting dissection after DCB treatment.

The co-primary endpoints are bailout stenting during the index procedure and primary patency at 12 months. Secondary endpoints include freedom from clinically driven target lesion revascularisation, target limb major amputation, all-cause mortality, wound healing, health-related quality of life, procedural success, slow-flow phenomenon, procedural costs and other prespecified clinical and imaging outcomes.

Duplex ultrasound follow-up examinations will undergo blinded central review by an independent duplex ultrasound core laboratory. Procedural angiographic outcomes will undergo an independent blinded quality assurance review after database lock by experienced investigators according to the prespecified study methodology. Clinical events will be adjudicated by an independent Clinical Events Committee according to prespecified endpoint definitions.

Patients will be followed for 24 months after the index procedure.

Tipo de estudo

Intervencional

Inscrição (Estimado)

142

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

  • Nome: Marc Sirvent, PhD
  • Número de telefone: 2575 +34938425000
  • E-mail: msirvent@fphag.org

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

  • Adulto
  • Adulto mais velho

Aceita Voluntários Saudáveis

Não

Descrição

Inclusion Criteria:

  • ≥18 years of age.
  • Rutherford class 4-5.
  • Estimated life expectancy >1 year, per investigator's judgment.
  • Significant atherosclerotic lesions (≥50% stenosis or chronic total occlusion) in the femoropopliteal segment, including in-stent restenosis.
  • Signed informed consent.
  • Willingness to comply with follow-up visits.
  • ≥1 patent infragenicular artery (<50% stenosis) at the end of the procedure.
  • Target vessel diameter ≤8 mm.

Exclusion Criteria:

  • Pregnant or planning pregnancy during the study.
  • Participation in another drug/device trial.
  • Inability to cross the target lesion with a guidewire. Successful crossing is defined as advancement of the guidewire tip distal to the target lesion without vessel perforation or flow-limiting dissection.
  • Inadequate treatment of proximal lesion (>30% residual stenosis).
  • Severe calcification of the target vessel [group 4 of Fanelli classification17 defined as circumferential calcification (270º-360º)], evidenced before contrast injection or digital subtraction angiography.
  • Thrombus in the target vessel.
  • Anastomotic stenosis of a bypass.
  • Use of atherectomy, thrombectomy, laser, or similar devices.
  • Prior or planned above-the-ankle amputation of the target limb.
  • Coagulopathy, hypercoagulable state, bleeding diathesis, platelets <80 000/µL or >700 000/µL, or other blood disorder.
  • Gastrointestinal bleeding requiring transfusion within 3 months.
  • Contraindication to antiplatelet/anticoagulant/thrombolytic therapy.
  • Acute coronary syndrome within 30 days.
  • Stroke or TIA within 90 days.
  • Hypersensitivity/contraindication to nitinol.
  • Comorbidities precluding treatment or follow-up (per investigator).
  • Hypersensitivity/allergy to contrast not manageable medically.
  • Hypersensitivity/allergy to heparin, aspirin, paclitaxel, clopidogrel, or other antiplatelet/anticoagulant agents.
  • Contraindication to dual antiplatelet therapy.

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Dobro

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Comparador Ativo: Non-compliant plain balloon (PBA)
  • Vessel preparation using non-compliant plain balloon
  • Definitive treatment: drug-coated balloon angioplasty (Legflow XP™; Manufacturer: Cardionovum GmbH Bonn, Germany).
The intervention consists of preparing the artery with a non-compliant plain balloon before using the DCB (Legflow XP™; Manufacturer: Cardionovum GmbH Bonn, Germany).
Outros nomes:
  • Grupo de controle
  • Group 0
Comparador Ativo: Scoring balloon (SB)
  • Vessel preparation using non-compliant scoring balloon (DKutting™; Manufacturer: DK Medical Technology Co., Ltd., Suzhou, China)
  • Definitive treatment: drug-coated balloon angioplasty (Legflow XP™; Manufacturer: Cardionovum GmbH Bonn, Germany) as definitve treatment.
The intervention consists of preparing the artery with a non-compliant scoring balloon (DKutting™; Manufacturer: DK Medical Technology Co., Ltd., Suzhou, China) before using the DCB (Legflow XP™; Manufacturer: Cardionovum GmbH Bonn, Germany) as definitve treatment.
Outros nomes:
  • Grupo de intervenção
  • Grupo 1
  • Grupo de tratamento

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Bailout stenting
Prazo: At index procedure
The need for bailout stenting during the index procedure, defined as stent implantation due to residual stenosis >30% or a flow-limiting dissection (type C according to the Kobayashi classification)
At index procedure
Primary Patency
Prazo: At 12 months
Primary patency at 12 months defined as absence of ≥50% restenosis (peak systolic velocity ratio<2.5) and no clinically driven target lesion revascularisation (CD-TLR), as adjudicated by the duplex core laboratory and the Clinical Events Committee.
At 12 months

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Device success
Prazo: During the index procedure
Device success, defined as successful delivery, inflation, and retrieval of the assigned balloon catheter, resulting in a residual stenosis <30% without flow-limiting dissection (FLD) on final angiography.
During the index procedure
Technical success
Prazo: During the index procedure.
Technical success, defined as successful use of a device or technique to re-establish vessel patency with a residual stenosis <30% by visual estimation and <50% by duplex during the index procedure.
During the index procedure.
Procedural cost
Prazo: During the index procedure
Procedural cost, defined as the total acquisition cost (€) of all lesion preparation balloons (including adjunctive predilatation balloons, if required) and bailout stents used during the index procedure for the target lesion.
During the index procedure
Slow-flow phenomenon
Prazo: During the index procedure
Slow-flow phenomenon, defined as an angiographic reduction in antegrade flow occurring after DCB inflation compared with the immediately preceding angiogram, in the absence of residual stenosis >30%, flow-limiting dissection, or vasospasm. The presence or absence of slow-flow phenomenon will be determined by the independent blinded angiographic review.
During the index procedure
Procedural success
Prazo: Occurring <24 hours and <1 month of the index procedure.
Procedural success, defined as technical success with absence of rupture, distal embolization, thrombosis, access complications, or major adverse cardiovascular events. These events should be listed as occurring <24 hours and <1 month of the procedure.
Occurring <24 hours and <1 month of the index procedure.
Freedom from device and procedure-related death
Prazo: Until 30 days post-procedure
Freedom from device and procedure-related death through 30 days post-procedure.
Until 30 days post-procedure
Freedom from Major Adverse Events (MAE)
Prazo: Up to 24 months post-procedure

Freedom from Major Adverse Events (MAE) up to 24 months post-procedure.

MAE are defined as the composite of:

  • Major Adverse Cardiovascular Events (MACE), including all-cause death, myocardial infarction, stroke, or major bleeding requiring transfusion or surgical intervention.
  • Major Adverse Limb Events (MALE), including above-the-ankle target limb amputation or major re-intervention involving the target lesion, defined as new bypass graft, jump/interposition graft revision, thrombectomy, thrombolysis or endovascular reintervention.
Up to 24 months post-procedure
Primary patency
Prazo: At 6 and 24 months post-procedure
Primary patency at 6 and 24 months post-procedure, defined as absence of ≥50% restenosis (peak systolic velocity ratio<2.5) and no CD-TLR, as adjudicated by the duplex core laboratory and the Clinical Events Committee (CEC).
At 6 and 24 months post-procedure
Freedom from CD-TLR
Prazo: Up to 24 months post-procedure

Freedom from CD-TLR up to 24 months post-procedure.

  • CD-TLR is defined as any repeat revascularisation procedure performed to maintain or restore patency within the treated segment, including 5 mm proximal and 5 mm distal to the edges of the originally treated lesion, due to clinical deterioration.
  • Clinical deterioration is defined as a ≥1-category worsening in Rutherford classification, impaired wound healing, or new or recurrent ulceration or rest pain attributable to the target lesion
Up to 24 months post-procedure
Change in EQ-5D questionnaire
Prazo: Up to 24 months post-procedure
Change in EQ-5D questionnaire from baseline up to 24 months post-procedure
Up to 24 months post-procedure
Amputation free survival
Prazo: Up to 24 months post-procedure.

Amputation free survival up to 24 months post-procedure.

• Amputation free survival is defined as survival without above-the-ankle amputation of the target limb.

Up to 24 months post-procedure.
Wound healing evolution
Prazo: Up to 24 months post-procedure

Wound healing evolution up to 24 months post-procedure, assessed according to the following predefined ordinal classification:

  • Healed: Complete epithelialisation of the target wound maintained for at least 14 consecutive days.
  • Improved: Reduction in target wound area >50% compared with baseline.
  • Unchanged: Increase or decrease in target wound area ≤50% compared with baseline.
  • Worsened: Increase in target wound area >50% compared with baseline. The target wound will be defined as the largest or clinically most relevant wound identified at baseline.
Up to 24 months post-procedure
Wound healing time
Prazo: Days from the index procedure to complete epithelialisation of the target wound

Wound healing time is defined as the number of days from the index procedure to complete epithelialisation of the target wound, without drainage or need for dressing, as assessed by the treating physician.

• Major amputation of the index limb or death prior to complete wound healing will be considered failure of the wound healing endpoint.

Days from the index procedure to complete epithelialisation of the target wound
Change in Rutherford classification
Prazo: Up to 24 months post-procedure.
Change in Rutherford classification up to 24 months post-procedure.
Up to 24 months post-procedure.

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Estimado)

1 de dezembro de 2026

Conclusão Primária (Estimado)

1 de dezembro de 2029

Conclusão do estudo (Estimado)

1 de dezembro de 2030

Datas de inscrição no estudo

Enviado pela primeira vez

9 de agosto de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

9 de agosto de 2026

Primeira postagem (Real)

13 de agosto de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

14 de agosto de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

12 de agosto de 2026

Última verificação

1 de agosto de 2026

Mais Informações

Termos relacionados a este estudo

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

NÃO

Descrição do plano IPD

Data collected within the DASBAD-NC study will be made available to researchers upon reasonable request. Access to the data is controlled to ensure the protection of participant privacy and compliance with applicable data protection laws and regulations. Data will be shared upon revision and approval based on scientific merit by the DASBAD-NC management group (which includes a qualified statistician) of a detailed proposal for their use. The data required for the approved, specified purposes and the trial protocol will be provided after the completion of a data-sharing agreement that will be set up by the principal investigator and his team. All data provided will be anonymized to respect the privacy of patients who have participated in the trial. Estimated timeframe for response will be within 30 days. Requests for data should be addressed to the sponsor and PI (msirvent@fphag.org).

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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