TORUS 2 IDE 临床研究 (TORUS2)
PQ Bypass Pivotal IDE 动脉内支架移植研究用于闭塞和再狭窄 Fem-pop 血运重建 - 2 试验:TORUS 2
研究概览
详细说明
Peripheral Arterial Disease, specifically in the superficial femoral arteries (SFA) and proximal popliteal arteries, are treated by a range of alternative practices and procedures for the patient population identified in the indications for use statement. Non-invasive approaches include exercise and drug therapy.
Minimally-invasive approaches include endovascular intervention using percutaneous transluminal angioplasty using a plain or drug-coated balloon, stents (bare metal, drug-eluting and covered) and various modalities of atherectomy.
SFA Stent Graft Systems have a clinical history that demonstrates that this device type is well understood, and the benefits and risks are well-characterized, i.e. mature technology.
Endologix believes that the clinical performance of the TORUS stent would be comparable to marketed SFA Stent Graft System. The TORUS 2 IDE Clinical Study will confirm this and is designed to demonstrate the safety and effectiveness of the TORUS Stent Graft System in patients with SFA and/or proximal popliteal artery disease
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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Arizona
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Mesa、Arizona、美国、85206
- Southwest CVA
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Mesa、Arizona、美国、85206
- Vascular Heart & Lung Associates
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Phoenix、Arizona、美国、85018
- Phoenix Cardiovascular Research Group
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Yuma、Arizona、美国、85349
- Yuma Cardiology Associates
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Arkansas
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Little Rock、Arkansas、美国、72211
- Arkansas Heart
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California
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Burlingame、California、美国、94010
- Bay Area Vein & Vascular Institute
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San Francisco、California、美国、94143
- UCSF
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Colorado
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Aurora、Colorado、美国、80045
- Rocky Mountain Regional VAMC
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Connecticut
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Darien、Connecticut、美国、06820
- The Vascular Experts
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Florida
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Jacksonville、Florida、美国、32256
- First Coast Cardiovascular Institute
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Miami Beach、Florida、美国、33140
- Palm Vascular Centers
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Pensacola、Florida、美国、32504
- Coastal Vascular & Interventional
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Winter Park、Florida、美国、32792
- Florida Cardiology
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Illinois
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Elk Grove、Illinois、美国、60007
- AMITA Health
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Maryland
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Hyattsville、Maryland、美国、20782
- MedStar Health Research Insitute
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Michigan
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Bay City、Michigan、美国、48708
- McLaren Bay Region
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Flint、Michigan、美国、48507
- Michigan Vascular Center
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Roseville、Michigan、美国、48066
- Eastlake Cardiovascular
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Mississippi
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Tupelo、Mississippi、美国、38801
- Northern Mississippi Medical Center
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New York
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New York、New York、美国、10032
- Columbia University Medical Center
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North Carolina
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Charlotte、North Carolina、美国、28204
- Novant Health
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Raleigh、North Carolina、美国、27607
- NC Heart & Vascular Research
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Ohio
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Cincinnati、Ohio、美国、45219
- The Lindner Center for Research & Education
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Oklahoma
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Oklahoma City、Oklahoma、美国、73116
- Naadi
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Rhode Island
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Providence、Rhode Island、美国、02906
- The Miriam Hospital
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South Carolina
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Greenville、South Carolina、美国、29615
- Prisma Health
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South Dakota
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Sioux Falls、South Dakota、美国、57108
- North Central Heart
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Tennessee
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Germantown、Tennessee、美国、38138
- Stern Cardiovascular Foundation
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Texas
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Lubbock、Texas、美国、79430
- Texas Tech
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McKinney、Texas、美国、75069
- North Dallas Research Associates
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Virginia
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Norfolk、Virginia、美国、23507
- Sentara Vascular Specialists
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Wisconsin
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Green Bay、Wisconsin、美国、54301
- Bellin Hospital
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
描述
纳入标准:
- 患者为男性或女性,入组时年龄 > 18 岁且≤ 90 岁。
- 患者在任何特定于研究的调查或程序之前提供书面知情同意书。
- 患者愿意在 36 个月内根据指定的时间表接受所有后续评估。
- 患者是血管造影和血管内介入治疗的合适人选,并且如果需要,有资格进行标准手术修复。
- 患者患有有症状的下肢外周动脉疾病 (PAD),需要干预以缓解自体股腘动脉的新发阻塞或闭塞或再狭窄。
- 患者的 PAD 分类为 Rutherford 分类 2、3 或 4。
- 患者已通过 (i) ≤ 0.90(或目标肢体运动后≤ 0.75)的静息踝臂指数 (ABI) 记录 PAD。 仅当无法可靠地评估 ABI 时才执行静息趾肱指数 (TBI)。 TBI 必须 <0.70; (ii) 正常 ABI,血管造影、超声、MRA 或 CT 证据表明直径狭窄≥ 60%。
- 患者在天然股腘动脉内有单个或多个狭窄、再狭窄或闭塞性病变(“目标病变”),可以用导丝穿过并完全扩张。
- 单一目标病变必须由单一支架覆盖。 如果病灶之间的间隙≤ 5 cm 且病灶之间的直径狭窄 > 30%,则串联靶病灶被视为单个连续病灶。
- 根据协议符合治疗条件的目标病变至少在股骨底部上方 3 厘米处。
- 目标病变参考血管直径在 5.0 毫米和 6.7 毫米之间,由操作员目视估计。
- 目标病变的总长度为 ≥ 80 毫米至 ≤ 180 毫米,根据操作员的目视估计,直径狭窄≥ 60%。 如果病灶之间的间隙≤ 5 cm 且病灶之间的直径狭窄 > 30%,则串联靶病灶被视为单个连续病灶。
- 患者在接受治疗的节段远端有一条未闭腘动脉(无狭窄 ≥ 50%)。
- 患者至少有一条膝下血管未闭(< 50% 狭窄)并流向脚踝。
排除标准:
- 患者不能或不愿遵守研究方案的程序要求,或难以遵守参加随访的要求。
- 患者患有研究者认为会将预期寿命限制在 24 个月以下的合并症。
- 患者在本研究的指标程序后 30 天内进行任何计划的大手术(包括目标肢体的任何截肢)。
- 患者的目标血管在入组前已接受过任何类型的外科手术。
- 患者的目标血管已接受旁路手术治疗。
- 患者的 PAD 分类为 Rutherford 分类 0、1、5 或 6。
- 患者在入组时已知或怀疑有活动性全身感染。
- 患者有已知的凝血病或有出血素质、血小板减少症且血小板计数低于 100,000/微升或 INR(国际标准化比值)>1.8。
- 患者在入组前三个月内被诊断为中风。
- 入组前 60 天内患者有不稳定型心绞痛或心肌梗塞病史。
- 患者有抗血小板、抗凝或溶栓治疗的禁忌症。
- 患者已知对用于进行血管内介入治疗的造影剂或药物过敏,这些药物不能充分预先给药。
- 患者已知对钛、镍或钽过敏(不包括因镍过敏引起的轻度接触性皮炎)。
- 患者在首次手术前 72 小时内接受过溶栓治疗。
- 患者患有急性或慢性肾脏疾病(例如,血清肌酐 > 2.5 mg/dL 或 > 220 μmol/L 或 GFR < 30 ml/min),或正在进行腹膜或血液透析。
- 入组前 7 天内需要冠状动脉介入治疗的患者。
- 患者怀孕或哺乳。
- 患者正在参与另一项涉及研究产品(药物、生物或医疗设备)的研究。
- 患者有其他医学、社会或心理问题,研究者认为这些问题使他们无法接受这种治疗,以及治疗前后的程序和评估。
- 患者有严重的疾病或流入道阻塞 (≥ 50%),但在指数手术时尚未成功治疗(成功衡量为 ≤ 30% 残余狭窄,无并发症)。
- 患者没有向脚踝提供径流的流出血管(狭窄≥ 50%)。
- 预扩张球囊没有完全扩张。
- 目标血管中存在动脉瘤或急性血栓的证据。
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:不适用
- 介入模型:单组作业
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的:TORUS 覆膜支架系统
TORUS 覆膜支架系统 (SGS) 由覆膜支架 (SG) 和覆膜支架输送系统 (SGDS) 组成。
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TORUS 覆膜支架是一种血管内假体,旨在改善其植入区域的血流,而 TORUS 覆膜支架输送系统是一种标准的销拉式输送系统,用于将 SG 植入所需区域。
使用 TORUS 覆膜支架可以改善外周血管系统的血流。
其他名称:
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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初级通畅
大体时间:12个月
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主要通畅被定义为没有临床驱动的目标病变血运重建 (CD-TLR) 并且没有复发性目标病变直径狭窄 > 50% 通过双重超声与 > 2.5 的峰值收缩速度比。
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12个月
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Freedom From a Major Adverse Event (MAE)
大体时间:30 days
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An MAE is defined as all-cause death, target limb major amputation and clinically-driven target lesion revascularization (CD-TLR)
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30 days
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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技术成功
大体时间:在索引过程中
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技术成功被定义为能够穿过和扩张病变以实现≤30%的残余狭窄
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在索引过程中
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程序成功
大体时间:手术后 24 小时内
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程序成功被定义为没有任何 MAE 的技术成功。
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手术后 24 小时内
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主要不良事件 (MAE) 率
大体时间:12个月
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全因死亡、目标肢体大截肢和临床驱动的目标病变血运重建 (CD-TLR) 的综合发生率。
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12个月
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支架断裂率
大体时间:12个月
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使用 VIVA 定义的支架断裂率
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12个月
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Major Amputation on Target Limb
大体时间:Through 36 months
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Major Amputation on Target Limb were adjudicated by the Clinical Event Committee (CEC), and rates were tabulated through 30 days, 6 months, 12 months, 24 months, and 36 months
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Through 36 months
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Patency Rate
大体时间:Through 12 months
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Absence of CD-TLR and absence of recurrent target lesion diameter stenosis >50% by duplex ultrasound with a peak systolic velocity ratio of >2.5.
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Through 12 months
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Clinically Driven Target Lesion Revascularization
大体时间:Through 36 months
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Clinically Driven Target Lesion Revascularization were adjudicated by the Clinical Event Committee (CEC), and rates were tabulated through 30 days, 6 months, 12 months, 24 months, and 36 months
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Through 36 months
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Walking Improvement Questionnaire (WIQ) Assessment
大体时间:Change from baseline to 12-Month follow-up (Collected at 1M,6M, and 12M)
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Walking Impairment Questionnaire (WIQ) - The WIQ is a patient-reported outcome measure that assesses self-reported walking ability in individuals with peripheral arterial disease (PAD). It evaluates perceived difficulty performing walking tasks related to walking distance, walking speed, and stair climbing, which reflect functional limitations caused by PAD. Scale Structure and Scoring: The WIQ consists of three subscales: Walking Distance Walking Speed Stair Climbing Each subscale is scored from 0 to 100, where higher scores indicate better walking function. The Composite PAD Score (PADSCORE) is calculated by averaging the three subscale scores, resulting in a total composite score ranging from 0 to 100. Scale Ranges and Interpretation: WIQ Subscale Scores: 0 (worst function) to 100 (best function) WIQ Composite PAD Score: 0 (worst walking impairment) to 100 (no walking impairment) Direction of Outcome: For all WIQ scores, higher values represent a better outcome |
Change from baseline to 12-Month follow-up (Collected at 1M,6M, and 12M)
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Quality of Life Assessment by the EQ5D VAS
大体时间:Change from baseline to 12-Month follow-up (Collected at 1M, 6M, and 12M)
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EuroQol Visual Analog Scale (EQ-5D-VAS) - The EQ-5D-VAS is a patient-reported outcome measure that assesses overall self-rated health-related quality of life. Participants rate their current health status using a visual analog scale anchored by the best and worst imaginable health states. Scale Structure and Scoring: Participants mark their perceived health status on a vertical visual analog scale. Scale Range and Interpretation: EQ-5D-VAS Score Range: 0 to 100 0: Worst imaginable health state (minimum) 100: Best imaginable health state (maximum) Direction of Outcome: Higher EQ-5D-VAS scores represent a better outcome, reflecting better perceived health-related quality of life. Lower scores indicate worse perceived health status. Unit of Measure: EQ-5D-VAS (scores on a scale) |
Change from baseline to 12-Month follow-up (Collected at 1M, 6M, and 12M)
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Change in Ankle-Brachial Index
大体时间:Change from Baseline through 36 months
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Change in Ankle-Brachial Index (ABI) in study subjects from baseline to each study interval through follow-up. Scale Structure and Scoring: Change in ABI was calculated as the difference between post-baseline ABI and baseline ABI for each participant for the target limb. ABI is a unitless ratio and does not have a fixed theoretical minimum or maximum value. Therefore, interpretation is based on clinically established thresholds rather than absolute scale limits: ABI ≤ 0.90: Consistent with peripheral arterial disease ABI 0.91-1.29: Generally considered normal arterial perfusion ABI ≥ 1.30: Suggestive of non-compressible arteries (e.g., arterial calcification) Change in ABI: Positive change (increase): Improvement in lower-extremity perfusion Negative change (decrease): Worsening arterial perfusion Direction of Outcome: For Change in ABI, higher (more positive) values represent a better outcome |
Change from Baseline through 36 months
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Change in Toe Pressures
大体时间:Change from Baseline through 36 months
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Change in Toe-Brachial Index (TBI) in study subjects from baseline to each study interval through follow-up for the target limb. If ABI could not be assessed the TBI was assessed. Scale Structure and Scoring: TBI is calculated as: TBI = Toe systolic blood pressure ÷ Brachial systolic blood pressure Change in TBI was calculated as the difference between post-baseline TBI and baseline TBI for each participant. Scale Range and Clinical Interpretation: TBI is a unitless ratio and does not have a fixed theoretical minimum or maximum value. Interpretation is therefore based on clinically established thresholds rather than absolute scale limits: TBI < 0.70: Consistent with peripheral arterial disease TBI ≥ 0.70: Generally considered normal digital perfusion For Change in TBI: A positive change (increase) indicates improvement in distal (digital) perfusion A negative change (decrease) indicates worsening arterial perfusion |
Change from Baseline through 36 months
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Change in Rutherford Clinical Classification
大体时间:From procedure through 36 months
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Clinical success: improvement in ≥ 1 Rutherford class
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From procedure through 36 months
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合作者和调查者
赞助
调查人员
- 首席研究员:Ehrin Armstrong,, MD、Denver Veteran's Administration Hospital
- 首席研究员:Peter Schneider,, MD、University of California
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.