This study is designed to evaluate the safety and efficacy of autologous Vascular Repair Cells (VRC) for patients with peripheral arterial disease as a treatment for critical limb ischemia. The double-blind study is expected to enroll 150 patients, randomized into two patient groups. The treatment group will receive intramuscular (IM) injections of the VRCs into the affected limb; the control group will receive intramuscular injections with an electrolyte solution (without cells). Both groups will receive the standard of care appropriate for their medical condition.
The study will assess the safety and ability of Aastrom TRC autologous bone marrow cells to restore peripheral blood flow affected by critical limb ischemia. Peripheral arterial disease (PAD), also known as Peripheral Vascular Disease (PVD), occurs when peripheral arteries are damaged by arterial hypertension and/or by the formation of atherosclerotic plaques. PAD is a chronic disease that progressively constricts arterial circulation of limbs. The term critical limb ischemia (CLI) is used for all patients with chronic ischemia rest pain, ulcers, or gangrene in limbs attributable to objectively proven PAD. These sequelae represent the end stage of PAD. PAD is associated with several other clinical conditions, i.e. hypertension, cardiovascular disease, hyperlipidemia, diabetes, tobacco use, obesity and stroke. The double-blind study is expected to enroll 150 patients, randomized into two patient groups. The treatment group will receive intramuscular injections of the TRC product into the affected limb; the control group will receive intramuscular injections with an electrolyte solution (without cells). Both groups will receive the standard of care appropriate for their medical condition.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
86
IM injection
IM Injection
Cardiology, P.C.
Birmingham, Alabama, United States
Arizona Heart Institute
Phoenix, Arizona, United States
University of California, San Francisco
San Francisco, California, United States
Malcolm Randall Veterans Administration Medical Center, part of the North Florida/South Georgia Veterans Health System
Gainesville, Florida, United States
University of Miami/Miller School of Medicine
Miami, Florida, United States
Loyola University Stritch School of Medicine
Maywood, Illinois, United States
Southern Illinois University School of Medicine
Springfield, Illinois, United States
The Care Group, LLC
Indianapolis, Indiana, United States
VA Ann Arbor Healthcare System
Ann Arbor, Michigan, United States
St. Joseph Mercy Hospital
Ann Arbor, Michigan, United States
...and 10 more locations
Safety of TRCs in patients with CLI(key safety parameters include vital signs, physical exams, laboratory results, assessment of aspiration and injection sites, adverse events, major amputations, wounds presence(size and grading using the Wagner scale)
Time frame: throughout trial
Composite efficacy endpoint assessing time to treatment failure(failure defined as major amputation, doubling of wound size, and new gangrene)
Time frame: Day 7 and Months 3, 6, 9, 12
Percentage of patients failing treatment
Time frame: Day 7, and Months 3,6,9, and 12
Time to major amputation
Time frame: Day 7 and Month 3, 6, 9, and 12
Percentage of patients undergoing major amputation
Time frame: Day 7 and Months 3, 6, 9, 12
Incidence of revascularization interventions throughout duration of study
Time frame: Day 7 and Months 3,6,9,12
Incidence of bypass surgery for patients throughout duration of study
Time frame: Day 7 and Months 3,6,9,12
Healing of all wounds in the target limb
Time frame: Day 7 and Months 3,6,9,12
Ankle and/or toe pressure and ankle brachial pressure index and/or toe brachial index
Time frame: Day 7 and Months 3,6,9,12
Pain, as measured by visual analog scale(VAS)
Time frame: Day 7 and Months 3,6,9,12
The King's College Vascular Quality of Life Questionnaire
Time frame: Baseline and Months 6 and 12
Walking distance as measured by six-minute walk test(with or without walking device)
Time frame: Baseline and Month 12
Concurrent Meds for trends
Time frame: Day 7 and Months 3, 6, 9, 12
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