Comparison of the SUpera® PERipheral System in the Superficial Femoral Artery

Abbott Medical Devices325 enrolled

Overview

This is a prospective, multicenter, non-randomized, single arm, pivotal trial. The main objective of this study is to demonstrate the safety and effectiveness of the IDev SUPERA® Nitinol Stent System in treating subjects with obstructive superficial femoral artery (SFA) disease. The primary endpoint will be the primary patency of the SFA evaluated at 12 months. The outcome will be compared to a performance goal based on clinical trials of percutaneous transvenous angioplasty (PTA) alone.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

325

Conditions

Peripheral Vascular Disease

Interventions

SUPERA® Nitinol Stent SystemDEVICE

Percutaneous Angioplasty of the Superior Femoral Artery with placement of a SUPERA® Stent at time of PTA

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Age greater than or equal to 18 years and of age of legal consent. 2. Women of child bearing potential must have a negative pregnancy test within 7 days prior to the index procedure. 3. Subject has lifestyle limiting claudication or rest pain (Rutherford-Becker scale 2-4) with a resting ankle-brachial index (ABI) less than or equal to 0.9. TBI (toe-brachial index) is performed only unable to assess ABI. TBI must be less than or equal to 0.7. 4. A single superficial femoral artery lesion with greater than 60% stenosis or total occlusion. 5. Stenotic lesion(s) or occluded length within the same vessel (one long or multiple serial lesions) greater than or equal to 40 mm to less than or equal to 140 mm. Reference vessel diameter (RVD) greater than or equal to 4.0 mm and less than or equal to 6.0 mm by visual assessment. 6. All lesions are to be located with the distal point at least 3 cm above the knee joint, defined as the distal end of the femur at the knee joint, and proximal point at least 2 cm below the origin of the profunda artery. 7. Patent infrapopliteal and popliteal artery, i.e., single vessel runoff or better with at least one of three vessels patent (less than 50% stenosis) to the ankle or foot. 8. The target lesion(s) can be successfully crossed with a guide wire and dilated. 9. Poor aortoiliac or common femoral "inflow" (i.e., angiographically defined greater than 50% stenosis of the iliac or common femoral artery) that would be deemed inadequate to support a femoropopliteal bypass graft must be successfully treated prior to treatment of the target lesion. This can be done just prior to treatment of the target lesion. Successful treatment is defined as less than 30% stenosis after either PTA or stenting of the inflow lesion. After treatment of the inflow lesion, the pressure gradient across the target lesion will be obtained and if the pressure gradient is greater than or equal to 20 mmHg, then the subject will be included in the study. 10. A subject with bilateral obstructive SFA disease is eligible for enrollment into the study. If a subject with bilateral disease is enrolled, the target limb will be selected at the Investigator's discretion, who may use the criteria of lesion length, percent stenosis, and/or calcification content. The contra-lateral procedure should not be done until at least 30 days after the index procedure (staged); however, if contralateral treatment is performed prior to treatment of the target lesion, the waiting period will be at least 14 days prior to the index procedure. 11. The subject is eligible for standard surgical repair, if necessary. 12. A subject who requires a coronary intervention should have it performed at least 7 days prior to the treatment of the target lesion. 13. Subject must provide written informed consent. 14. Subject must be willing to comply with the specified follow-up evaluation schedule. Exclusion Criteria: 1. Thrombophlebitis or deep venous thrombus, within the previous 30 days. 2. Receiving dialysis or immunosuppressant therapy within the previous 30 days. 3. Thrombolysis of the target vessel within 72 hours prior to the index procedure, where complete resolution of the thrombus was not achieved. 4. Stroke within the previous 90 days. 5. Ipsilateral femoral aneurysm or aneurysm in the SFA or popliteal artery. 6. Required stent placement via a popliteal approach. 7. Required stent placement across or within 0.5 cm of the SFA/PFA bifurcation. 8. Procedures which are pre-determined to require stent-in-stent placement to obtain patency, such as in-stent restenosis. 9. Significant vessel tortuosity or other parameters prohibiting access to the lesion or 90° tortuosity which would prevent delivery of the stent device. 10. Required stent placement within 1 cm of a previously deployed stent. 11. Subject required a coronary intervention, and the coronary intervention was done less than 7 days prior to or planned within 30 days after the treatment of the target lesion. 12. Known allergies to any of the following: aspirin and all three of the following: clopidogrel bisulfate (Plavix®), ticlopidine (Ticlid®), and prasugrel (Effient®); heparin, nitinol (nickel titanium), or contrast agent, that cannot be medically managed. 13. Presence of thrombus prior to crossing the lesion. 14. Known or suspected active infection at the time of the procedure. 15. Presence of an ipsilateral arterial artificial graft. 16. Use of cryoplasty, laser, or atherectomy devices at the time of index procedure. 17. Restenotic lesion that had previously been treated by atherectomy, laser or cryoplasty within 3 months of the index procedure. 18. Subject has tissue loss, defined as Rutherford-Becker classification category 5 or 6. 19. History of neutropenia, coagulopathy, or thrombocytopenia that was unexplained or is considered to be at risk for reoccurrence. 20. Known bleeding or hypercoagulability disorder or significant anemia (Hb \< 8.0) that cannot be corrected. 21. Subject has the following laboratory values: 1. platelet count less than 80,000/μL, 2. international normalized ratio (INR) greater than 1.5, 3. serum creatinine level greater than 2.0 mg/dL. 22. Subject requires general anesthesia for the procedure. 23. Subject is pregnant or plans to become pregnant during the study. 24. Subject has a co-morbid illness that may result in a life expectancy of less than 1 year. 25. Subject is participating in an investigational study of a new drug, biologic or device at the time of study screening. NOTE: Subjects who are participating in the long term follow-up phase of a previously investigational and now FDA-approved product are not excluded by this criterion.

Locations (49)

Outcomes

Primary Outcomes

Primary Safety Endpoint: Freedom From Death, Target Lesion Revascularization (TLR), or Any Amputation of the Index Limb to 30 (±7) Days.

Time frame: 30 days

Primary Efficacy Endpoint: SFA Patency at 12 Months (± 30 Days), Defined as Freedom From Restenosis (PSVR ≥ 2.0) and TLR.

Patency of the target lesion was defined as no evidence of restenosis or occlusion within the originally treated lesion based on a centrally-read Color Flow Doppler ultrasound in the absence of target lesion revascularization (TLR). Occlusion and restenosis were defined as no color flow or an increase in peak systolic velocity of \> 2.0 when compared to the proximal normal segment.

Time frame: 12 months

Secondary Outcomes

Technical (Lesion) Success

Technical (lesion) success, defined as the attainment of \<50% residual stenosis by Quantitative Angiography (QA) by any percutaneous method as determined by the Angiographic core laboratory.

Time frame: intraoperative

Procedural Success

Defined as device success with \< 50% residual stenosis immediately after stent placement, mean trans-stenotic pressure gradient less than 5 mmHg, and without the occurrence of death, amputation or repeat revascularization of the target lesion during the hospital stay.

Time frame: intraoperative

Device Success

Device success, defined as achievement of a final residual diameter stenosis of \<50% (by QA), using the assigned treatment only.

Time frame: intraoperative

Secondary Safety Composite Endpoint

Secondary safety endpoint was a combined rate of death at 30 (± 7) days, or TLR, index limb amputation, and an increase in Rutherford-Becker Classification by 2 classes at 12 months (± 30 Days) (comparing pre- to post-procedural assessments).

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.

Cardiology Associates of Mobile, Inc.

Fairhope, Alabama, United States

Banner Good Samaritan Medical Center

Phoenix, Arizona, United States

Tucson Medical Center

Tucson, Arizona, United States

Arkansas Heart Hospital

Little Rock, Arkansas, United States

ACT / CVRI & Cedar Sinai Medical Center

Beverly Hills, California, United States

Hartford Hospital

Hartford, Connecticut, United States

Yale University

New Haven, Connecticut, United States

Bradenton Cardiology Center

Bradenton, Florida, United States

First Coast Cardiovascular Institute

Jacksonville, Florida, United States

Mount Sinai Medical Cente

Miami Beach, Florida, United States

...and 39 more locations

Time frame: 12 months (± 30 Days)

Secondary Safety Endpoint

Secondary safety endpoint was a combined rate of death at 30 (± 7) days, or TLR, index limb amputation, and an increase in Rutherford-Becker Classification by 2 classes (comparing pre- to post-procedural assessments).

Time frame: 24 months (± 30 Days)

Secondary Safety Endpoint

Secondary safety endpoint was a combined rate of death at 30 (± 7) days, or TLR, index limb amputation, and an increase in Rutherford-Becker Classification by 2 classes at 36 months (± 30 Days)(comparing pre- to post-procedural assessments).

Time frame: 36 months (± 30 Days)

Long-Term Safety Endpoint (Clinically Driven TLR, Index Limb Amputation)

Time frame: 12 months (± 30 Days)

Long-Term Safety Endpoint (Clinically Driven TLR, Index Limb Amputation)

Time frame: 24 months (± 30 Days)

Long-Term Safety Endpoint (Clinically Driven TLR, Index Limb Amputation)

Time frame: 36 months (± 30 Days)

Stent Fracture Rate

Stent fractures were analyzed by X-ray evaluation by a designated core laboratory and defined as type I, II, III, IV or V. Stent fracture classification * Type I - a single strut fracture only. * Type II - multiple single nitinol stent fractures that can occur at different sites. * Type III - multiple nitinol stent fractures resulting in complete transverse linear fracture but without stent displacement. * Type IV - a complete transverse linear type III fracture with stent displacement. * Type V - a spiral dissection of a stent.

Time frame: 12 months (± 30 Days)

Stent Fracture Rate

Stent fractures were analyzed by X-ray evaluation by a designated core laboratory and defined as type I, II, III, IV or V.

Time frame: 24 months (± 30 Days)

Stent Fracture Rate

Stent fractures were analyzed by X-ray evaluation by a designated core laboratory and defined as type I, II, III, IV or V.

Time frame: 36 months (± 30 Days)

Ankle-brachial Index (ABI) Measurements on Target Limb

A ratio of the highest ankle systolic blood pressure in one leg, usually measured with a 10 cm cuff at the ankle and using a continuous wave Doppler to detect return of blood flow in the anterior tibial and posterior tibial arteries, to the highest of either arm systolic blood pressure. Performed at rest with subject in supine position.

Time frame: Baseline

Ankle-brachial Index (ABI) Measurements on Target Limb

Time frame: 1 month (± 7 Days)

Ankle-brachial Index (ABI) on Target Limb

Time frame: 6 Months (± 14 Days)

Ankle-brachial Index (ABI) on Target Limb

Time frame: 12 Months (± 30 Days)

Target Lesion Revascularization (TLR)

Defined as any repeat percutaneous intervention with or without evidence of stenosis ≥ 50%, to improve blood flow inside or within 5 mm proximally and/or distally of the treated target lesion.

Time frame: 6 months (± 14 Days)

Target Lesion Revascularization (TLR)

Defined as any repeat percutaneous intervention with or without evidence of stenosis ≥ 50%, to improve blood flow inside or within 5 mm proximally and/or distally of the treated target lesion.

Time frame: 12 months (± 30 Days)

Target Lesion Revascularization (TLR)

Defined as any repeat percutaneous intervention with or without evidence of stenosis ≥ 50%, to improve blood flow inside or within 5 mm proximally and/or distally of the treated target lesion.

Time frame: 24 months (± 30 Days)

Target Lesion Revascularization (TLR)

Defined as any repeat percutaneous intervention with or without evidence of stenosis ≥ 50%, to improve blood flow inside or within 5 mm proximally and/or distally of the treated target lesion.

Time frame: 36 months (± 30 Days)

SFA Patency: PSV Ratio ≥ 2.0

Time frame: 6 Months (± 14 days)

SFA Patency: PSV Ratio > 2.4

Time frame: 6 Months (± 14 days)

SFA Patency: PSV Ratio > 2.4

Time frame: 12 Months (±30 days)

Target Vessel Revascularization

Defined as any repeat percutaneous intervention or bypass surgery performed in the target vessel at 6 months post-procedure.

Time frame: 6 months (± 14 days)

Target Vessel Revascularization

Defined as any repeat percutaneous intervention or bypass surgery performed in the target vessel at 12 months post-procedure.

Time frame: 12 months (±30 days)

Target Vessel Revascularization

Defined as any repeat percutaneous intervention or bypass surgery performed in the target vessel at 24 months post-procedure.

Time frame: 24 months (±30 days)

Target Vessel Revascularization

Defined as any repeat percutaneous intervention or bypass surgery performed in the target vessel at 36 months post-procedure.

Time frame: 36 months (±30 days)

Limb Ischemia Improvement: Rutherford Becker Scale

Defined as an improvement in the Rutherford-Becker Clinical Improvement Scale of greater than or equal to one. Grade +3 = Markedly improved. Symptoms are gone or markedly improved. ABI increased to \>0.90. Grade +2 = Moderately improved. Still symptomatic but with improvement in lesion category. ABI increased by 0.10 but not normalized. Grade +1 = Minimally improved. Categorical improvement in symptoms without significant ABI increase (0.10 or less) or vice versa (but not both). Grade 0 = No change. No categorical shift and less than 0.10 change in ABI. Grade -1 = Mildly worse. Either worsening of symptoms or decrease in ABI of 0.10. Grade -2 = Moderate worsening. Deterioration of the subject's condition by one category or unexpected minor amputation. Grade -3 = Marked worsening. Deterioration of the subject's condition by more than one category or major amputation.

Time frame: 1 month (± 7 days)

Limb Ischemia Improvement: Rutherford Becker Scale

Time frame: 12 Months (±30 days)

Limb Ischemia Improvement: Rutherford Becker Scale

Time frame: 24 Months (±30 days)

Limb Ischemia Improvement: Rutherford Becker Scale

Time frame: 36 Months (±30 days)

Major Adverse Events (MAVE)

Defined as a composite rate of 1. stent thrombosis, 2. clinically apparent distal embolization (defined as causing end-organ damage, e.g. lower extremity ulceration, tissue necrosis, or gangrene), 3. procedure-related arterial rupture, 4. acute limb ischemia, 5. target limb amputation, 6. procedure related bleeding event requiring transfusion.

Time frame: 30 days (±7 days)

Major Adverse Events (MAVE)

Time frame: 6 Months (±14 days)

Major Adverse Events (MAVE)

Time frame: 12 months (±30 days)

Major Adverse Events (MAVE)

Time frame: 24 months (±30 days)

Major Adverse Events (MAVE)

Time frame: 36 months (±30 days)

Index Limb Amputations

Amputation was defined as the surgical removal of tissue anywhere from the toe to hip in the ipsilateral limb of the target site.

Time frame: 6 months (±14 days)

Index Limb Amputations

Amputation was defined as the surgical removal of tissue anywhere from the toe to hip in the ipsilateral limb of the target site.

Time frame: 12 months (±30 days)

Index Limb Amputations

Amputation was defined as the surgical removal of tissue anywhere from the toe to hip in the ipsilateral limb of the target site.

Time frame: 24 months (±30 days)

Index Limb Amputations

Amputation was defined as the surgical removal of tissue anywhere from the toe to hip in the ipsilateral limb of the target site.

Time frame: 36 months (±30 days)

Quality of Life Assessed (QoL) by SF-12 Questionnaire

The Medical Outcomes Study 12-Item Short form survey (SF-12) was used to assess generic QoL. SF-12 Health Survey is validated measure using 12 questions to measure functional health and well-being from the patient's point of view. Scores on the scale are 0% (indicating poor perceived health status) to 100% (indicating excellent perceived health status) possible. Physical and mental summary scores from the SF-12 are scaled to a U.S. population mean of 50 and standard deviation of 10 (higher scores are better). Multiple groups have suggested minimum clinically important changes in SF-12 summary scores to be greater than 2-2.5 points, and moderate changes to be greater than 5 points.

Time frame: Baseline

Quality of Life Assessed by SF-12 Questionnaire

The Medical Outcomes Study 12-Item Short form survey (SF-12) was used to assess generic QoL.SF-12 Health Survey is validated measure using 12 questions to measure functional health and well-being from the patient's point of view. Scores on the scale are 0% (indicating poor perceived health status) to 100% (indicating excellent perceived health status) possible. Physical and mental summary scores from the SF-12 are scaled to a U.S. population mean of 50 and standard deviation of 10 (higher scores are better). Multiple groups have suggested minimum clinically important changes in SF-12 summary scores to be greater than 2-2.5 points, and moderate changes to be greater than 5 points.

Time frame: 6 Months (± 14 Days)

Quality of Life Assessed by SF-12 Questionnaire

The Medical Outcomes Study 12-Item Short form survey (SF-12) was used to assess generic QoL.SF-12 Health Survey is validated measure using 12 questions to measure functional health and well-being from the patient's point of view. Scores on the scale are 0% (indicating poor perceived health status) to 100% (indicating excellent perceived health status) possible. Physical and mental summary scores from the SF-12 are scaled to a U.S. population mean of 50 and standard deviation of 10 (higher scores are better). Multiple groups have suggested minimum clinically important changes in SF-12 summary scores to be greater than 2-2.5 points, and moderate changes to be greater than 5 points.

Time frame: 12 Months (± 30 Days)

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Physical Limitation

The PAQ assesses Peripheral arterial disease (PAD)-related physical limitation, symptoms, quality of life, social function and treatment satisfaction on 0-100 scales; higher scores are better. A threshold of 8 points has been proposed as a minimum clinically important difference for the PAQ summary scale.

Time frame: Baseline

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Physical Limitation

The PAQ assesses PAD-related physical limitation, symptoms, quality of life, social function and treatment satisfaction on 0-100 scales; higher scores are better. A threshold of 8 points has been proposed as a minimum clinically important difference for the PAQ summary scale.

Time frame: 6 months (± 14 Days)

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Physical Limitation

Time frame: 12 months (± 30 Days)

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Symptoms

Time frame: Baseline

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Symptoms

Time frame: 6 months (± 14 Days)

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Symptoms

Time frame: 12 months (± 30 Days)

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Symptom Stability

Time frame: Baseline

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Symptom Stability

Time frame: 6 months (± 14 Days)

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Symptom Stability

Time frame: 12 months (± 30 Days)

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Social Limitation

Time frame: Baseline

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Social Limitation

Time frame: 6 months (± 14 Days)

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Social Limitation

Time frame: 12 months (± 30 Days)

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Treatment Satisfaction

Time frame: Baseline

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Treatment Satisfaction

Time frame: 6 months (± 14 Days)

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Treatment Satisfaction

Time frame: 12 months (± 30 Days)

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Quality of Life

Time frame: Baseline

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Quality of Life

Time frame: 6 months (± 14 Days)

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Quality of Life

Time frame: 12 months (± 30 Days)

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Summary Score

Time frame: Baseline

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Summary Score

Time frame: 6 months (± 14 Days)

Quality of Life Assessed by Peripheral Artery Questionnaire (PAQ): Summary Score

Time frame: 12 months (± 30 Days)

Clinical Category: Rutherford Becker

Category and Clinical Description 0 = Asymptomatic, no hemodynamically significant occlusive disease, 1 = Mild claudication, 2 = Moderate claudication, 3 = Severe claudication, 4 = Ischemic rest pain, 5 = Minor tissue loss, non-healing ulcer, or focal gangrene with diffuse pedal ischemia, 6 = Major tissue loss, extending above transmetatarsal level, functional foot no longer salvageable. Claudication is defined as a pain, cramps, fatigue, or equivalent in leg muscles occurring during walking that results from inadequate blood supply, usually due to atherosclerotic arterial obstruction.

Time frame: Baseline

Clinical Category: Rutherford Becker

Time frame: 1 Month (± 7 Days)

Clinical Category: Rutherford Becker

Time frame: 12 Months (± 30 Days)

Clinical Category: Rutherford Becker

Time frame: 24 Months (± 30 Days)

Clinical Category: Rutherford Becker

Time frame: 36 Months (± 30 Days)

Clinical Improvement Compared With Baseline: Rutherford Becker Scale

Clinical Improvement Compared With Baseline Grade +3 = Markedly Improved, Grade +2 = Moderately Improved, Grade +1 = Minimally Improved, Grade 0 = No Change, Grade -1 = Mildly Worse, Grade -2 = Moderately Worsening, Grade -3 = Markedly Worsening

Time frame: 1 month (± 7 Days)

Clinical Improvement Compared With Baseline: Rutherford Becker Scale

Time frame: 12 Months (± 30 Days)

Clinical Improvement Compared With Baseline: Rutherford Becker Scale

Time frame: 24 Months (± 30 Days)

Clinical Improvement Compared With Baseline: Rutherford Becker Scale

Time frame: 36 Months (± 30 Days)

Exercise Tolerance Test: Claudication Pain Distance

Absolute Claudication Distance (ACD) for this study was determined by the point of termination or maximum distance walked on the treadmill due to claudication.

Time frame: Baseline

Exercise Tolerance Test: Claudication Pain Distance

Absolute Claudication Distance (ACD) for this study was determined by the point of termination or maximum distance walked on the treadmill due to claudication.

Time frame: 1 month (± 7 Days)

Exercise Tolerance Test: Claudication Pain Distance

Absolute Claudication Distance (ACD) for this study was determined by the point of termination or maximum distance walked on the treadmill due to claudication.

Time frame: 12 months

Exercise Tolerance Test: Claudication Pain Time (CPT)

Absolute Claudication Distance (ACD) for this study was determined by the point of termination or maximum distance walked on the treadmill due to claudication.

Time frame: Baseline

Exercise Tolerance Test: Claudication Pain Time (CPT)

Absolute Claudication Distance (ACD) for this study was determined by the point of termination or maximum distance walked on the treadmill due to claudication.

Time frame: 1 month (± 7 Days)

Exercise Tolerance Test: Claudication Pain Time (CPT)

Absolute Claudication Distance (ACD) for this study was determined by the point of termination or maximum distance walked on the treadmill due to claudication.

Time frame: 12 months (± 30 Days)

Exercise Tolerance Test: Maximal Walking Distance

Absolute Claudication Distance (ACD) for this study was determined by the point of termination or maximum distance walked on the treadmill due to claudication.

Time frame: Baseline

Exercise Tolerance Test: Maximal Walking Distance

Absolute Claudication Distance (ACD) for this study was determined by the point of termination or maximum distance walked on the treadmill due to claudication.

Time frame: 1 month (± 7 Days)

Exercise Tolerance Test: Maximal Walking Distance

Absolute Claudication Distance (ACD) for this study was determined by the point of termination or maximum distance walked on the treadmill due to claudication.

Time frame: 12 months (± 30 Days)

Exercise Tolerance Test: Maximal Walking Time

Absolute Claudication Distance (ACD) for this study was determined by the point of termination or maximum distance walked on the treadmill due to claudication.

Time frame: Baseline

Exercise Tolerance Test: Maximal Walking Time

Absolute Claudication Distance (ACD) for this study was determined by the point of termination or maximum distance walked on the treadmill due to claudication.

Time frame: 1 month (± 7 Days)

Exercise Tolerance Test: Maximal Walking Time

Absolute Claudication Distance (ACD) for this study was determined by the point of termination or maximum distance walked on the treadmill due to claudication.

Time frame: 12 months (± 30 Days)