ABSORB BTK Study: A prospective, multicenter, controlled clinical evaluation of the use of a bioresorbable drug eluting stent in the arterial vasculature below the knee
The aim of this study is to evaluate the performance of a bioresorbable vascular scaffold (BVS) coated with the drug Everolimus. This will be used to treat short length blockages of up to 55mm (5.5cm) in arteries below the knee. This will be performed to treat patients who have severe leg pain or have developed skin ulcers or gangrene which are not healing due to insufficent blood supply. The ABSORB Everolimus Eluting Bioresorbable Vascular Scaffold works on similar principles of drug eluting stents which have been used for a considerable time in treating blocked arteries. However this product consists of a scaffold coated with a drug so rather than leaving a metallic stent in the blood vessel, this product primarily delivers the drug, gives mechanical support to the blood vessel and once it is no longer needed the scaffold absorbs into the body leaving no permanent metallic implant. This same device has been used safely and effectively in the arteries which supply the heart both in clinical trials and current practice and has also been evaluated in the leg arteries in a single-centre pilot study. This study aims to evaluate it's use in a larger number of patients in multiple centres and compare that to a historical control group of metal drug eluting stents. The study will evaluate both ultrasound and angiographic derived patency in those arteries out to a 36 month follow-up time point. This data will be collected in patients who fulfill the inclusion criteria and who are then treated and followed over time.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
4
Absorb Bioresorbable Vascular Scaffold
Prince of Wales Hospital
Sydney, New South Wales, Australia
Epworth Hospital
Melbourne, Victoria, Australia
Reinier de Graf Hospital
Delft, Netherlands
Auckland City Hospital
Auckland, New Zealand
Angiographic patency
Freedom from angiographic binary in-scaffold restenosis (\>50% stenosis)
Time frame: 12 months
Technical success
Technical success defined as the ability to cross and dilate the lesion to achieve residual angiographic stenosis no greater than 30% and residual stenosis less than 50% by duplex ultrasound (US) imaging.
Time frame: Procedure
Haemodynamic primary, assisted primary and secondary patency
Haemodynamic primary, assisted primary and secondary patency as assessed by ultrasound
Time frame: 1 month
Haemodynamic primary, assisted primary and secondary patency
Haemodynamic primary, assisted primary and secondary patency as assessed by ultrasound
Time frame: 6 months
Haemodynamic primary, assisted primary and secondary patency
Haemodynamic primary, assisted primary and secondary patency as assessed by ultrasound
Time frame: 12 months
Haemodynamic primary, assisted primary and secondary patency
Haemodynamic primary, assisted primary and secondary patency as assessed by ultrasound
Time frame: 24 months
Haemodynamic primary, assisted primary and secondary patency
Haemodynamic primary, assisted primary and secondary patency as assessed by ultrasound
Time frame: 36 months
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Limb salvage rate (LSR)
Limb salvage defined as 1 minus major amputation rate (major amputation is defined as at or above ankle, as opposed to minor amputation being at or below metatarsus preserving functionality of foot)
Time frame: 12 months
Target lesion revascularization (TLR)
Target lesion revascularization (TLR) is defined as a repeat intervention to maintain or re-establish patency within the region of the treated arterial vessel plus 5 mm proximal and distal to the treated lesion edge
Time frame: 12 months
Rutherford Category
Clinical success defined as an improvement of Rutherford classification of one class or more as compared to the pre-procedure Rutherford classification
Time frame: 12 months
Adverse clinical events
Clinical events defined as fatal, life-threatening, or judged to be severe by the investigator; resulted in persistent or significant disability; necessitated surgical or percutaneous intervention; or required prolonged hospitalization
Time frame: 12 months