This study postulates that the application of Sirolimus, an anti-proliferative agent that inhibits neointimal hyperplasia, via Sirolimus coated balloon (SCB) will be safe and will result in better arterial patency in infrainguinal peripheral arterial disease (PAD). The aim is to evaluate the efficacy (12 month freedom from clinically driven target lesion revascularisation) and safety (freedom from major adverse events) of sirolimus coated balloons in the treatment of infrainguinal PAD.
It is imperative to have effective treatment strategies for PAD which can maintain the patency of arteries. The current standard of care for PAD is angioplasty which includes usage of drug coated balloons (DCB). Paclitaxel is the only anti-proliferative drug available in all currently available DCB technology. Sirolimus is another highly effective anti-proliferative drug of immense potential as demonstrated by superior results in Sirolimus drug eluting stents in coronary disease. The physical properties of Sirolimus have made it challenging for it to be similarly applied to DCB technology and it is only due to recent advances in nanotechnology that it is now possible to develop Sirolimus coated balloons (SCB), which is the study device used in this study. The study device allows delivery and deposition of sirolimus to the arterial wall. By applying this agent into lesions in peripheral arterial disease, this study aim to effectively reduce neointimal hyperplasia, and therefore prolong the patency of the artery and improve our limb salvage rates for PAD and CLI patients. Subjects will be followed up in the clinic at 6 month, 12 month, and 24 month post-intervention to assess primary and secondary outcome of safety and efficacy.
Study Type
OBSERVATIONAL
Enrollment
50
The Xtreme Touch (Magic Touch PTA) - Neo Sirolimus PTA Balloon Catheter is the world's first sirolimus coated PTA balloon. The purpose of the X-TOSI all-comers registry is to collect short and long-term clinical performance data on the Xtreme Touch (Magic Touch PTA) -Neo sirolimus PTA balloon catheter in the treatment of atherosclerotic disease in the infrainguinal arteries in an all-comers patient population in real world daily clinical practice.
Sengkang General Hospital
Singapore, Singapore
Efficacy: Number of Patients with Primary patency
Defined as by duplex ultrasonography-derived peak systolic velocity ratio of \< = 2.4
Time frame: 6 months
Safety: Number of Patients with Freedom from Major Adverse Events (MAE) defined as composite of
1. freedom from device- and procedure-related mortality, and major target limb amputation through to 30 days, and 2. Freedom from clinically driven target lesion revascularization (TLR) within 6 months post-index procedure.
Time frame: 6 months
Number of Patients with Freedom from clinically-driven TLR
Freedom From Clinically Driven Target Lesion Revascularization
Time frame: 6, 12, and 24 months
Number of Patients with Freedom from clinically-driven TVR
Freedom From Clinically Driven Target Vessel Revascularization
Time frame: 6 and 24 months
Number of Patients with Primary patency
Percentage of subjects with duplex ultrasound Clinical Primary Patency
Time frame: 12 and 24 months
Number of Patients with Freedom from MAE
b. A composite of freedom from device- and procedure-related mortality, and major target limb amputation
Time frame: 12 and 24 months
Number of Patients with Amputation-free survival
Amputation-free survival of patients
Time frame: 6, 12 and 24 months
Number of Patients with Improvement in Rutherford classification
Improvement in Rutherford classification compared to the pre-procedure Rutherford classification
Time frame: 6, 12 and 24 months
Number of Patients with Device success
Successful delivery, inflation, deflation, and retrieval of the Xtreme Touch - Neo balloon catheter.
Time frame: Day 0
Number of Patients with Technical success
Successful completion of the endovascular procedure and immediate morphological success with ≤ 50% residual diameter reduction of the treated lesion as determined by visual estimation
Time frame: Day 0
Number of Patients with Procedural success
Participants will be followed for the duration of hospital stay, an expected average of 1-2 days
Time frame: Participants will be followed for the duration of hospital stay, an expected average of 1-2 days
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