The purpose of this study is to evaluate the efficacy of the standard of care revascularization of the lower extremity with the addition of revascularization of the lateral plantar artery and anterior pedal loop of the foot as treatment for diabetic peripheral neuropathy.
This is a 26 week, single arm, single-site, Investigator-initiated, exploratory trial evaluating the efficacy of the standard of care revascularization of the lower extremity with the addition of revascularization of the lateral plantar artery and anterior pedal loop of the foot as treatment for participants with PAD, diabetic neuropathy and have a clinical diagnosis of type 1 or type 2 diabetes whose main symptoms are numbness and/or tingling of the feet with or without pain. Participants who satisfy eligibility criteria may undergo standard of care revascularization of one lower extremity as required, with the addition of revascularization of the lateral plantar artery and anterior pedal loop followed by a 26-week follow-up phase. Standard of Care revascularization will be performed in any limb with ≥ 50% stenosis as determined by intra-vascular ultrasound (IVUS) at the time of planned study intervention. Participants will be evaluated prior to intervention and at 2, 4, 14 and 26 weeks after the pedal loop intervention.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
30
Angiogram and IVUS with revascularization of the lateral plantar artery and pedal arch on target foot.
Diabetes and Glandular Disease Clinic, P.A.
San Antonio, Texas, United States
Intra-epidermal Nerve Fiber Density
Change from baseline in intra-epidermal nerve fiber density (IENFD) via skin biopsy of the revascularized foot over the extensor digitorum brevis muscle (EDBM) at week 26.
Time frame: 26 weeks
Intra-epidermal Nerve Fiber Density
Number and percent of participants whose IENFD have increased by at least 20% from baseline
Time frame: 14 and 26 weeks
Utah Early Neuropathy Scale
Number and percentage of participants with improvement on Utah Neuropathy Scale (UENS)
Time frame: 14 and 26 weeks
Sural Nerve Action Potential Amplitude
Number and percentage of participants with improvement of sural nerve action potential amplitude
Time frame: 14 and 26 weeks
Sudoscan
Number and percentage of participants with 20% improvement on Sudoscan
Time frame: 14 and 26 weeks
Intra-epidermal Nerve Fiber Density
Number and percentage of participants with improvement of intra-epidermal nerve fiber density
Time frame: 14 weeks
Neuropathic Pain Syndrome Inventory
Improvement in quality of life as measured by the Neuropathic Pain Syndrome Inventory
Time frame: 14 and 26 weeks
Patency of Lateral Plantar Artery
Number and percentage of participants with patency of lateral plantar artery per ultrasound
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Time frame: 14 and 26 weeks