RESCUE is a Europe-wide study that will follow 400 people with critical limb-threatening ischemia (CLTI). It aims to see how well Esprit BTK™ Everolimus Eluting Resorbable Scaffolds work in real-life medical settings. The study focuses on people who have heavily calcified arteries in the infrapopliteal areas of the leg. These drug-eluting resorbable scaffolds release a medication that helps prevent the inner wall of the blood vessel from thickening after injury or surgery. This can reduce the chance of the artery becoming blocked again (a problem called restenosis), while also giving temporary structural support to the vessel. Over time, the scaffold naturally dissolves in the body, which may lower the long-term risks associated with permanent metal stents.
Study Type
OBSERVATIONAL
Enrollment
400
The Esprit BTK™ is a bioresorbable vascular scaffold designed for arteries below the knee. It provides temporary support to keep the vessel open while releasing everolimus-an antiproliferative drug that helps prevent excessive tissue growth and reduces the risk of restenosis. As the scaffold delivers the medication, it gradually dissolves, potentially lowering long-term risks associated with permanent stents.
Number of lesions free from Clinically-Driven Target Lesion Revascularization (CD-TLR)
Defined as freedom from any endovascular re-intervention to the target lesion (± 10 mm) or surgical bypass performed because of restenosis or occlusion of the target lesion.
Time frame: 12 months
CD-TLR-free survival per target lesion
Defined as the time between first index procedure and any endovascular re-intervention to the target lesion (± 10 mm) or surgical bypass performed because of restenosis or occlusion of the target lesion.
Time frame: Until the end of the follow-up period of 3 years
Clinical response using Rutherford classification categories
The Rutherford classification is a clinical scale used to categorize the severity of peripheral arterial disease: Category 0 = asymptomatic; Category 1 = mild claudication; Category 2 = moderate claudication; Category 3 = severe claudication; Category 4 = ischemic rest pain; Category 5 = minor tissue loss; Category 6 = severe tissue loss.
Time frame: 12, 24, and 36 months
Wound status
Defined as healing status of the dominant ischemic wound of the target limb (complete, partial, unchanged, worsening).
Time frame: 12, 24, and 36 months
Freedom from major amputation of the target limb
Defined as absence of any amputation of the target limb (above ankle).
Time frame: 12 and 24 months
Amputation-free survival
Defined as time between first index procedure and amputation of the target limb, minor (digital, metatarsal), major below the knee or major above the knee (excluding any amputation planned before the index procedure).
Time frame: Until the end of the follow-up period of 3 years
Overall survival
Defined as the time between the first index procedure and death of any cause.
Time frame: Until the end of the follow-up period of 3 years
Patient-reported health-related quality-of-life
Measured by Vascular Quality of Life Questionnaire - 6 items (VascuQol-6), which is a short patient-reported outcome measure (PROM), used to assess health-related quality of life in people with PAD. It consists of 6 questions, each scored from 1 to 7, with 1 as the worst possible quality of life and 7 as the best possible quality of life. Higher overall scores reflect better quality of life for patients with PAD.
Time frame: Baseline, Day 0 (day of procedure), 6-, 12-, 24-, 26-months post treatment
Frequency and severity of procedural complications and other adverse events
Grading according to the classification system of the Cardiovascular and Interventional Radiological Society of Europe.
Time frame: Within 30 days after the index procedure
Frequency of major adverse limb events (MALE) and peri-operative death (POD).
MALE include above-ankle amputation in the index limb, major re-intervention on the index limb at 6 months and POD includes perioperative (30-day) mortality.
Time frame: 6 months for MALE; Within 30 days after the index procedure for POD
Clinical response using ankle-brachial index (ABI)
The ankle-brachial index (ABI) is a non-invasive measure calculated as the ratio of systolic blood pressure at the ankle to systolic blood pressure at the arm. ABI categories commonly used to classify peripheral arterial disease are: \>1.40 = non-compressible arteries; 1.00-1.40 = normal; 0.91-0.99 = borderline; 0.41-0.90 = mild to moderate peripheral arterial disease; \<0.40 = severe peripheral arterial disease.
Time frame: 12, 24, and 36 months
Clinical response using toe pressure
The toe pressure test measures distal limb perfusion by recording systolic pressure at the toe. In CLTI patients, toe pressure ≤30 mmHg is commonly used to indicate severe ischemia, while values \>30 mmHg suggest better perfusion.
Time frame: 12, 24, and 36 months
Clinical response using WIfi (wound, ischemia and foot infection) score
The WIfI classification is a staging system used to assess CLTI based on wound extent, ischemia severity, and foot infection. Each component is graded from 0 (none) to 3 (severe). Lower WIfI scores indicate a lower risk of limb loss and a lesser urgency for revascularization, whereas higher scores indicate greater disease severity, higher amputation risk, and greater potential benefit from revascularization.
Time frame: 12, 24, and 36 months
Restoration of normal lumen per target lesion
Defined as residual stenosis ≤30%, immediately after completion of full planned procedure.
Time frame: Immediately upon procedure completion
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