Evaluating Plaque Photoablation Using an Excimer Laser in Patients With Lower Extremity Vascular Disease

Peripheral Arterial Disease Clinical Trial

Official title:

A Prospective, Multi Center Pilot Study Evaluating Plaque Photoablation Using the RA-308 Excimer Laser in Subjects With Symptomatic Infrainguinal Lower Extremity Vascular Disease

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02653456
• Other study ID #: RMS-102
• Status: Completed
• Phase: N/A
• Start date: April 7, 2016
• Est. completion date: July 14, 2017

Study information

• Verified date: October 2018
• Source: Ra Medical Systems
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to evaluate the safety and efficacy of an excimer laser in the treatment of patients with lower extremity vascular disease with chronic total occlusions.

Description:

The study is a multi center, prospective, non-randomized, open-label study conducted at a minimum of one investigational center. 50 subjects can be enrolled. Follow-up occurs at the end of the procedure in the form of an angiogram to determine if the lesion was crossed. Additional follow-up may not necessary because of the binary nature of the crossing, and also because any future follow-up would be assessing the effectiveness of adjunct therapy, e.g. balloon angioplasty. Long term results are entirely dependent on this subsequent treatment. Because the DABRA crosser only allows adjunct devices to be used, 30-day follow-up measuring the performance of the adjunct therapy might affect the physician's choice of therapy, and compromise the patient's treatment. Therefore, 30-day follow-up, which evaluates the effectiveness of the adjunct therapy, might raise ethical concerns. However, the follow-up can be done by Ankle-Brachial Index, Doppler ultrasound, auscultation, or by discussion of the level of claudication and motion pain with the patient. To evaluate the safety and efficacy of the RA-308 Excimer Laser System and DABRA Catheter for treating subjects with symptomatic infrainguinal lower extremity vascular disease with chronic total occlusions that cannot be crossed with standard guide wires, or lesions where an attempt to cross would, in the opinion of the interventionalist, result in either a subintimal path or a perforation.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 64
• Est. completion date: July 14, 2017
• Est. primary completion date: May 3, 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• signed informed consent

• symptomatic infrainguinal lower extremity vascular disease (Rutherford category 3, 4, 5 or 6), stable for at least 2 weeks prior to study inclusion

• lesions in the superficial femoral artery (SFA), popliteal, or infrapopliteal arteries at least one angiographically identifiable infrageniculate artery

• patients must be poor surgical candidates, indicated by at least one of the following conditions:

• absence of venous autologous grafts (that is, lack of a suitable vein to use for bypass)

• poor (diffusely diseased or <=1mm diameter) or no distal vessels available for graft anastamosis

• high risk of surgical mortality, evidenced by American Society of Anesthesiologists Physical Class 4 or higher

Exclusion Criteria:

• age below 18 years

• pregnancy, or plan to become pregnant

• participation in another cardiovascular or peripheral vascular study

• myocardial infarction (MI) in prior month

• stents at treatment site

• disorders or allergies precluding use of radiographic contrast

• renal insufficiency sever enough to contraindicate use of radiographic contrast

• contraindication to treatment with anticoagulants

• untreated ipsilateral iliac stenosis >70%

• inability or unwillingness of the patient to comply with intended examinations

• unavailability of required procedural or imaging equipment

• lesion located in a graft

• hemodynamically significant arrhythmia or left ventricular ejection fraction <20%

• life expectancy less than 6 months

• necrosis necessitating major amputation

• unwillingness of the patient to be anti-coagulated

Related Conditions & MeSH terms

• Peripheral Arterial Disease
• Peripheral Vascular Diseases
• Vascular Diseases

Intervention

Device:
• RA-308 Excimer Laser and DABRA Catheter
See information already included in arm description

Locations

Country	Name	City	State
United States	California Heart & Vascular Clinic	El Centro	California
United States	Merit Health Wesley	Hattiesburg	Mississippi
United States	University of California San Diego	San Diego	California

Sponsors (1)

Lead Sponsor	Collaborator
Ra Medical Systems

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Crossing the Target Lesion	Crossing the target lesion based on angiographic analysis	at time of procedure
Secondary	Number of Participants With no Device-related Major Adverse Events	Number of participants with no device-related major adverse events as determined by physician evaluation	at time of procedure, up to an hour
Secondary	Number of Participants With Target Lesion Revascularization	Number of participants with target lesion revascularization as determined by physician evaluation	30 days
Secondary	Number of Participants With Target Lesion Revascularization	Number of participants with target lesion revascularization as determined by physician evaluation	6 months