Trial Review

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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/ct2/show/NCT05055297




Registration number
NCT05055297
Ethics application status
Date submitted
14/09/2021
Date registered
24/09/2021
Date last updated
3/05/2024

Titles & IDs
Public title
SELUTION4BTK Trial
Scientific title
SELUTION SLR™ 014 BTK: A Prospective Randomized Multicenter Single Blinded Study to Assess the Safety and Effectiveness of the SELUTION SLR™ 014 Drug Eluting Balloon in the Treatment of Below-the-Knee (BTK) Atherosclerotic Disease in Patients With Chronic Limb Threatening Ischemia (CLTI)
Secondary ID [1] 0 0
S2021-01
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Peripheral Arterial Disease 0 0
Chronic Limb-Threatening Ischemia Nos of Native Arteries of Extremities 0 0
Condition category
Condition code
Cardiovascular 0 0 0 0
Diseases of the vasculature and circulation including the lymphatic system
Cardiovascular 0 0 0 0
Other cardiovascular diseases

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Devices - SELUTION SLR™ DEB 014
Treatment: Devices - Plain (Uncoated) Balloon Angioplasty (PTA)

Experimental: SELUTION SLR™ DEB 014 -

Active Comparator: Plain (Uncoated) Balloon Angioplasty (PTA) -


Treatment: Devices: SELUTION SLR™ DEB 014
a non-surgical procedure that uses a catheter to inflate a drug-eluting balloon to open up peripheral below-the-knee arteries that have been narrowed by chronic limb-threatening ischemia

Treatment: Devices: Plain (Uncoated) Balloon Angioplasty (PTA)
a non-surgical procedure that uses a catheter to inflate a commercially available, non-drug-eluting balloon to open up peripheral below-the-knee arteries that have been narrowed by chronic limb-threatening ischemia
Intervention code [1] 0 0
Treatment: Devices
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Primary Efficacy Endpoint
Timepoint [1] 0 0
6 months
Primary outcome [2] 0 0
Primary Safety Endpoint
Timepoint [2] 0 0
30 days
Secondary outcome [1] 0 0
Primary sustained clinical improvement
Timepoint [1] 0 0
1, 6, 12, 24, and 36 months
Secondary outcome [2] 0 0
Secondary sustained clinical improvement
Timepoint [2] 0 0
1, 6, 12, 24, and 36 months
Secondary outcome [3] 0 0
Major amputation
Timepoint [3] 0 0
1, 6, 12, 24, and 36 months
Secondary outcome [4] 0 0
Amputation-free survival
Timepoint [4] 0 0
1, 6, 12, 24, and 36 months
Secondary outcome [5] 0 0
Primary assisted patency
Timepoint [5] 0 0
1, 6, 12, 24, and 36 months
Secondary outcome [6] 0 0
Secondary patency
Timepoint [6] 0 0
1, 6, 12, 24, and 36 months
Secondary outcome [7] 0 0
CD-TLR
Timepoint [7] 0 0
1, 6, 12, 24, and 36 months
Secondary outcome [8] 0 0
Clinically driven (CD-TVR)
Timepoint [8] 0 0
1, 6, 12, 24, and 36 months
Secondary outcome [9] 0 0
Rutherford category
Timepoint [9] 0 0
1, 6, 12, 24, and 36 months
Secondary outcome [10] 0 0
ABI/TBI/Toe Pressure
Timepoint [10] 0 0
1, 6, 12, 24, and 36 months
Secondary outcome [11] 0 0
Quality of Life (QOL) measures
Timepoint [11] 0 0
1, 6, 12, 24, and 36 months
Secondary outcome [12] 0 0
MALE
Timepoint [12] 0 0
1, 6, 12, 24, and 36 months
Secondary outcome [13] 0 0
Major cardiovascular events
Timepoint [13] 0 0
1, 6, 12, 24, and 36 months
Secondary outcome [14] 0 0
All-cause mortality
Timepoint [14] 0 0
1, 6, 12, 24, and 36 months
Secondary outcome [15] 0 0
Device success
Timepoint [15] 0 0
Post-procedure
Secondary outcome [16] 0 0
Procedural (technical) success
Timepoint [16] 0 0
Post-procedure
Secondary outcome [17] 0 0
Clinical success
Timepoint [17] 0 0
Evaluated at discharge defined as immediately prior to hospital discharge from the index procedure or within 7 days, whichever occurs first
Secondary outcome [18] 0 0
Secondary Angiographic Imaging Measures
Timepoint [18] 0 0
6 months
Secondary outcome [19] 0 0
Wound healing
Timepoint [19] 0 0
1, 6, 12, 24, and 36 months
Secondary outcome [20] 0 0
Wound Ischemia, foot infection (WifI) Classification
Timepoint [20] 0 0
1, 6, 12, 24, and 36 months

Eligibility
Key inclusion criteria
Clinical

1. Subject age is = 18 years or older depending on local regulations.

2. Subject life expectancy is = 1 year.

3. Subject has documented chronic limb-threatening ischemia in the target limb with
Rutherford classification category 4 or 5 and symptoms of > 2 weeks duration.

4. Subject is willing and able to provide written informed consent and comply with study
procedures and required follow-up evaluations.

5. Female subjects of childbearing potential must be non-breastfeeding and have a
negative pregnancy test = 7 days before the procedure.

Angiographic

Subjects must meet all the following criteria to be enrolled in the trial:

1. Target lesion(s) must be de novo or non-stented restenotic lesion(s) located within
the BTK arteries distal to the tibial plateau and above the tibiotalar joint line. BTK
arteries include the P3 segment of the popliteal artery, the tibio-peroneal trunk,
peroneal artery, anterior tibial artery, and posterior tibial artery.

2. BTK Target lesions cannot be contiguous with inflow lesions and at least 3 cm of
normal artery should extend beyond the tibial plateau to ensure there is no overlap.

3. Target lesions must have a diameter stenosis of = 70% (including total occlusions) by
visual estimate and must be indicated for PTA treatment.

4. Target vessel reference diameter(s) are = 2mm and = 4mm. Note: the SELUTION SLR 014
DEB and the control PTA balloon size cannot exceed 4.0 mm.

5. Target lesions must be confined to a single target vessel. NOTE: Subjects with other
non-target BTK lesions in separate non-target vessels may be enrolled, provided that
the non-target lesions have been successfully treated (residual stenosis = 30% with no
distal embolization or flow limiting = Grade C dissection). NOTE: Any adjunctive
therapies are permitted for the treatment of non-target BTK lesions, but no DEB or DES
may be used.

6. Any target lesion must be = 30 mm in length and the total combined length of all
target lesions must be = 140 mm (total treatment length = 150 mm allowing for 5 mm
proximal and distal shoulder treatment). Note: All target lesions and all inflow
lesions must be treatable by one or more SELUTION SLR 014/018 DEB(s) such that the
total planned per-subject drug dose (calculated by summing the drug dose of all
individual planned balloon sizes) would be = 7069 µg. Note: A total treated segment
length of = 150 mm for BTK and = 200 mm for inflow segment is acceptable irrespective
of DEB balloon diameter.

7. The tibial and pedal runoff distal to the target lesions must be patent OR the target
vessel(s) must reconstitute above the ankle or display normal terminal branching as
follows:

1. If the target vessel is the P3 segment, any 1 of the 3 distal arteries must show
a patent (= 50% stenosis by visual estimate) outflow.

2. If the target vessel is the peroneal artery, the artery must demonstrate normal
terminal branching.

3. If the target vessel is the anterior tibial (AT) or posterior tibial (PT) artery,
the artery must reconstitute = 1 cm above the tibiotalar joint to provide an
intact runoff vessel (AT: dorsalis pedis; PT: plantar artery).

4. If the target vessel is the tibio-peroneal trunk, outflow for either the peroneal
OR the posterior tibial artery must be patent (= 50% stenosis by visual
estimate).

8. Subjects is free of significant inflow vessel disease or any inflow disease has been
successfully treated (see angiographic inclusion # 9). Significant inflow disease is
defined as = 50% stenosis by visual estimate. Inflow vessels include the ipsilateral
common iliac, external iliac, common femoral, profunda femoris, superficial femoral or
popliteal artery proximal (= 3 cm) to the tibial plateau. Note: If access site doesn't
permit angiographic imaging of the common iliac and common femoral artery (CFA), then
non-invasive imaging (CTA or MRA) must be provided to exclude presence of significant
inflow disease. If non-invasive imaging is not possible, a DUS of the CFA with a
multiphasic wave form excluding significant disease AND a palpable ipsilateral femoral
pulse must be documented.

9. Subjects with significant inflow disease (= 50% stenosis by visual estimate) must have
documented successful treatment before randomizing the subject. Successful treatment
of inflow disease is defined as = 30% final residual stenosis and no distal
embolization or flow-limiting > Grade C dissection. Note: Treatment of the common
femoral and profunda femoris is not permitted. Inflow vessel treatment can be
performed with any commercially available non-DCB or non-DES device; if DCB treatment
is required, SELUTION SLR 018 must be used.

10. The BTK target lesion preparation must be documented to be successful by angiography
(= 30% residual stenosis and no distal embolization or flow-limiting = Grade C
dissection) before randomization. Note: Lesion preparation can include atherectomy
(rotational, orbital, directional or laser), cutting, scoring, contoured balloons or
intravascular lithotripsy and PTA only.

Clinical
Minimum age
18 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
Subjects will be excluded if any of the following criteria apply:

1. Subject has extensive tissue loss (Rutherford category 6) extending above the trans
metatarsal level, salvageable only with complex foot reconstruction or non-traditional
trans metatarsal amputations. This includes subjects with:

1. Osteomyelitis involving proximal to the metatarsal head(s)

2. Any heel wound or wound with calcaneal bone involvement

d) Wounds that would require flap coverage or complex wound management for large soft
tissue defect e) Full-thickness wounds on the dorsum of the foot with exposed tendon
or bone

2. Subject has chronic renal insufficiency (dialysis dependent, or glomerular filtration
rate [GFR] = 30 ml/min/1.73 m2 within 30 days of index procedure) or has undergone
renal transplantation.

3. Subject has acute renal insufficiency confirmed by 50% increase of serum creatinine
within 48 hours before procedure and/or decrease in urine output.

4. Subject has acute limb ischemia with onset of index limb symptoms less than 2 weeks
prior to index procedure.

5. Subjects has wounds that are deemed to be neuropathic or non-ischemic in nature or any
venous or mixed wounds.

6. Subject has had prior major amputation of the ipsilateral extremity or planned major
amputation of either leg.

7. Target limb iliac or common femoral artery bypass within 6 weeks of index procedure.

8. Prior (within 14 days) or planned (within 30 days) surgical or endovascular
procedures. The following procedures are permitted:

1. Target limb inflow treatment at the index procedure, provided it meets the
criteria in Angiographic Inclusion Criteria #12

2. Contralateral limb iliac artery treatment

3. Diagnostic angiography

4. Foot wound debridement

5. Planned minor amputation of digit(s) at the phalangeal level

9. Target lesion has undergone prior DCB within 1 year, or ANY prior DES or bare metal
stent (BMS) treatment (no in-stent restenosis [ISR] treatment is permitted). Note:
Prior stent is permitted if the target lesion is located = 30 mm from the stent AND
there is = 30% in-stent diameter stenosis.

10. Target lesion(s) requires treatment with alternative therapies such as thrombolysis,
thrombus aspiration, stenting, cryoplasty, brachytherapy, or re-entry device. Note:
The following adjunctive lesion preparation therapies are permitted: Atherectomy
(rotational, orbital, directional or laser), cutting/scoring/contoured balloon, or
intravascular lithotripsy.

11. Target lesion requires treatment via pedal access or upper extremity access.

12. Subject has undergone non-coronary artery treatment with any limus-based drug coated
balloon (DCB) or DES or other device within 3 months prior to index procedure.

13. Subject has known hypersensitivity or allergy to Sirolimus or other pharmacologic
agents required for the procedure (such as contrast agent, heparin, bivalirudin) that
cannot be adequately pre-treated.

14. Subject has contraindication to antiplatelet therapy.

15. Subject has experienced disabling stroke or ST-segment elevation myocardial infarction
(STEMI) within 3 months of index procedure.

16. Subject has acute coronary syndrome. Stabilized Acute Coronary Syndrome (ACS) is
permitted.

17. Subject has non-atherosclerotic disease of the target vessel (including aneurysmal
disease and vasculitis) or Buerger's disease.

18. Subject has hypercoagulable state or disorder, or coagulopathy, including platelet
count = 100,000 per microliter.

19. Subject has systemic infection (White Blood Count [WBC] > 12,000 and febrile). [Note:
Enrollment permitted after successful treatment of infection with resolution of
leukocytosis and/or febrile state].

20. Subject is known to be immune compromised (e.g., Human Immunodeficiency virus [HIV],
Systemic Lupus Erythematosus [SLE]) or is receiving treatment with immune suppressive
medications (NOTE: topical corticosteroids are permitted)

21. Subject is receiving (or is scheduled to receive) cancer treatment with surgery or
chemotherapy or radiation therapy or has metastatic malignancy. Note: local
application of chemotherapeutic creams is allowed.

22. Subject has New York Heart Association (NYHA) class IV congestive heart failure.

23. Subject is bedridden.

24. Subject has a body mass index (BMI) < 18.

25. Subject is currently participating in another investigational drug or device study
that has not completed primary endpoint follow-up.

26. Subject has other anatomic, medical, social, or psychological conditions that in the
investigator's opinion could limit the patient's ability to participate in the
clinical study and/or comply with the follow-up requirements.

Angiographic

Subjects will be excluded if any of the following criteria apply:

1. Presence of a previously placed stent in the target vessel(s), UNLESS the target
lesion is located = 30 mm from the stent AND there is = 30% in-stent diameter
stenosis.

2. There is significant (> 50% diameter stenosis) inflow disease in the common femoral
and profunda femoris arteries (inflow treatment of the common femoral and profunda
femoris is not permitted).

3. The target lesion could not be successfully pre-dilated (residual stenosis > 30%,
distal embolization, or flow-limiting = Grade C dissection after pre-dilatation).

4. Intra-arterial thrombus, thromboembolism or atheroembolism in the index limb noted on
initial diagnostic angiography or following treatment of inflow disease or
pre-treatment of target lesion.

5. Subject requires treatment of the tibial arteries distal to the tibiotalar joint line,
or treatment of the pedal arteries. Angioplasty at or below the tibiotalar joint is
not permitted.

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?
The people receiving the treatment/s


Intervention assignment
Parallel
Other design features
Phase
Not Applicable
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Recruiting
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
19/05/2022
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
30/07/2028
Actual
Sample size
Target
376
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
Recruitment outside Australia
Country [1] 0 0
United States of America
State/province [1] 0 0
Arkansas
Country [2] 0 0
United States of America
State/province [2] 0 0
California
Country [3] 0 0
United States of America
State/province [3] 0 0
Colorado
Country [4] 0 0
United States of America
State/province [4] 0 0
Connecticut
Country [5] 0 0
United States of America
State/province [5] 0 0
Florida
Country [6] 0 0
United States of America
State/province [6] 0 0
Georgia
Country [7] 0 0
United States of America
State/province [7] 0 0
Illinois
Country [8] 0 0
United States of America
State/province [8] 0 0
Iowa
Country [9] 0 0
United States of America
State/province [9] 0 0
Louisiana
Country [10] 0 0
United States of America
State/province [10] 0 0
Maryland
Country [11] 0 0
United States of America
State/province [11] 0 0
Massachusetts
Country [12] 0 0
United States of America
State/province [12] 0 0
North Carolina
Country [13] 0 0
United States of America
State/province [13] 0 0
Ohio
Country [14] 0 0
United States of America
State/province [14] 0 0
Rhode Island
Country [15] 0 0
United States of America
State/province [15] 0 0
Tennessee
Country [16] 0 0
United States of America
State/province [16] 0 0
Texas
Country [17] 0 0
United States of America
State/province [17] 0 0
Virginia
Country [18] 0 0
Austria
State/province [18] 0 0
Graz
Country [19] 0 0
France
State/province [19] 0 0
Boulogne-Billancourt
Country [20] 0 0
France
State/province [20] 0 0
Paris
Country [21] 0 0
Germany
State/province [21] 0 0
Arnsberg
Country [22] 0 0
Germany
State/province [22] 0 0
Bad Krozingen
Country [23] 0 0
Germany
State/province [23] 0 0
Buchholz
Country [24] 0 0
Germany
State/province [24] 0 0
Essen
Country [25] 0 0
Hong Kong
State/province [25] 0 0
Pok Fu Lam
Country [26] 0 0
Hong Kong
State/province [26] 0 0
Shatin
Country [27] 0 0
Italy
State/province [27] 0 0
Cotignola
Country [28] 0 0
Italy
State/province [28] 0 0
Genova
Country [29] 0 0
Netherlands
State/province [29] 0 0
Nieuwegein
Country [30] 0 0
New Zealand
State/province [30] 0 0
Auckland
Country [31] 0 0
Singapore
State/province [31] 0 0
Singapore
Country [32] 0 0
Switzerland
State/province [32] 0 0
Bern

Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
Name
MedAlliance, LLC
Address
Country
Other collaborator category [1] 0 0
Other
Name [1] 0 0
NAMSA
Address [1] 0 0
Country [1] 0 0

Ethics approval
Ethics application status

Summary
Brief summary
This study aims to demonstrate superior efficacy and equivalent safety of the SELUTION SLR™
DEB 014 compared to plain (uncoated) balloon angioplasty in the treatment of peripheral
arterial disease (PAD) in the BTK arteries in CLTI patients.
Trial website
https://clinicaltrials.gov/ct2/show/NCT05055297
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Kara Piscani
Address 0 0
Country 0 0
Phone 0 0
+14846805857
Fax 0 0
Email 0 0
kara.piscani@cordis.com
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/ct2/show/NCT05055297