Angioplasty or bypass surgery in critical limb ischemia
ISRCTN | ISRCTN08459809 |
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DOI | https://doi.org/10.1186/ISRCTN08459809 |
Secondary identifying numbers | DFG No. 247 |
- Submission date
- 25/05/2011
- Registration date
- 31/01/2012
- Last edited
- 31/01/2012
- Recruitment status
- Stopped
- Overall study status
- Stopped
- Condition category
- Circulatory System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year
Plain English summary of protocol
Not provided at time of registration
Contact information
Prof Hans-Henning Eckstein
Scientific
Scientific
Clinic for Vascular Surgery
Isar Hospital [Klinikum rechts der Isar]
Technische Universitaet Muenchen
Ismaninger Str. 22
Munich
81675
Germany
Study information
Study design | Open multi-centre randomised two-armed parallel group study |
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Primary study design | Interventional |
Secondary study design | Randomised controlled trial |
Study setting(s) | Hospital |
Study type | Treatment |
Participant information sheet | Not available in web format, please use the contact details below to request a patient information sheet |
Scientific title | Angioplasty or bypass surgery in critical limb ischemia: a randomised controlled trial for patients with ischemic rest pain or tissue loss of the legs |
Study objectives | Endovascular treatment is not inferior as compared to operative treatment in patients with ischemic rest pain or tissue loss of the legs (consistent to Fontaine stages III or IV and Rutherford classes 4 to 6) |
Ethics approval(s) | Not provided at time of registration |
Health condition(s) or problem(s) studied | Critical limb ischemia |
Intervention | As of 31/01/2012, this study was stopped due to patient recruitment issues. Intervention type I: Best endovascular treatment (angioplasty +/- stent) Intervention type II: Best surgical treatment (below the knee vein bypass) |
Intervention type | Other |
Primary outcome measure | 1. Perioperative death (POD, 30 days) 2. Any major adverse limb event (MALE) within 1 year 2.1. Above ankle amputation of the index limb 2.2. Major reintervention (new bypass graft, jump/interposition graft revision, or thrombectomy/thrombolysis) |
Secondary outcome measures | 1. Clinical safety endpoints 1.1. Major adverse cardiovascular event (MACE): myocardial infarction, stroke or death (any cause) within 30 days 1.2. Any MALE (definition see above) within 30 days 1.3. Above-ankle amputation within 30 days 2. Clinical efficacy endpoints 2.1. Any MALE (definition see above) within 2 years 2.2. Primary sustained clinical improvement: upward shift on the Rutherford or Fontaine classifcation to a level of intermittent claudication (IC) without the need for repeated target lesion revascularization (TLR) in surviving patients and without the need for unplanned amputation within 2 years 2.3. Secondary sustained clinical improvement: upward shift on the Rutherford or Fontaine classification to a level of IC including the need for repeated TLR in surviving patients and without the need for unplanned amputation within 2 years 2.4. Above ankle amputation of the index limb within 2 years 2.5. Amputation-Free Survival (AFS): above ankle amputation of the index limb or death (any cause) within 2 years 2.6. Any reintervention or above ankle amputation of the index limb within 2 years 2.7. Death (any cause) within 2 years 3. Haemodynamic endpoints (30 days, 3, 6, 12, 18, 24 months) 3.1. Failure to increase Ankle brachial Index (ABI) by at least 0.15 post-procedure as compared to baseline value 3.2. Decrease in ABI by 0.15 or greater as compared to post-procedure value 3.3. Duplex ultrasound or angiography demonstrating occlusion of graft or any treated vessel, or >50% stenosis in the presence or recurrent clinical symptoms 4. Further secondary endpoints 4.1. Wound healing documeted by serial photographs 4.2. Quality of life (PAVK 86, MOS-SF 36) 4.3. Total costs of treatment modalities |
Overall study start date | 01/10/2012 |
Completion date | 30/09/2016 |
Reason abandoned (if study stopped) | "Participant recruitment issue": lack of recruitment of participants in previous phase of trial ISRCTN39997806, so this study was not started |
Eligibility
Participant type(s) | Patient |
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Age group | Adult |
Sex | Both |
Target number of participants | 550 |
Key inclusion criteria | 1. Critical limb ischemia (CLI) lasting > 2 weeks (Fontaine stages III or IV or Rutherford classes 4 to 6 as assessed by clinical examination 2. Ankle pressure < 50 mm Hg, toe pressure <30 mm Hg, TcPo2 < 30 mm Hg 3. Availability of adequate saphenous vein for bypass surgery |
Key exclusion criteria | 1. Acute limb-threatening ischemia (either embolic or thrombotic) 2. Non-atherosclerotic disease or documented hypercoagulopathy 3. End-stage renal disease and other severe co-morbidities with a life expectancy of less than 2 years American Society of Anesthesiologists [(ASA) IV, V] 4. Chronic total occlusions of the common/superficial femoral artery (>20cm) or the popliteal artery and proximal trifurcation vessels [according to TransAtlantic InterSociety (TASC) II D lesions] 5. Isolated single or multiple stenosis of the infrainguinal arteries that could be treated by endovascular means 6. Impaired infow of the aorto-iliac arteries (>50% stenosis or occlusions) 7. Contraindications for antiplatelet agents and/or anticoagulants 8. Surgical or catheter intervention on the index leg within the last 3 months |
Date of first enrolment | 01/10/2012 |
Date of final enrolment | 30/09/2016 |
Locations
Countries of recruitment
- Germany
Study participating centre
Clinic for Vascular Surgery
Munich
81675
Germany
81675
Germany
Sponsor information
Technical University of Munich [Technische Universitaet Muenchen] (Germany)
University/education
University/education
Klinikum rechts der Isar
Ismaninger Str. 22
Munich
81675
Germany
Website | http://portal.mytum.de/ |
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https://ror.org/02kkvpp62 |
Funders
Funder type
Research organisation
German Research Foundation [Deutsche Forschungsgemeinschaft (DFG)] ref: 247
No information available
Results and Publications
Intention to publish date | |
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Individual participant data (IPD) Intention to share | No |
IPD sharing plan summary | Not provided at time of registration |
Publication and dissemination plan | Not provided at time of registration |
IPD sharing plan |