BARD® The VENOVO™ Venous Stent Study for Treatment of Iliofemoral Occlusive Disease (VERNACULAR)

• ClinicalTrials.gov Identifier: NCT02655887
• Recruitment Status: Completed
• First Posted: January 14, 2016
• Results First Posted: June 12, 2019
• Last Update Posted: February 4, 2021
• Sponsor: C. R. Bard
• Information provided by (Responsible Party): C. R. Bard

Study Description

Brief Summary:

The BARD® Venovo™ Venous Stent Study is a non-randomized clinical study intended to collect confirmatory evidence of the safety and effectiveness of the Venous Stent for the treatment of iliofemoral occlusive disease.

Condition or disease	Intervention/treatment	Phase
May-Thurner Syndrome; Peripheral Vascular Disease; Venous Disease; Iliofemoral Occlusive Disease	Device: VENOVO™ Venous Stent	Not Applicable

Detailed Description:

This is a prospective, multi-center, non-randomized, single-arm clinical study of the VENOVO ™ Venous Stent for the treatment of iliofemoral occlusive disease. The study will be conducted at a maximum of 35 investigational sites ("sites") in the United States, and Europe and Australia/New Zealand. Enrollment will continue until a maximum of one hundred seventy (170) subjects are treated with the VENOVO™ Venous Stent, which is an estimated three-hundred forty (340) consecutive subjects in a non-randomized fashion. It is assumed that approximately 50% of the treated subjects will be U.S. subjects. Clinical follow-up for all treated subjects will be performed at hospital discharge, 30-days, and 6-, 12-, 24-, and 36-months post-index procedure.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 170 participants
• Allocation: N/A
• Intervention Model: Single Group Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: The BARD® VENOVO™ Venous Stent Study - A Prospective, Non-Randomized, Multi-Center, Single-Arm Study of the Treatment of Iliofemoral Occlusive Disease - an Assessment for Effectiveness and Safety (VERNACULAR)
• Actual Study Start Date: June 15, 2016
• Actual Primary Completion Date: June 19, 2018
• Actual Study Completion Date: October 30, 2020

Arms and Interventions

Arm	Intervention/treatment
Experimental: VENOVO™ Venous Stent.; Implant of the VENOVO™ Venous Stent	Device: VENOVO™ Venous Stent; VENOVO™ Venous stent placement

Outcome Measures

Primary Outcome Measures :

1. Number of Participants With Primary Patency of the Venous Stent at 12 Months Post-Index Procedure [ Time Frame: 12 months post-index procedure ]

   Primary patency rate at 12 months post-index procedure evaluated against a literature-derived Performance Goal (PG) of 74%. Primary patency defined as: freedom from Target Vessel Revascularization (TVR); freedom from thrombus occlusion and stenosis > 50% as measured by Duplex Ultrasound (DUS).

   Please note that both the primary effectiveness and the primary safety endpoint are considered co-primary endpoints. That is, both endpoints need to be significant to claim the study as successful.

2. Number of Participants With Freedom From Major Adverse Events (MAEs) [ Time Frame: 30 days post-index procedure ]

   Freedom from major adverse events (MAEs) defined as: Target Vessel Revascularization; Device and/or procedure related death; Major amputation of target limb; Pulmonary Embolism which is clinically important; Vascular injury requiring surgical/endovascular intervention; Embolization /migration of stent; Device or procedure related acute DVT involving the treated limb.

   Please note that both the primary effectiveness and the primary safety endpoint are considered co-primary endpoints. That is, both endpoints need to be significant to claim the study as successful.

Secondary Outcome Measures :

1. Endpoint With Hypothesis Testing: Index of Venous Clinical Severity Score (VCSS) From Baseline to 12 Months [ Time Frame: Evaluation at 12 months post-index procedure ]
   The Venous Clinical Severity Score (VCSS) system includes 10 clinical descriptions (pain, varicose veins, venous edema, skin pigmentation, inflammation, induration, number of active ulcers, duration of active ulceration, size of active ulceration. and level of compliance with medical compression therapy), scored from 0 to 3 (total possible score, 30) with 0 means absent, 1 means mild, 2 means moderate and 3 means severe. Total VCSS is the sum of all VCSS assessment scores from categories for a given time point. Twelve-month data is the change between baseline score and 12-month follow-up score. Results calculated for Intent-to-Treat (ITT) subjects. Lower values represent a better outcome, that is, a level of pain less than that experienced at baseline.
2. Endpoint With Hypothesis Testing: Index of Quality of Life (QoL) From Baseline to 12 Months [ Time Frame: Evaluation at 12 months post-index procedure ]
   The Quality of Life (QoL) assessment of Chronic Venous Insufficiency Questionnaire (CIVIC-20) is a 20-item questionnaire which provides a global index and an outline of 4 QoL dimensions - pain (4 items), physical (4 items), psychological (9 items) and social (4 items). Items are scored on a scale from 1 to 5. A low score corresponds to greater patient comfort. Total CIVIQ-20 score is the sum of all 20-item scores The score of each dimension was obtained by adding up the scores of each constituent item within that dimension. Twelve-month data is the change between baseline score and 12-month follow-up score. Results calculated for evaluable ITT subjects. Lower values represent a better outcome, that is, a better QoL than that experienced at baseline.
3. Endpoint Without Hypothesis Testing: Index of CEAP at 30 Days, 6 Months, and 12 Months Post Procedure [ Time Frame: Evaluation through 30 day, 6 months and 12 months post index procedure ]
   Clinical-Etiologic-Anatomic-Pathophysiologic (CEAP) Classification is a system that describes a doctor's physical exam findings for vein problem(s), the cause of the problem(s), the location in the leg, and the mechanism responsible for the manifestation of the vein problem. For Clinical classification, the clinical components indicates disease severity, ranging from none (0 points) to active ulcers (6 points).For each category of Etiology, Anatomy, and Pathophysiology classifications, at each time point, frequency of each category is reported. Subsequent clinical study reports will present CEAP at 24 and 36-months follow-up. Changes from baseline measures to given time points are presented. Lower mean scores represent an improvement from baseline measure.
4. Endpoint Without Hypothesis Testing: Number of Participants With Acute Technical Success [ Time Frame: At time of Index Procedure ]
   Acute technical success is defined as successful deployment of stent(s) to intended target with adequate lesion coverage as assessed by the Investigator.
5. Endpoint Without Hypothesis Testing: Number of Participants With Acute Procedure Success (ITT Subjects) [ Time Frame: Less than 30 days post index procedure ]
   Technical success is defined as no major adverse events experienced between index procedure and discharge
6. Endpoint Without Hypothesis Testing: Number of Participants With Lesion Success (ITT Subjects) [ Time Frame: At the conclusion of index procedure ]
   Lesion Success is defined as the attainment of less or equal to 50% residual stenosis at the conclusion of the index procedure.
7. Endpoint Without Hypothesis Testing: Number of Participants With Freedom From Target Lesion Revascularization (TLR) (ITT Subjects) [ Time Frame: Evaluation throrugh 30 day, 6 months and 12 months post index procedure ]
   Freedom from Target Lesion Revascularization (TLR) through 30 days is specific to the first revascularization procedure of the target lesion.
8. Endpoint Without Hypothesis Testing: Number of Participants With Freedom From Target Vessel Revascularization (TVR) (ITT Subjects) [ Time Frame: Evaluation through 30 days, 6 months and 12 months post index procedure ]
   Freedom from Target Vessel Revascularization (TVR) is defined as the first revascularization procedure of the target vessel, as determined by an Independent Core Lab. Freedom from Target Lesion Revascularization (TLR) and Freedom from TVR results are the same through the 12 month analysis as all TLRs were also TVRs in this case.
9. Endpoint Without Hypothesis Testing: Number of Participants Without Device Stent Fracture at 12 Months Follow-Up [ Time Frame: Evaluation at 12 months post-index procedure ]
   Stents were evaluated at the 12 month follow-up for fracture analysis. Evaluable ITT subjects are included in this analysis.

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

1. The subject provides written informed consent using an Informed Consent Form approved by Ethics Committee/ Institutional Review Board for the site.
2. Subject agrees to comply with the protocol-mandated follow-up procedures and visits.
3. The subject is a male or non-pregnant female ≥ 18 years old with an expected lifespan sufficient to allow for completion of all study procedures.
4. The subject has symptomatic (non-malignant) venous outflow obstruction in iliofemoral "venous segments".
5. The subject has symptomatic venous outflow obstruction (non-malignant) in iliofemoral venous segments(Clinical-Etiology-Anatomic-Pathophysiologic (CEAP) "C" ≥ 3 or VCSS pain score of ≥ 2).
6. The subject is able and willing to comply with any required medication regimen.
7. The reference vessel diameters are between 7mm and 19 mm.

Exclusion Criteria:

1. Subject is unable or unwilling to provide written informed consent, or is unable or unwilling to conform to the study protocol follow-up procedures and visits.
2. Subject is or plans to become pregnant during the study.
3. Subject has contralateral disease of the common femoral vein, external iliac vein, common iliac vein, or any combination thereof and does not meet the venous outflow obstruction requirement or has a malignant obstruction.
4. The subject is asymptomatic, has a CEAP "C" <3, or a VCSS pain score of <2.
5. The subject has a venous obstruction that extends into the inferior vena cava (IVC) or below the level of the lesser trochanter.
6. The subject has a known uncorrectable bleeding diathesis or active coagulopathy.
7. The subject has a known allergy or sensitivity to Nickel or Titanium or intolerance to antiplatelet, anticoagulant or thrombolytic medications medications required per the protocol
8. The subject has a known allergy or sensitivity to contrast media, which cannot be adequately pre-medicated.
9. The subject has any planned surgical interventions within 30 days prior to, or within 30 days after the planned study procedure.
10. The subject has a lesion or occlusion which cannot be traversed with a guidewire.
11. The subject has had prior stenting in the target vessel.
12. The subject has iliofemoral venous segments unsuitable for treatment with available sizes of study devices.
13. The subject has another medical condition, which may cause him/her to be non-compliant with the protocol, confound the data interpretation, or is associated with a life expectancy insufficient to allow completion of study procedures and follow ups.
14. The subject is currently participating in an investigational drug, biologic, or another device study.
15. The subject is currently on dialysis or has a serum creatinine ≥2.5mg/dl.

Contacts and Locations

Locations

United States, Connecticut

Vascular Breakthroughs, LLC

Darien, Connecticut, United States, 06820

Yale University

New Haven, Connecticut, United States, 06520

United States, Iowa

Midwest Cardiovascular Research Foundation

Davenport, Iowa, United States, 52803

United States, Michigan

Metro Health Hospital

Wyoming, Michigan, United States, 49519

United States, Missouri

Cox Medical Centers

Springfield, Missouri, United States, 65807

United States, New York

Mount Sinai Medical Center

New York, New York, United States, 10029

United States, North Carolina

North Carolina Heart and Vascular

Raleigh, North Carolina, United States, 27607

United States, Texas

Cardiothoracic and Vascular Surgeons

Austin, Texas, United States, 78746

United States, Virginia

Centra Health, Inc., dba Stroobants Cardiovascular Center

Lynchburg, Virginia, United States, 24501

Sentara Medical Group

Virginia Beach, Virginia, United States, 23542

United States, Washington

Lake Washington Vascular, PLLC

Bellevue, Washington, United States, 98004

United States, West Virginia

CAMC Health Education and Research Institute

Charleston, West Virginia, United States, 25304

Australia, New South Wales

Royal Prince Alfred Hospital

Camperdown, New South Wales, Australia, 2050

Australia, Western Australia

JMLS Medical Services PTY LTDT/A PERTH INST. of VASCULAR RESEARCH

Perth, Western Australia, Australia, 6009

Germany

Uniklinik RWTH

Aachen, Germany, 52074

Klinikum Arnberg

Arnsberg, Germany, 59755

Universitaets-Herrzentrum Freiburg-Bad Krozingen

Bad Krozingen, Germany, 79189

Ireland

University Hospital Galway

Gaillimh, Ireland, H91 YR71

Netherlands

MUMC Maastricht

Maastricht, Netherlands, 6202 AZ

Spain

Fundacion de investigacion HM Hospitales

Madrid, Spain, 28660

United Kingdom

Guy's & St. Thomas' Hospital

London, United Kingdom, SE1 7EH

Sponsors and Collaborators

C. R. Bard

Investigators

• Principal Investigator: Michael Dake, MD; Lead Principal Investigator

  Study Documents (Full-Text)

Documents provided by C. R. Bard:

Study Protocol and Statistical Analysis Plan  [PDF] January 31, 2018

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Dake MD, O'Sullivan G, Shammas NW, Lichtenberg M, Mwipatayi BP, Settlage RA; VERNACULAR Trial Investigators. Three-Year Results from the Venovo Venous Stent Study for the Treatment of Iliac and Femoral Vein Obstruction. Cardiovasc Intervent Radiol. 2021 Dec;44(12):1918-1929. doi: 10.1007/s00270-021-02975-2. Epub 2021 Sep 20. Erratum in: Cardiovasc Intervent Radiol. 2021 Oct 19;:.

• Responsible Party: C. R. Bard
• ClinicalTrials.gov Identifier: NCT02655887
• Other Study ID Numbers: BPV-14-007
• First Posted: January 14, 2016
• Results First Posted: June 12, 2019
• Last Update Posted: February 4, 2021
• Last Verified: January 2021

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: Undecided

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: Yes

Keywords provided by C. R. Bard:

Vernacular; Iliofemoral Occlusive Disease

Additional relevant MeSH terms:

Vascular Diseases; Peripheral Vascular Diseases; Peripheral Arterial Disease; May-Thurner Syndrome; Cardiovascular Diseases; Atherosclerosis; Arteriosclerosis; Arterial Occlusive Diseases; Vascular Malformations; Cardiovascular Abnormalities; Congenital Abnormalities