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The DETOUR II Clinical Study

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT03119233
Recruitment Status : Recruiting
First Posted : April 18, 2017
Last Update Posted : June 25, 2019
Information provided by (Responsible Party):
PQ Bypass, Inc.

Brief Summary:
The study is to evaluate the safety and effectiveness of the PQ Bypass System to access, deliver guidewires and implant stent grafts for a percutaneous femoropopliteal (fem-pop) bypass.

Condition or disease Intervention/treatment Phase
Peripheral Arterial Disease Device: PQ Bypass System Not Applicable

Detailed Description:

The DETOUR II study is a prospective, single-arm, multi-center, international, non-randomized, safety and effectiveness clinical investigation of the PQ Bypass system.

The PQ Bypass System is intended to improve blood flow in patients with symptomatic peripheral arterial disease due to >15 cm long occlusions and diffuse stenoses of femoropopliteal arteries, including in-stent re-stenosis, with reference vessel diameters ranging from 5.0 - 6.7 mm.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 212 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: PQ Bypass System for Femoropopliteal Bypass II
Actual Study Start Date : December 13, 2017
Estimated Primary Completion Date : April 2021
Estimated Study Completion Date : June 2023

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: Single-Arm
The PQ Bypass system is used during a minimally invasive procedure to place stent grafts in the peripheral vasculature to improve blood flow.
Device: PQ Bypass System
The PQ Bypass System is intended to improve blood flow in patients with symptomatic peripheral arterial disease due to >15 cm long occlusions and diffuse stenoses of femoro-popliteal arteries, including in-stent re-stenosis, with reference vessel diameters ranging from 5.0 - 6.7 mm

Primary Outcome Measures :
  1. Primary Effectiveness Endpoint [ Time Frame: 12 months ]
    The rate of primary patency at 12 months defined as: no evidence of clinically significant stenosis (>/= 50%) based on duplex ultrasound (peak systolic velocity ratio of >2.5) within the stent graft or immediately above or below the treated arterial segment, and no clinically-driven re-intervention within the stented segment.

  2. Primary Safety Endpoint [ Time Frame: 30 days ]
    Freedom from a major adverse event (MAE) at 30 days post-procedure. MAE includes: Death; Target lesion revascularization (TLR) defined as any repeat percutaneous intervention of the target lesions (including 5 mm proximal and distal to the index device) or surgical bypass of the target vessel performed for the restenosis or other complication involving the target lesion; amputation of the treated limb; symptomatic deep vein thrombosis (DVT); pulmonary embolism (PE); and, procedure related bleeding requiring any transfusion of packed red blood cells or surgery.

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years to 90 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

All subjects are required to meet the following inclusion criteria in order to be considered eligible for participation in the study:

  1. Age 18 or older.
  2. Willing and able to provide informed consent.
  3. Severe claudication or rest pain or ischemic ulceration (Rutherford Becker scale 3-5) with a resting ABI ≤0.9. Resting TBI is utilized only if unable to reliably assess ABI. Resting TBI must be ≤0.5. Assessments are required for the target limb and contralateral limb.
  4. Venous Clinical Severity Score <3.
  5. Femoro-popliteal stenotic lesions >15 cm (TASC C and D) in length considered to be:

    • Chronic total occlusion (100% stenosis)
    • Diffuse stenosis (>50% stenosis)
    • In-stent restenosis (>50% stenosis)
  6. Reference vessel diameter (RVD) ≥5.0 mm and ≤6.7 mm, as measured via pre-screening CTA/MRA using 3D multi-plane reconstruction.
  7. Patent iliac and femoral arteries and tibial veins and access vessels, of sufficient size and morphology (including tortuosity), to allow arterial access with 8 Fr. introducer sheath.
  8. Visible SFA stump at the SFA origin.
  9. Significant aortoiliac or common femoral "inflow" lesions (i.e. angiographically defined >50% stenosis of the iliac or common femoral artery) must be successfully treated prior to treatment of the target lesion. This can be done just prior to treatment of the target lesion. Successful treatment is defined as <30% stenosis after either PTA or stenting of the inflow lesion. After successful treatment of the inflow lesion, the subject will be included in the study following sheath placement distal to the treated lesion.
  10. A subject with bilateral obstructive SFA disease is eligible for enrollment into the study. If a subject with bilateral disease is enrolled, and both limbs meet the study enrollment criteria, the target limb for study treatment will be selected at the Investigator's discretion. Lesion characteristic such as lesion length, percent stenosis, and/or calcification content may be used in study treatment decision. The non-target limb may be treated using currently available (non-investigational) methods >30 days post index procedure.
  11. Non diseased patent popliteal artery 3 cm proximal to tibial plateau.
  12. At least 1 continuous patent tibial artery (<50% stenosed) with flow to the ankle or foot.
  13. Patent femoral vein ≥10 mm in diameter or duplicate femoral vein.
  14. Subject is eligible for standard surgical repair, if necessary.
  15. Subject is ambulatory.
  16. Subject has >1 year life expectancy.
  17. Subject is able to comply with the necessary follow-up examinations and tests in accordance with protocol.

Exclusion Criteria:

Subjects will be excluded from participating in the study if they meet any of the following exclusion criteria:

  1. Age greater than 90.
  2. Acute vessel thrombosis.
  3. Thrombophlebitis, within the previous 30 days.
  4. Thrombolysis of the target vessel within 72 hours prior to the index procedure, where complete resolution of the thrombus was not achieved.
  5. History of deep vein thrombosis on either limb.
  6. Has a known history of intracranial bleeding or aneurysm, myocardial infarction or stroke within the last 3 months.
  7. Requires coronary or peripheral procedure within 30 days prior to or planned within 30 days post treatment of the target lesion.
  8. Ipsilateral femoral aneurysm or aneurysm in the SFA or popliteal artery.
  9. Untreated flow-limiting aortoiliac occlusive disease.
  10. Has Chronic Kidney Disease stage 4 or greater (eGFR < 30mL/min).
  11. History of neutropenia, coagulopathy, or thrombocytopenia that was unexplained or is considered to be at risk for reoccurrence.
  12. Known bleeding or hypercoagulability disorder or significant anemia (Hb<8.0) that cannot be corrected.
  13. Morbid obesity (BMI >40).
  14. Rutherford Class 0 to 2 and 6.
  15. Prior major distal amputation (above the transmetatarsal) in the study limb.
  16. Planned amputation of the target limb.
  17. Known or suspected active infection at the time of the procedure.
  18. Immunosuppressant therapy within the previous 30 days.
  19. Previous bypass surgery on the target limb.
  20. Decompensated heart failure (Stage III or IV), COPD FEV1 <30% normal, or <50% normal with chronic respiratory failure present), metastatic malignancy, dementia, or other major co-morbidities that would prevent the post-interventional movement.
  21. Has known hypersensitivities, allergies or contraindications to: nitinol, PTFE; aspirin, heparin, antiplatelet, anticoagulant or thrombolytic therapy; or anticoagulation or contrast media that cannot be medically managed.
  22. Participating in another clinical study for which follow-up may impact the current study.
  23. A condition that in the view of the investigator precludes participation in this study.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT03119233

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Contact: Victoria Versprille +1 (908) 328-5787

Show Show 21 study locations
Sponsors and Collaborators
PQ Bypass, Inc.
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Principal Investigator: Jihad Mustapha, MD Advanced Cardiac and Vascular Amputation Prevention Centers
Principal Investigator: Sean Lyden, MD The Cleveland Clinic

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Responsible Party: PQ Bypass, Inc. Identifier: NCT03119233    
Other Study ID Numbers: STP 203
First Posted: April 18, 2017    Key Record Dates
Last Update Posted: June 25, 2019
Last Verified: June 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: Yes
Device Product Not Approved or Cleared by U.S. FDA: Yes
Additional relevant MeSH terms:
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Peripheral Arterial Disease
Peripheral Vascular Diseases
Arterial Occlusive Diseases
Vascular Diseases
Cardiovascular Diseases