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Revascularization With Open Bypass Versus Angioplasty and STenting of the Lower Extremity Trial (ROBUST) (ROBUST)

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ClinicalTrials.gov Identifier: NCT01602159
Recruitment Status : Recruiting
First Posted : May 18, 2012
Last Update Posted : October 6, 2017
Information provided by (Responsible Party):
Johns Hopkins University

May 16, 2012
May 18, 2012
October 6, 2017
July 2009
June 2018   (Final data collection date for primary outcome measure)
  • Clinical improvement [ Time Frame: 12 Month Post Operatively ]
    Clinical Improvement is measured as at least 1 Rutherford category
  • Patency rate [ Time Frame: 12 Month Post Operatively ]
    Primary, primary assisted and secondary at 6, 12 month
  • Cost effectiveness [ Time Frame: 12 Month Post Operatively ]
    Cost Effectiveness factoring procedure and hospital admission costs
Same as current
Complete list of historical versions of study NCT01602159 on ClinicalTrials.gov Archive Site
  • Quality of Life improvement [ Time Frame: 12 Month Post Operatively ]
    Improvement of quality of life measured using VQL
  • Re-intervention rate [ Time Frame: 12 Month Post Operatively ]
  • Technical success of both treatment modalities [ Time Frame: 12 Month Post Operatively ]
  • 30-day operative mortality [ Time Frame: 12 Month Post Operatively ]
  • Time to return to work and regular activities [ Time Frame: 12 Month Post Operatively ]
  • Morbidity associated with both treatment modalities [ Time Frame: 12 Month Post Operatively ]
Same as current
Not Provided
Not Provided
Revascularization With Open Bypass Versus Angioplasty and STenting of the Lower Extremity Trial (ROBUST)
Revascularization With Open Bypass Versus Angioplasty and STenting of the Lower Extremity Trial (ROBUST)

This is a prospective randomized controlled trial to compare clinical improvement, cost effectiveness and patency rates between new and improved Nitinol stents and open bypass surgery in the superficial femoral artery disease.

Secondary outcomes also include comparing quality of life, re-intervention rate, mortality, morbidity and time to return to work or regular activities.

Patients with superficial femoral artery lesions will be considered. Patients with TASC II A lesions will not be randomized but treated with PTA/stenting as standard of care. Patients with TASC II B and C lesions will be prospectively randomized into either receiving open bypass or stenting.

Patients with TASC D lesions will be treated with open bypass surgery after angiography.

The investigators will collect pre-procedure, peri-procedural and clinical follow-up data on all enrolled the patients.

Not Provided
Not Provided
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
  • Superficial Femoral Artery Stenosis
  • Superficial Femoral Artery Occlusion
  • Claudication
  • Rest Pain
  • Procedure: Open Bypass Surgery
    Open Bypass Surgery with Autogenous vein or PTFE Graft
  • Procedure: Angioplasty and Stenting
    Angioplasty and Stenting of the superficial Femoral artery with Nitinol stent (Life Stent flexStar Stent System by Bard Inc. Tempe AZ).
    Other Name: Life Stent flexStar Stent System by Bard Inc. Tempe AZ
  • Active Comparator: Open Bypass Surgery
    Open Bypass Surgery
    Intervention: Procedure: Open Bypass Surgery
  • Active Comparator: Angioplasty and Stenting
    Intervention: Procedure: Angioplasty and Stenting
Malas MB, Qazi U, Glebova N, Arhuidese I, Reifsnyder T, Black J, Perler BA, Freischlag JA. Design of the Revascularization With Open Bypass vs Angioplasty and Stenting of the Lower Extremity Trial (ROBUST): a randomized clinical trial. JAMA Surg. 2014 Dec;149(12):1289-95. doi: 10.1001/jamasurg.2014.369.

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
June 2018
June 2018   (Final data collection date for primary outcome measure)

Inclusion Criteria:

Clinical Inclusion:

  1. Must be at least 18 years of age.
  2. Patient has been informed of the nature of the study, and has provided written informed consent, approved by the appropriate Institutional Review Board (IRB)/Medical Ethics Committee (MEC) of the respective clinical site.
  3. Symptomatic patient as evidence by IC or CLI.
  4. Patient has failed maximized medical treatment and exercise program.
  5. Patient has a resting ABI < 0.9 or an abnormal exercise ABI if resting ABI is normal.Patient with non-compressible arteries (ABI > 1.2) must have a TBI < 0.8.
  6. Patient has a de novo or restenotic lesion(s) with > 50% stenosis documented angiographically.
  7. Patient agrees to return for all required clinical contacts following study enrollment.
  8. Patient has no childbearing potential or has a negative pregnancy test within one week prior to the study procedure.

Anatomical Inclusion:

  1. Patient with any SFA lesion
  2. At least one tibial vessel runoff with < 50% stenosis
  3. Lesion starts start at least 1 cm distal to the deep femoral artery
  4. Lesion end at least 3 cm above the knee joint
  5. Target vessel reference diameter is > 3 mm & < 6.5 mm

Exclusion Criteria:

Clinical exclusion:

  1. Known allergic reaction to anesthesia not able to overcome by medication.
  2. Known allergic reaction to contrast not able to overcome by medication.
  3. Known history of intolerance to study medicating including ASA, clopidogrel, or ticlopidine.
  4. Bleeding disorder or refuses blood transfusion.
  5. Prior stenting or bypass of SFA (prior PTA is not an exclusion criteria)
  6. Unstable angina, recent MI within a month
  7. Malignancy or other condition limiting life expectancy to < 5 years.
  8. Renal insufficiency (serum Cr > 2.0)
  9. Patient has any condition that precludes proper angiographic assessment or makes percutaneous arterial access unsafe (e.g., morbid obesity).

Anatomic Exclusion:

  1. Lesion < 1 cm from origin of DFA
  2. Lesion < 3 cm from the knee joint
  3. Chronic total occlusion of SFA > 20cm.
  4. Chronic total occlusion of CFA.
  5. Proximal trifurcation occlusions.
Sexes Eligible for Study: All
18 Years and older   (Adult, Senior)
Contact: Mahmoud B Malas, M.D., MHS 410-550-4335 bmalas1@jhmi.edu
Contact: Melissa M Scudder 410-550-1355 mscudde1@jhmi.edu
United States
Not Provided
Not Provided
Johns Hopkins University
Johns Hopkins University
Not Provided
Principal Investigator: Mahmoud B Malas, M.D., MHS Johns Hopkins University
Johns Hopkins University
October 2017

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP