Bioresorbable Arterial Scaffold for Peripheral Artery Disease

(RESOLV I Trial)

Recruiting at 8 trial locations

Overseen By Andrew J Ford, Jr.

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: R3 Vascular Inc.

Must be taking: Antiplatelet medications

Must not be taking: Immunosuppressive medications

Disqualifiers: Pregnancy, Renal insufficiency, Stroke, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 4 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 1

Duration: 1 day

30 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new stent called the MAGNITUDE® Bioresorbable Arterial Scaffold, designed to aid individuals with peripheral artery disease in their legs. Peripheral artery disease can cause severe pain and may lead to amputation due to poor blood flow. The scaffold restores blood flow in the leg arteries and gradually dissolves over time, unlike permanent metal stents. Individuals experiencing significant leg pain due to blocked leg arteries and who haven't undergone major leg surgeries might be suitable for this trial. As an unphased trial, this study offers a unique opportunity to contribute to innovative research that could enhance treatment options for peripheral artery disease.

Will I have to stop taking my current medications?

The trial protocol does not specify if you need to stop taking your current medications. However, if you are on antiplatelet medications, you should not have any planned surgery or procedure that requires stopping these medications within 6 months after the procedure.

What prior data suggests that this device is safe for treating peripheral artery disease?

Research shows that the MAGNITUDE® Bioresorbable Arterial Scaffold is made from a material that slowly dissolves in the body. It has been successfully used to treat blockages in heart arteries, suggesting it might also be safe for use in leg arteries. Previous studies have found that it can significantly improve blood flow in patients with peripheral artery disease, leading to better circulation and less pain.

While the scaffold looks promising, similar devices have encountered issues like blood clots forming around them in other trials. However, each device is unique, and the MAGNITUDE® scaffold is specifically designed for the arteries in the lower leg.

This trial marks the first time this scaffold is being tested in humans for this specific use, so safety data is still being collected. Researchers will carefully monitor the treatment over five years to identify and address any potential risks. ^{1 2 3 4 5}

Why are researchers excited about this trial?

The MAGNITUDE® Bioresorbable Arterial Scaffold is unique because it offers a new way to treat Peripheral Artery Disease (PAD) by using a scaffold that gradually dissolves in the body. Unlike traditional metal stents, which remain in the artery permanently, this scaffold supports the artery temporarily and then safely resorbs, potentially reducing long-term complications. Researchers are excited because this approach could improve blood flow without leaving a permanent implant, lowering the risk of future blockages and making follow-up treatments easier.

What evidence suggests that the MAGNITUDE® Bioresorbable Arterial Scaffold is effective for peripheral artery disease?

Research has shown that the MAGNITUDE® Bioresorbable Scaffold, which participants in this trial will receive, can greatly improve blood flow in individuals with peripheral artery disease. Patients using similar scaffolds have experienced better circulation and fewer symptoms, such as leg pain. Unlike traditional metal stents, these scaffolds are designed to dissolve over time, supporting the artery as it heals and then disappearing. Early studies suggest that these dissolvable scaffolds can lead to better long-term outcomes, such as a reduced risk of limb amputation. This treatment aims to safely restore blood flow and enhance the quality of life for those with severe artery blockages in their legs. ^{1 2 3 4 6}

Who Is on the Research Team?

Juan F Granada, MD

Principal Investigator

Cardiovascular Research Foundation (CRF)

Are You a Good Fit for This Trial?

This trial is for adults aged 18-90 with severe peripheral arterial disease, causing leg pain or risk of limb amputation. Participants must have specific types of blockages in their lower leg arteries and agree to follow-up visits over five years. Pregnant individuals, those with recent major cardiovascular events, uncontrolled diabetes, known allergies to device materials or study medications, prior below-the-knee bypasses or stents in the target vessel are excluded.

Inclusion Criteria

Any non-target leg lesions I have can be treated before my main treatment.

Subject agrees not to participate in any other investigational device or drug study for a period of at least six months following the index procedure. Questionnaire-based studies, or other studies that are non-invasive and do not require investigational devices or medications are allowed

The blood vessels being studied are between 2.5 and 3.5 millimeters wide as measured by a special imaging test.

Exclusion Criteria

I am currently being treated for cancer or have a blood disorder.

I have severe kidney problems or am on dialysis.

I will need surgery that requires stopping blood thinners within 6 months.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive the R3 Vascular MAGNITUDE® Bioresorbable Drug-Eluting Scaffold for treating infrapopliteal artery lesions

1 day

1 visit (in-person)

Initial Follow-up

Participants are monitored for safety and effectiveness, with assessments at 30 days and 180 days post-implantation

6 months

Multiple visits (in-person and virtual)

Long-term Follow-up

Participants are monitored for long-term safety and effectiveness, with assessments up to 5 years post-implantation

5 years

Annual visits (in-person and virtual)

What Are the Treatments Tested in This Trial?

Interventions

• MAGNITUDE® Bioresorbable Arterial Scaffold

Trial Overview The trial tests a new MAGNITUDE® Bioresorbable Drug-Eluting Scaffold designed to dissolve over time after improving blood flow in the lower leg's diseased artery. This first-in-human study aims to alleviate symptoms and reduce amputation risks by comparing it against standard care for up to three treated vascular blockages.

How Is the Trial Designed?

Group I: MAGNITUDE® Scaffold Experimental Treatment 1 Intervention

Subject with up to three study lesions treated by implanting a maximum of 3 R3 Vascular MAGNITUDE® Bioresorbable Drug-Eluting Scaffolds

MAGNITUDE® Bioresorbable Arterial Scaffold is already approved in United States, Canada for the following indications:

Approved in United States as Magnitude scaffold for:

• Below-the-knee peripheral arterial disease (PAD)

Approved in Canada as Magnitude scaffold for:

• Below-the-knee peripheral arterial disease (PAD)

Who Is Running the Clinical Trial?

R3 Vascular Inc.

Lead Sponsor

Trials

3

Recruited

360+

Cardiovascular Research Foundation Clinical Trials Center

Collaborator

Trials

1

Recruited

30+

Massachusetts General Physicians Organization / Vascore

Collaborator

Trials

1

Recruited

30+

Cardiovascular Research Foundation, New York

Collaborator

Trials

28

Recruited

27,800+

VasCore Vascular Ultrasound Core Lab

Collaborator

Trials

2

Recruited

190+

Published Research Related to This Trial

In a study of 101 patients undergoing peritoneal dialysis, a higher neutrophil-lymphocyte ratio (NLR) was independently associated with increased arterial stiffness, as measured by brachial-ankle pulse wave velocity (baPWV).

The findings suggest that NLR could serve as a useful inflammatory marker for assessing arterial stiffness in these patients, but further research is needed to establish a causal relationship and explore potential treatments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neutrophil-lymphocyte ratio is associated with arterial stiffness in patients with peritoneal dialysis. Cai, K., Luo, Q., Zhu, B., et al.[2018]

The new heart-thigh pulse wave velocity (htPWV) method shows comparable results to the established carotid-femoral pulse wave velocity (cfPWV) in measuring arterial stiffness, with no significant difference in mean values between the two methods (713 ± 145 cm/s for cfPWV vs. 699 ± 150 cm/s for htPWV).

The htPWV method is advantageous for clinical use as it requires less technical skill and time, making it a promising tool for easily assessing arterial stiffness in patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Heart-Thigh Cuff Pulse Wave Velocity: A Novel Nontechnical Measure of Arterial Stiffness. Fico, BG., Gourley, DD., Wooten, SV., et al.[2020]

In a study of 31 patients with advanced infrapopliteal peripheral artery disease (PAD), the Absorb bioresorbable vascular scaffold (BVS) demonstrated a high primary patency rate of 96.7% and a freedom from clinically driven target vessel failure (CD-TVF) of 95.1% at 12 months, indicating its efficacy in managing complex lesions.

The Absorb BVS showed a favorable safety profile, with no instances of scaffold thrombosis or significant bleeding, and all patients remained alive at the 12-month follow-up, suggesting it is a safe option for treating chronic limb ischemia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Single arm retrospective study of bioresorbable vascular scaffolds to treat patients with severe infrapopliteal arterial disease. Dia, A., Venturini, JM., Kalathiya, R., et al.[2020]

The new thin-walled Magnitude bioresorbable scaffold (BRS) showed significantly fewer fractures during biomechanical testing compared to the Absorb BRS, indicating better structural integrity under stress.

In a study involving 22 swine, the Magnitude-BRS demonstrated superior strut coverage and lower late recoil at 14 and 28 days, suggesting enhanced vascular healing and stability compared to the Absorb scaffold.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

In vitro mechanical behavior and in vivo healing response of a novel thin-strut ultrahigh molecular weight poly-l-lactic acid sirolimus-eluting bioresorbable coronary scaffold in normal swine. Cheng, Y., Gasior, P., Ramzipoor, K., et al.[2020]

In a study of 125 patients with acute coronary syndromes, the ABSORB bioresorbable vascular scaffold demonstrated a high procedural success rate of 98.2% and a major adverse cardiac event-free survival rate of 90.7% over 4 years.

The use of a predilation-sizing-postdilation (PSP) technique significantly improved event-free survival to 95.8%, highlighting its importance in optimizing outcomes for patients receiving this treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Longer Inflation Duration and Predilation-Sizing-Postdilation Improve Bioresorbable Scaffold Outcomes in a Long-term All-Comers Canadian Registry. Haddad, K., Tanguay, JF., Potter, BJ., et al.[2019]

A 58-year-old man with left subclavian steal syndrome was successfully treated with a bioresorbable vascular scaffold, which improved his symptoms and hemodynamics immediately after implantation.

Two years after the procedure, follow-up imaging confirmed that the treated vessel remained open, demonstrating the long-term efficacy and potential of bioresorbable scaffolds in treating vascular diseases.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Successful Treatment of a Subclavian Artery Stenosis With a Coronary Bioresorbable Vascular Scaffold. Giordano, A., Messina, S., Biondi-Zoccai, G.[2022]

In a study of 31 patients with advanced infra-popliteal peripheral arterial disease, the Absorb bioresorbable vascular scaffold demonstrated a high procedural success rate of 100% and a low rate of clinically driven target vessel failure (93.5%) at 24 months.

The scaffold showed excellent primary patency rates of 96.7% at 12 months and 87.1% at 24 months, with no observed scaffold thrombosis or peri-procedural bleeding, indicating both safety and efficacy in managing chronic limb ischemia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Two-year follow-up of bioresorbable vascular scaffolds in severe infra-popliteal arterial disease. Dia, A., Venturini, JM., Kalathiya, RJ., et al.[2022]

Bioresorbable scaffolds offer a temporary support for blood vessels, gradually dissolving to reduce the risk of long-term complications associated with permanent metal implants.

These scaffolds are designed to release drugs in a controlled manner, initially providing a high concentration to prevent vascular injuries and excessive tissue growth, which can help in treating conditions like restenosis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Bioresorbable Scaffold-Based Controlled Drug Delivery for Restenosis. Tesfamariam, B.[2020]

In a study of 114 rheumatoid arthritis (RA) patients, a significant relationship was found between cumulative inflammatory burden (measured as ESR years) and arterial stiffness, indicating that higher inflammation correlates with stiffer arteries.

The analysis showed that for every 100 ESR-years increase, arterial stiffness (measured by aortic augmentation index) increased by 0.51, suggesting that managing inflammation could be important for cardiovascular health in RA patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Arterial stiffness and cumulative inflammatory burden in rheumatoid arthritis: a dose-response relationship independent of established cardiovascular risk factors. Crilly, MA., Kumar, V., Clark, HJ., et al.[2009]

The ART-BRS bioresorbable scaffold demonstrated early lumen enlargement in a porcine model, starting at 3 months and continuing up to 18 months, while the bare metal stent (BMS) showed no significant changes over time.

Complete bioresorption of the ART-BRS occurred by 24 months, with mild to moderate inflammation peaking at 6 months, indicating a favorable long-term vascular response compared to traditional stents.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of a Drug-Free Early Programmed Dismantling PDLLA Bioresorbable Scaffold and a Metallic Stent in a Porcine Coronary Artery Model at 3-Year Follow-Up. Yahagi, K., Yang, Y., Torii, S., et al.[2019]

In hemodialyzed patients, the pulse wave velocity ratio (PWV-ratio) is significantly higher on the side of the body where the vascular access (VA) is placed compared to the contralateral side, indicating increased arterial stiffness in that area.

The study found a strong correlation between arterial stiffness measurements (cf-PWV, cb-PWV, and PWV-ratio) on both sides of the body, suggesting that researchers should consider the specific side of measurement when evaluating PWV-ratio in future studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Central-To-Peripheral Arterial Stiffness Gradient in Hemodialyzed Patients Depends on the Location of the Upper-limb Vascular Access. Bia, D., Galli, C., Zocalo, Y., et al.[2019]

In young rheumatoid arthritis (RA) patients, the aortic augmentation index (AIx) is significantly higher compared to healthy controls, indicating increased arterial dysfunction, while carotid-radial pulse wave velocity (PWV) does not show a significant difference.

Treatment with infliximab, an anti-TNF-alpha therapy, significantly lowers PWV in RA patients, suggesting it improves arterial wall function, although it does not affect AIx, highlighting the different sensitivities of these measures in assessing arterial health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Non-invasive assessment of arterial stiffness indices by applanation tonometry and pulse wave analysis in patients with rheumatoid arthritis treated with TNF-alpha blocker remicade (infliximab). Cypiene, A., Laucevicius, A., Venalis, A., et al.[2015]

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT04912323

Study of the R3 Vascular Drug-Eluting Bioresorbable ... This first-in-human clinical feasibility study will evaluate the safety and performance of the R3 Vascular MAGNITUDE® Bioresorbable Drug-Eluting Scaffold ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11264025/

Bioresorbable Scaffolds for Below-the-Knee Arterial Disease Initially, the ABSORB BVS showed promising results. However, in larger randomized trials, the ABSORB BVS led to higher rates of scaffold thrombosis than drug- ...

3. evtoday.com evtoday.com/news/r3-vasculars-magnitude-bioresorbable-scaffold-evaluated-in-resolv-fih-study

R3 Vascular's Magnitude Bioresorbable Scaffold Evaluated ... Overall, across the severity of peripheral artery disease by Rutherford class, the investigators observed significant improvement after ...

4. crfconnect.com crfconnect.com/episode/r3-vascular-magnitude-bioresorbable-drug-eluting-scaffold-1892

R3 Vascular MAGNITUDE Bioresorbable Drug Eluting ... Angiographic and Clinical Outcomes of the Thin-Strut MAGNITUDE Bioresorbable Scaffold in Patients with Below-the-Knee Arterial Disease: ...

5. sciencedirect.com sciencedirect.com/science/article/pii/S2950347724000276

Peripheral vascular bioresorbable scaffolds: Past, present, ... Bioresorbable vascular scaffold (BVS) has emerged as a promising technology after more than 60 years of development in peripheral vascular stents.

6. drugdeliverybusiness.com drugdeliverybusiness.com/r3-first-patient-drug-eluting-scaffold-study/

R3 reports first patient in next-gen drug-eluting scaffold study The trial evaluates the company's next-generation Magnitude drug-eluting bioresorbable scaffold for below-the-knee peripheral arterial disease ( ...