An interventional study of TORUS Stent Graft System in Peripheral Arterial Disease, sponsored by Endologix. Completed at 32 sites in United States. Open to participants aged 18 Years to 90 Years. Per ClinicalTrials.gov, last updated 2026-07-10.
Sponsored by Endologix · Not applicable, Interventional, and Treatment
The primary objective of the TORUS 2 IDE Clinical Study is to evaluate the safety and effectiveness of the TORUS Stent Graft System in the treatment of obstructive atherosclerotic lesions of the native SFA or the superficial femoral and/or proximal popliteal arteries.
Peripheral Arterial Disease, specifically in the superficial femoral arteries (SFA) and proximal popliteal arteries, are treated by a range of alternative practices and procedures for the patient population identified in the indications for use statement. Non-invasive approaches include exercise and drug therapy.
Minimally-invasive approaches include endovascular intervention using percutaneous transluminal angioplasty using a plain or drug-coated balloon, stents (bare metal, drug-eluting and covered) and various modalities of atherectomy.
SFA Stent Graft Systems have a clinical history that demonstrates that this device type is well understood, and the benefits and risks are well-characterized, i.e. mature technology.
Endologix believes that the clinical performance of the TORUS stent would be comparable to marketed SFA Stent Graft System. The TORUS 2 IDE Clinical Study will confirm this and is designed to demonstrate the safety and effectiveness of the TORUS Stent Graft System in patients with SFA and/or proximal popliteal artery disease
Exclusion Criteria:
The TORUS Stent Graft System (SGS) is comprised of a Stent Graft (SG) and a Stent Graft Delivery System (SGDS).
Device: TORUS Stent Graft System
The TORUS Stent Graft is an intravascular prosthesis intended to improve blood flow in the area in which it is implanted and the TORUS Stent Graft Delivery System is a standard pin-and-pull delivery system used to implant the SG in the desired area. Use of the TORUS Stent Graft allows for improving blood flow in the peripheral vasculature.
Also known as: TORUS Stent Graft, PQ Bypass™ Stent Graft System
Freedom From a Major Adverse Event (MAE)
An MAE is defined as all-cause death, target limb major amputation and clinically-driven target lesion revascularization (CD-TLR)
Time frame: 30 days
Primary Patency
Primary patency is defined as the absence of clinically-driven target lesion revascularization (CD-TLR) and absence of recurrent target lesion diameter stenosis \>50% by duplex ultrasound with a peak systolic velocity ratio of \>2.5.
Time frame: 12 months
Technical Success
Technical success is defined as the ability to cross and dilate the lesion to achieve residual stenosis of ≤30%
Time frame: At the time of the index procedure
Procedural Success
Procedural Success is defined as technical success with out any MAEs.
Time frame: Within 24 hours of the procedure
Major Adverse Event (MAE) Rate
Composite rate of all-cause death, target limb major amputation and clinically-driven target lesion revascularization (CD-TLR).
Time frame: 12 months
Major Amputation on Target Limb
Major Amputation on Target Limb were adjudicated by the Clinical Event Committee (CEC), and rates were tabulated through 30 days, 6 months, 12 months, 24 months, and 36 months
Time frame: Through 36 months
Patency Rate
Absence of CD-TLR and absence of recurrent target lesion diameter stenosis \>50% by duplex ultrasound with a peak systolic velocity ratio of \>2.5.
Time frame: Through 12 months
Clinically Driven Target Lesion Revascularization
Clinically Driven Target Lesion Revascularization were adjudicated by the Clinical Event Committee (CEC), and rates were tabulated through 30 days, 6 months, 12 months, 24 months, and 36 months
Time frame: Through 36 months
Walking Improvement Questionnaire (WIQ) Assessment
Walking Impairment Questionnaire (WIQ) - The WIQ is a patient-reported outcome measure that assesses self-reported walking ability in individuals with peripheral arterial disease (PAD). It evaluates perceived difficulty performing walking tasks related to walking distance, walking speed, and stair climbing, which reflect functional limitations caused by PAD. Scale Structure and Scoring: The WIQ consists of three subscales: Walking Distance Walking Speed Stair Climbing Each subscale is scored from 0 to 100, where higher scores indicate better walking function. The Composite PAD Score (PADSCORE) is calculated by averaging the three subscale scores, resulting in a total composite score ranging from 0 to 100. Scale Ranges and Interpretation: WIQ Subscale Scores: 0 (worst function) to 100 (best function) WIQ Composite PAD Score: 0 (worst walking impairment) to 100 (no walking impairment) Direction of Outcome: For all WIQ scores, higher values represent a better outcome
Time frame: Change from baseline to 12-Month follow-up (Collected at 1M,6M, and 12M)
Quality of Life Assessment by the EQ5D VAS
EuroQol Visual Analog Scale (EQ-5D-VAS) - The EQ-5D-VAS is a patient-reported outcome measure that assesses overall self-rated health-related quality of life. Participants rate their current health status using a visual analog scale anchored by the best and worst imaginable health states. Scale Structure and Scoring: Participants mark their perceived health status on a vertical visual analog scale. Scale Range and Interpretation: EQ-5D-VAS Score Range: 0 to 100 0: Worst imaginable health state (minimum) 100: Best imaginable health state (maximum) Direction of Outcome: Higher EQ-5D-VAS scores represent a better outcome, reflecting better perceived health-related quality of life. Lower scores indicate worse perceived health status. Unit of Measure: EQ-5D-VAS (scores on a scale)
Time frame: Change from baseline to 12-Month follow-up (Collected at 1M, 6M, and 12M)
Stent Fracture Rate
Stent fracture rate using VIVA definitions
Time frame: 12 months
Change in Ankle-Brachial Index
Change in Ankle-Brachial Index (ABI) in study subjects from baseline to each study interval through follow-up. Scale Structure and Scoring: Change in ABI was calculated as the difference between post-baseline ABI and baseline ABI for each participant for the target limb. ABI is a unitless ratio and does not have a fixed theoretical minimum or maximum value. Therefore, interpretation is based on clinically established thresholds rather than absolute scale limits: ABI ≤ 0.90: Consistent with peripheral arterial disease ABI 0.91-1.29: Generally considered normal arterial perfusion ABI ≥ 1.30: Suggestive of non-compressible arteries (e.g., arterial calcification) Change in ABI: Positive change (increase): Improvement in lower-extremity perfusion Negative change (decrease): Worsening arterial perfusion Direction of Outcome: For Change in ABI, higher (more positive) values represent a better outcome
Time frame: Change from Baseline through 36 months
Change in Toe Pressures
Change in Toe-Brachial Index (TBI) in study subjects from baseline to each study interval through follow-up for the target limb. If ABI could not be assessed the TBI was assessed. Scale Structure and Scoring: TBI is calculated as: TBI = Toe systolic blood pressure ÷ Brachial systolic blood pressure Change in TBI was calculated as the difference between post-baseline TBI and baseline TBI for each participant. Scale Range and Clinical Interpretation: TBI is a unitless ratio and does not have a fixed theoretical minimum or maximum value. Interpretation is therefore based on clinically established thresholds rather than absolute scale limits: TBI \< 0.70: Consistent with peripheral arterial disease TBI ≥ 0.70: Generally considered normal digital perfusion For Change in TBI: A positive change (increase) indicates improvement in distal (digital) perfusion A negative change (decrease) indicates worsening arterial perfusion
Time frame: Change from Baseline through 36 months
Change in Rutherford Clinical Classification
Clinical success: improvement in ≥ 1 Rutherford class
Time frame: From procedure through 36 months
| Milestone | TORUS Stent Graft System |
|---|---|
| Started | 188 |
| Completed | 120 |
| Not completed | 68 |
An MAE is defined as all-cause death, target limb major amputation and clinically-driven target lesion revascularization (CD-TLR)
| Participants | TORUS Stent Graft System |
|---|---|
| Freedom From a Major Adverse Event (MAE) | 184 |
Primary patency is defined as the absence of clinically-driven target lesion revascularization (CD-TLR) and absence of recurrent target lesion diameter stenosis \>50% by duplex ultrasound with a peak systolic velocity ratio of \>2.5.
| Participants | TORUS Stent Graft System |
|---|---|
| Primary Patency | 91 |
Technical success is defined as the ability to cross and dilate the lesion to achieve residual stenosis of ≤30%
| Participants | TORUS Stent Graft System |
|---|---|
| Technical Success | 188 |
Procedural Success is defined as technical success with out any MAEs.
| Participants | TORUS Stent Graft System |
|---|---|
| Procedural Success | 188 |
Composite rate of all-cause death, target limb major amputation and clinically-driven target lesion revascularization (CD-TLR).
| Participants | TORUS Stent Graft System |
|---|---|
| Major Adverse Event (MAE) Rate | 45 |
Major Amputation on Target Limb were adjudicated by the Clinical Event Committee (CEC), and rates were tabulated through 30 days, 6 months, 12 months, 24 months, and 36 months
| Participants | TORUS Stent Graft System |
|---|---|
| Cumulative Complications within 30 days | 0 |
| Cumulative Complications within 6 Months | 0 |
| Cumulative Complications within 12 Months | 2 |
| Cumulative Complications within 24 Months | 3 |
| Cumulative Complications within 36 Months | 5 |
Absence of CD-TLR and absence of recurrent target lesion diameter stenosis \>50% by duplex ultrasound with a peak systolic velocity ratio of \>2.5.
| Participants | TORUS Stent Graft System |
|---|---|
| Patency Rate | 91 |
Clinically Driven Target Lesion Revascularization were adjudicated by the Clinical Event Committee (CEC), and rates were tabulated through 30 days, 6 months, 12 months, 24 months, and 36 months
| Participants | TORUS Stent Graft System |
|---|---|
| Cumulative Complications within 30 days | 4 |
| Cumulative Complications within 6 Months | 17 |
| Cumulative Complications within 12 Months | 41 |
| Cumulative Complications within 24 Months | 57 |
| Cumulative Complications within 36 Months | 64 |
Walking Impairment Questionnaire (WIQ) - The WIQ is a patient-reported outcome measure that assesses self-reported walking ability in individuals with peripheral arterial disease (PAD). It evaluates perceived difficulty performing walking tasks related to walking distance, walking speed, and stair climbing, which reflect functional limitations caused by PAD. Scale Structure and Scoring: The WIQ consists of three subscales: Walking Distance Walking Speed Stair Climbing Each subscale is scored from 0 to 100, where higher scores indicate better walking function. The Composite PAD Score (PADSCORE) is calculated by averaging the three subscale scores, resulting in a total composite score ranging from 0 to 100. Scale Ranges and Interpretation: WIQ Subscale Scores: 0 (worst function) to 100 (best function) WIQ Composite PAD Score: 0 (worst walking impairment) to 100 (no walking impairment) Direction of Outcome: For all WIQ scores, higher values represent a better outcome
| PADSCORE | TORUS Stent Graft System |
|---|---|
| Walking Impairment Change from Baseline 1M | 24.7 ± 41 |
| Walking Impairment Change from Baseline 6M | 28.9 ± 42.2 |
| Walking Impairment Change from Baseline 12M | 18.3 ± 43.2 |
EuroQol Visual Analog Scale (EQ-5D-VAS) - The EQ-5D-VAS is a patient-reported outcome measure that assesses overall self-rated health-related quality of life. Participants rate their current health status using a visual analog scale anchored by the best and worst imaginable health states. Scale Structure and Scoring: Participants mark their perceived health status on a vertical visual analog scale. Scale Range and Interpretation: EQ-5D-VAS Score Range: 0 to 100 0: Worst imaginable health state (minimum) 100: Best imaginable health state (maximum) Direction of Outcome: Higher EQ-5D-VAS scores represent a better outcome, reflecting better perceived health-related quality of life. Lower scores indicate worse perceived health status. Unit of Measure: EQ-5D-VAS (scores on a scale)
| score on a scale | TORUS Stent Graft System |
|---|---|
| Change from baseline to 1-Month | 6.6 ± 16.3 |
| Change from baseline to 6-Month | 5.5 ± 19.1 |
| Change from baseline to 12-Month | 7.4 ± 20.3 |
Stent fracture rate using VIVA definitions
| Participants | TORUS Stent Graft System |
|---|---|
| Stent Fracture Rate | 0 |
Change in Ankle-Brachial Index (ABI) in study subjects from baseline to each study interval through follow-up. Scale Structure and Scoring: Change in ABI was calculated as the difference between post-baseline ABI and baseline ABI for each participant for the target limb. ABI is a unitless ratio and does not have a fixed theoretical minimum or maximum value. Therefore, interpretation is based on clinically established thresholds rather than absolute scale limits: ABI ≤ 0.90: Consistent with peripheral arterial disease ABI 0.91-1.29: Generally considered normal arterial perfusion ABI ≥ 1.30: Suggestive of non-compressible arteries (e.g., arterial calcification) Change in ABI: Positive change (increase): Improvement in lower-extremity perfusion Negative change (decrease): Worsening arterial perfusion Direction of Outcome: For Change in ABI, higher (more positive) values represent a better outcome
| Ankle-Brachial Index (ABI) | TORUS Stent Graft System |
|---|---|
| Change from Baseline through 30 Days | .2 ± .3 |
| Change from Baseline through 6 Months | .2 ± .3 |
| Change from Baseline through 12 Months | .3 ± .3 |
| Change from Baseline through 24 Months | .3 ± .3 |
| Change from Baseline through 36 Months | .3 ± .4 |
Change in Toe-Brachial Index (TBI) in study subjects from baseline to each study interval through follow-up for the target limb. If ABI could not be assessed the TBI was assessed. Scale Structure and Scoring: TBI is calculated as: TBI = Toe systolic blood pressure ÷ Brachial systolic blood pressure Change in TBI was calculated as the difference between post-baseline TBI and baseline TBI for each participant. Scale Range and Clinical Interpretation: TBI is a unitless ratio and does not have a fixed theoretical minimum or maximum value. Interpretation is therefore based on clinically established thresholds rather than absolute scale limits: TBI \< 0.70: Consistent with peripheral arterial disease TBI ≥ 0.70: Generally considered normal digital perfusion For Change in TBI: A positive change (increase) indicates improvement in distal (digital) perfusion A negative change (decrease) indicates worsening arterial perfusion
| Toe-Brachial Index (TBI) | TORUS Stent Graft System |
|---|---|
| Change from Baseline through 30 Days | .2 ± .3 |
| Change from Baseline through 6 Months | .2 ± .3 |
| Change from Baseline through 12 Months | .3 ± .3 |
| Change from Baseline through 24 Months | .3 ± .3 |
| Change from Baseline through 36 Months | .3 ± .4 |
Clinical success: improvement in ≥ 1 Rutherford class
| Participants | TORUS Stent Graft System |
|---|---|
| 30 Days | 154 |
| 6 Months | 139 |
| 12 Months | 133 |
| 24 Months | 102 |
| 36 Months | 69 |
Collected over Adverse Events are reported through 12 months. Serious Adverse events are reported through 12 Months.. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| TORUS Stent Graft System | 24/188 (12.8%) | 85/188 (45.2%) | 136/188 (72.3%) |
| Event | TORUS Stent Graft System |
|---|---|
| Vascular disordersVascular disorders | 60/188 |
| General disorders and administration site conditionsGeneral disorders | 17/188 |
| Infections and infestationsInfections and infestations | 14/188 |
| Cardiac disordersCardiac disorders | 9/188 |
| Musculoskeletal and connective tissue disordersMusculoskeletal and connective tissue disorders | 9/188 |
| Injury, poisoning and procedural complicationsInjury, poisoning and procedural complications | 7/188 |
| Respiratory, thoracic, and mediastinal disordersRespiratory, thoracic and mediastinal disorders | 7/188 |
| Gastrointestinal disordersGastrointestinal disorders | 6/188 |
| Neoplasms benign, malignant and unspecified (incl cysts and polyps)Neoplasms benign, malignant and unspecified (incl cysts and polyps) | 4/188 |
| Nervous system disordersNervous system disorders | 4/188 |
| Event | TORUS Stent Graft System |
|---|---|
| Vascular disordersVascular disorders | 81/188 |
| General disorders and administration site conditionsGeneral disorders | 39/188 |
| Musculoskeletal and connective tissue disordersMusculoskeletal and connective tissue disorders | 30/188 |
| Infections and infestationsInfections and infestations | 29/188 |
| Injury, poisoning and procedural complicationsInjury, poisoning and procedural complications | 18/188 |
| Cardiac disordersCardiac disorders | 17/188 |
| Nervous system disordersNervous system disorders | 12/188 |
| Respiratory, thoracic, and mediastinal disordersRespiratory, thoracic and mediastinal disorders | 9/188 |
| Gastrointestinal disordersGastrointestinal disorders | 6/188 |
| Blood and lymphatic system disordersBlood and lymphatic system disorders | 5/188 |
A total of 188 subjects (TORUS 2: 158 and TORUS 1: 30) were enrolled.
| Age, Continuous(years) | TORUS Stent Graft System |
|---|---|
| Mean | 69.7 ± 8.4 |
| Sex: Female, Male(Participants) | TORUS Stent Graft System |
|---|---|
| Female | 53 |
| Male | 135 |
| Ethnicity (NIH/OMB)(Participants) | TORUS Stent Graft System |
|---|---|
| Hispanic or Latino | 17 |
| Not Hispanic or Latino | 128 |
| Unknown or Not Reported | 13 |
| Race (NIH/OMB)(Participants) | TORUS Stent Graft System |
|---|---|
| American Indian or Alaska Native | 1 |
| Asian | 3 |
| Native Hawaiian or Other Pacific Islander | 3 |
| Black or African American | 17 |
| White | 130 |
| More than one race | 0 |
| Unknown or Not Reported | 4 |
| Region of Enrollment(Participants) | TORUS Stent Graft System |
|---|---|
| United States | 158 |
| Europe | 30 |
| History of Renal Insufficiency(Participants) | TORUS Stent Graft System |
|---|---|
| Count of participants | 32 |
| History of Smoking(Participants) | TORUS Stent Graft System |
|---|---|
| Count of participants | 153 |
| Diabetes Mellitus(Participants) | TORUS Stent Graft System |
|---|---|
| Count of participants | 94 |
7 further baseline measures are reported on the registry.
Documents are hosted by the registry — open the source record to download them.
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