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RecruitingNCT07353905INVIGORUpdated Jul 9, 2026

Intravascular Ultrasound Imaging Guidance for Optimal Revascularization of Limb Arteries

An interventional study of Intravascular Ultrasound (IVUS) and Angiographic-guided Intervention in Peripheral Arterial Disease and Lower Extremity Arterial Disease, sponsored by Baylor Research Institute. Recruiting at 6 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-07-09.

Sponsored by Baylor Research Institute · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
350
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study will test whether using ultrasound imaging within blood vessels during minimally invasive treatment of leg arteries in patients with peripheral artery disease leads to better clinical outcomes.

Read the detailed description

This is a U.S. prospective multicenter randomized controlled trial to evaluate the clinical outcomes of Intravascular ultrasound (IVUS) guided Lower Extremity (LE) endovascular intervention in patients with symptomatic peripheral artery disease (PAD) (Rutherford class 2-5).

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Conditions studied

  • Peripheral Arterial Disease
  • Lower Extremity Arterial Disease

Keywords

  • Intravascular Ultrasound
  • Angioplasty
  • Endovascular Treatment
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Age ≥18 years
  • Symptomatic LE PAD - Rutherford Class 2-5
  • Angiographic evidence of >50% stenosis
  • Undergoing LE peripheral artery intervention
  • Target lesion is iliac, femoropopliteal, profunda or supramalleolar below-the-knee arteries (target lesions extending into the abdominal aorta and inframalleolar BTK may be included).

Exclusion criteria

Exclusion Criteria:

  • Prior intervention at the target lesion within 6 months
  • Target lesion is abdominal aorta or inframalleolar BTK arteries
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
350 participants (estimated)

Study arms

  • Active comparator
    Intravascular Ultrasound (IVUS)

    Intravascular Ultrasound (IVUS) is used during the treatment of the target lesion.

    Device: Intravascular Ultrasound (IVUS)

  • Active comparator
    Non-Intravascular Ultrasound (IVUS)

    Intravascular Ultrasound (IVUS) is not used in the treatment of the target lesion.

    Device: Angiographic-guided Intervention

Interventions

  • DeviceIntravascular Ultrasound (IVUS)

    pre-and post-procedural IVUS to guide atherectomy, balloon angioplasty based treatments and/or stent placement

  • DeviceAngiographic-guided Intervention

    Standard angiography-guided intervention without IVUS.

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What researchers measure

Primary outcomes

  1. Primary Patency

    Freedom from restenosis ≥50% or an increase in Duplex Ultrasound peak systolic velocity ≥2.5 times reference proximal segment or target lesion revascularization (TLR).

    Time frame: From enrollment to 6 months

Secondary outcomes

  1. Technical Success

    Technical success is defined as less than 30% residual stenosis in the target lesion following the index procedure. Residual stenosis determined by operator visual estimation.

    Time frame: Collected from index procedure

  2. Procedural Success

    Procedural success is technical success (less than 30 % residual stenosis in the target lesion) without the occurrence of procedural complications during the index procedure. Residual stenosis determined by operator visual estimation.

    Time frame: Collected from Index procedure

  3. Clinically driven-TLR (CD-TLR)

    Clinically driven-target limb revascularization. Information collected from the medical record.

    Time frame: From enrollment to 12 months

  4. Amputation-free Survival

    Defined as no evidence of amputation. Information is collected from the medical record

    Time frame: From enrollment to 12 months

  5. Functional Status Improvement (Vascular Quality of Life Questionnaire (VascuQoL-6))

    Vascular Quality of Life Questionnaire (VascuQoL-6) collected at index procedure and 12 months.

    Time frame: From enrollment to 12 months

  6. Functional Status Improvement (Rutherford Class Improvement)

    Rutherford class determined by physician and collected from the medical record.

    Time frame: From enrollment to 12 months

  7. Cost Effectiveness

    This analysis will calculate total cost-effectiveness by comparing costs between the two groups. Total cost will include the initial procedural cost, costs related to complications, and costs of any repeat reinterventions during follow-up.

    Time frame: Evaluated at 12 months

06

Study locations

4 of 6 sites recruiting
  • Baylor Scott & White The Heart Hospital - Dallas
    Dallas, Texas 75226, United States
    • Sarah Hale · Contact · sarah.hale@bswhealth.org · 469-814-4845
    • Sarah Weideman · Contact · sarah.weideman@bswhealth.org · 214-820-2927
    • Subhash Banerjee, MD · Principal investigator
    • Zachary Rosol, MD · Sub investigator
    • Javier Vasquez, MD · Sub investigator
    • Georges Feghali, MD · Sub investigator
    Recruiting
  • Baylor Scott & White The Heart Hospital - Fort Worth
    Fort Worth, Texas 76104, United States
    Not yet recruiting
  • Baylor Scott & White The Heart Hospital - Mckinney
    McKinney, Texas 75071, United States
    • Denise Espinoza · Contact · Denise.Espinoza@BSWHealth.org · (469) 814-4783
    • Erisa Stokes, BS · Contact · erisa.stokes@bswhealth.org
    • Robert Widmer, MD · Principal investigator
    • Arash Shirvani, MD · Sub investigator
    • Joseph Liechty, MD · Sub investigator
    • Sanjeev Trehan, MD · Sub investigator
    Recruiting
  • The Heart Hospital Baylor Plano
    Plano, Texas 75093, United States
    • Osniel Gonzalez Ramos, BS · Contact · osniel.gonzalezramos@bswhealth.org · 469-814-4862
    • Erisa Stokes, BS · Contact · erisa.stokes@bswhealth.org · 469-814-4819
    • Sameh Sayfo, MD · Principal investigator
    • Chadi Dib, MD · Sub investigator
    • John Kedora, MD · Sub investigator
    • Mazin Foteh, MD · Sub investigator
    • Srinivasa Potluri, MD · Sub investigator
    • Dennis Gable, MD · Sub investigator
    Recruiting
  • Baylor Scott & White Medical Center - Temple
    Temple, Texas 76508, United States
    Not yet recruiting
  • Baylor Scott & White The Heart Hospital - Waxahachie
    Waxahachie, Texas 75165, United States
    Recruiting
07

References and documents

Publications

  • PASS 2025 Power Analysis and Sample Size Software (2025). NCSS, LLC. Kaysville, Utah, USA, ncss.com/software/pass.
  • Divakaran S, Parikh SA, Hawkins BM, Chen S, Song Y, Banerjee S, Rosenfield K, Secemsky EA. Temporal Trends, Practice Variation, and Associated Outcomes With IVUS Use During Peripheral Arterial Intervention. JACC Cardiovasc Interv. 2022 Oct 24;15(20):2080-2090. doi: 10.1016/j.jcin.2022.07.050. PubMed 36265940 ↗
  • Rymer JA, Secemsky EA. Use of Intravascular Ultrasound to Optimize Peripheral Vascular Interventions: How Do We Optimize Outcomes and Improve Uptake? Circ Cardiovasc Interv. 2023 Apr;16(4):e013016. doi: 10.1161/CIRCINTERVENTIONS.123.013016. Epub 2023 Apr 18. No abstract available. PubMed 37071719 ↗
  • Shin J, Ahn CM, Lee SJ, Lee SH, Lee YJ, Kim BK, Hong MK, Jang Y, Kim TH, Park HW, Jang JY, Lee JH, Park JH, Kim SH, Im E, Park SH, Choi D, Ko YG; IVUS-DCB investigators. Twenty-Four-Month Outcomes of Intravascular Ultrasound-Guided Drug-Coated Balloon Angioplasty for Femoropopliteal Artery Disease. J Am Heart Assoc. 2025 Aug 19;14(16):e041564. doi: 10.1161/JAHA.125.041564. Epub 2025 Aug 12. PubMed 40792582 ↗
  • Allan RB, Puckridge PJ, Spark JI, Delaney CL. The Impact of Intravascular Ultrasound on Femoropopliteal Artery Endovascular Interventions: A Randomized Controlled Trial. JACC Cardiovasc Interv. 2022 Mar 14;15(5):536-546. doi: 10.1016/j.jcin.2022.01.001. PubMed 35272779 ↗
  • Meng W, Guo J, Pan D, Guo L, Gu Y. Intravascular Ultrasound-Guided Versus Angiography-Guided Endovascular Therapy for Femoropopliteal Artery Disease: A Scoping Review. J Endovasc Ther. 2025 Jun;32(3):627-634. doi: 10.1177/15266028231197396. Epub 2023 Sep 9. PubMed 37688486 ↗
  • Jang JS, Jin HY, Park YA, Yang TH, Seo JS, Kim DK, Wi JH. Meta-Analysis of Intravascular Ultrasound-Guided Versus Angiography-Guided Endovascular Treatment in Lower Extremity Artery Disease. Am J Cardiol. 2025 Mar 15;239:8-17. doi: 10.1016/j.amjcard.2024.12.012. Epub 2024 Dec 12. PubMed 39674438 ↗
  • Lee SJ, Kim TH, Lee JH, Ahn CM, Lee SH, Lee YJ, Kim BK, Hong MK, Jang Y, Park HW, Jang JY, Park JH, Kim SH, Im E, Park SH, Choi D, Ko YG; IVUS-DCB Investigators. Intravascular Ultrasound-Guided vs Angiography-Guided Drug-Coated Balloon Angioplasty in Patients With Complex Femoropopliteal Artery Disease. JACC Cardiovasc Interv. 2025 Mar 10;18(5):558-569. doi: 10.1016/j.jcin.2024.10.052. Epub 2025 Jan 22. PubMed 39846915 ↗
  • Soney H, Kakkilaya A, Vazquez DF, Banerjee R, Rosol Z, Tsai S, Banerjee S. Reproducibility of Femoropopliteal Artery Intravascular Ultrasound Imaging in Patients With Peripheral Artery Disease. Am J Cardiol. 2023 Jul 15;199:1-6. doi: 10.1016/j.amjcard.2023.04.026. Epub 2023 May 19. PubMed 37210800 ↗

Study documents

  • Protocol and statistical analysis plan · Jun 29, 2026

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No — We will need to get Information Security and sponsor approval before sharing our data. Any data shared would be aggregate, de-identified data shared in accordance with Baylor Scott \& White Research Institute's policies and procedures.

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Registry details

Key details

Study ID
NCT07353905
Lead sponsor
Baylor Research Institute
Collaborators
Philips Healthcare
Responsible party
Sponsor
First posted
Jan 21, 2026
Start date
Dec 12, 2025
Primary completion
Jan 2028 (estimated)
Completion
Jul 2028 (estimated)
Last update
Jul 9, 2026

Study contacts

Sarah Hale
Contact
sarah.hale@bswhealth.org
469-814-4845
Sarah Weideman
Contact
sarah.weideman@bswhealth.org
214-820-2927
Subhash Banerjee, MD
principal investigator · Baylor Scott & White Research Institute

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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