Contego’s Neuroguard Evaluated in 30-Day and 1-Year Outcomes in PERFORMANCE II 


November 1, 2023—The PERFORMANCE II study is a prospective, multicenter, single-arm study to evaluate the safety and effectiveness of the Neuroguard IEP 3-in-1 carotid stent and postdilation balloon system with integrated embolic protection (Contego Medical, Inc.) for the treatment of carotid artery stenosis in patients at elevated risk for adverse events following carotid endarterectomy.

William A. Gray, MD, presented the findings during a late-breaking clinical trial session at VIVA23, the Vascular InterVentional Advances annual vascular education symposium held by The VIVA Foundation on October 30 to November 2 in Las Vegas, Nevada.

As summarized in the VIVA press release, the PERFORMANCE II study’s primary endpoint is the 30-day rate of major adverse events, defined as death, all stroke, and myocardial infarction within 30 days of the index procedure, plus ipsilateral stroke between day 31 and 1 year. Events were adjudicated by an independent clinical events committee, and angiograms and duplex ultrasounds were evaluated by an independent core lab.

A total of 305 patients were enrolled at 40 sites in the United States and Europe.

Of the 305 patients enrolled, the mean age was 70 years, 20% were symptomatic. Additionally, 230 (75%) patients had physiologic high-risk criteria, and 75 (25%) patients had anatomic high-risk criteria. The mean baseline angiographic stenosis was 85%, and 34% of lesions were severely calcified.

At 30 days, the all-stroke rate was 1.31% (4 patients) and 0.98% (3 patients) in an intention-to-treat and per-protocol analysis, respectively. There were no major strokes, no contralateral strokes, one (0.3%) death (cardiovascular), and two (0.7%) non–ST-segment elevation myocardial infarctions through 30-day follow-up. Among asymptomatic patients, the 30-day stroke rate was 0.81% (2 patients).

There was one (0.37%) minor ipsilateral stroke between day 31 and 1 year. There were no major strokes and no neurological deaths at 1 year. Target lesion revascularization through 1 year was 1.47% (4 patients).

These 1-year outcomes of the PERFORMANCE II study demonstrate the safety and durability of the Neuroguard carotid stent system in a high-surgical-risk patient population and are the lowest event rates ever reported in an adequately powered, multicenter trial of any type of carotid revascularization, regardless of patient risk.