Coronary Artery Disease
Conditions
Keywords
Coronary Artery Disease, Drug eluting stent, Percutaneous Coronary Interventions, Optical Coherence Tomography
Brief summary
The objective of this study is to evaluate the completeness of struts coverage and vessel wall response to the new generation JACTAX drug-eluting stent vs Taxus stent in de novo coronary artery lesions at 6 months post index procedure. To investigate the completeness of the coverage as well as the number of uncovered stent struts per section, high resolution (\ 10-15 µm axial) intracoronary Optical Coherence Tomography (OCT) will be used.
Detailed description
The risk of late stent thrombosis represents a major concern for patients treated with first generation drug-eluting stents (DES). Delayed healing and poor endothelialization are common findings in vessels treated with DES and are probably related to the amount of drug and polymer applied to a DES. There is evidence to suggest that polymer applications may influence the processes of inflammation and vessel healing. The JACTAX family of DES have been designed to provide a maximum amount of drug delivered directly to coronary vessel tissue while excluding polymer and drug from contact within the vessel lumen. The JACTAX stents are comprised of a currently marketed bare metal stent (Libertè™) coated exclusively on the ablumenal stent surface with a carrier containing a bioerodable polymer, Polylactide and paclitaxel. The objective of this prospective study is to measure the completeness of strut coverage and vessel wall response (strut malapposition, neointima disomogeneities in texture) to the JACTAX stents vs Taxus Libertè in de novo coronary artery lesions at 6 months post index procedure. Optical Coherence Tomography (OCT) that detects smaller degrees of stent strut coverage more accurately than IVUS will be used at 6 months follow-up. Intravascular ultrasound (IVUS) will be performed as per normal practice at any index procedures and at 6 months follow-up.
Interventions
Jactax stent placed in coronary artery
JACTAX LD stent placed in coronary artery
Taxus Libertè stent placed in coronary artery
Sponsors
Study design
Eligibility
Inclusion criteria
General Inclusion Criteria 1. Patient is ≥ 18 years of age 2. Patient is eligible for percutaneous coronary intervention (PCI) 3. Patient demonstrates a left ventricular ejection fraction (LVEF) of ≥ 25% 4. Patient or legal guardian understands and agrees to comply with all specified study requirements and provides written Informed Consent to this effect. Angiographic Inclusion Criteria 1. Target lesion is de novo native coronary artery lesion (i.e., a coronary lesion not previously treated) ≤ 25 mm that can be treated with a single JACTAX, JACTAX LD or TAXUS stent 2. A second lesion in a second vessel may be treated with one (1) TAXUS™ Libertè™ DES or a bare metal stent.
Exclusion criteria
General
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Proportion of stent struts uncovered and/or malapposed at OCT | 6 months |
Secondary
| Measure | Time frame |
|---|---|
| Stent Thrombosis | 12 and 24 months |
| Target Lesion Revascularization | 12 and 24 months |
| Major Adverse Cardiac Events (MACE) | 12 and 24 months |
| QCA parameters: mean lumen diameter, acute gain, late loss and binary restenosis (≥ 50% diameter stenosis) rate | 6 months |
| IVUS parameters: neointimal area volume, stent and area volumes, stent apposition, and percent net volume obstruction | 6 months |
| Procedural success | through discharge |
Countries
Italy