Coronary Artery Disease, Coronary Artery Restenosis, Coronary Artery Stenosis, Coronary Disease
Conditions
Keywords
Stents, Drug-eluting Stent, Angioplasty, Coronary Artery stenosis, Coronary Artery Stent Restenosis, Stent Thrombosis
Brief summary
The purpose of this two part study is the assessment of the performance of the XIENCE V® Everolimus Eluting Coronary Stent System (XIENCE V® EECSS) in the treatment of the specific setting of patients with Multi-Vessel Coronary Artery Disease (MVD).
Detailed description
This is a clinical evaluation of the XIENCE V® everolimus eluting coronary stent system as a revascularization treatment of patients with multi-vessel coronary artery disease (MVD-CAD). The sutdy is composed of two parts: A Randomized Controlled Trial, outlined in a separate posting and the registry portion of this study, which is as follows: -A prospective controlled registry to analyze the clinical efficacy and safety at mid and long-term follow-up in patients with MVD treated with the XIENCE V® Everolimus Eluting Coronary Stent System (XIENCE V® EECSS).
Interventions
DEVICECoronary artery placement of a drug-eluting stent
Coronary artery placement of a drug-eluting stent (XIENCE V® EECSS)
Sponsors
Abbott Medical Devices
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Patient must be at least 18 years of age 2. Patient is able to verbally confirm understanding of risks, benefits and treatment alternatives of receiving the XIENCE V® EECSS and he/she or his/her legally authorized representative provides written informed consent prior to any study related procedure, as approved by the appropriate Medical Ethics Committee of the respective clinical site 3. Patient has been diagnosed a MVD, as documented by coronary angiography, i.e. presenting a severe stenosis (\>50%) amenable to PCI in at least 2 major epicardial vessels or their principal bifurcation branches (diagonal or obtuse marginal) 4. Patient must have evidence of myocardial ischemia (e.g., stable or unstable angina, silent ischemia, positive functional study or a reversible change in the electrocardiogram -ECG- consistent with ischemia) 5. Patient must be an acceptable candidate for coronary artery bypass graft (CABG) surgery 6. Patient must agree to undergo all protocol-required follow-up examinations. Angiographic Inclusion Criteria 1. Patients may receive up to 4 planned XIENCE V® EECSS stents, depending on the number of vessels treated and their respective lesion length. When multiple lesions are present in one or more main coronary branches, complete revascularization should be attempted with the implantation of a maximum of 4 planned stents 2. Target lesions must be de novo lesions (no prior stent implant, no prior brachytherapy) 3. Target vessel reference diameter must be between 2.5 mm and 4.0 mm by visual estimate 4. Target lesion \< or = 28 mm in length by visual estimation 5. Target lesions must be in a major artery or its principal branches (diagonal or obtuse marginal) with a visually estimated stenosis of \> or = 50% 6. Two lesions in a single main coronary artery or its branches do not constitute a MVD situation, therefore this type of patient must not be enrolled
Exclusion criteria
1. Patient has had a known diagnosis of acute myocardial infarction (AMI) within 72 hours preceding the index procedure (non-procedural/spontaneous MI, CK-MB \> or = to 2 times upper limit of normal) and CK and CK-MB have not returned within normal limits at the time of procedure 2. Patient has current unstable arrhythmias 3. Patient has a known left ventricular ejection fraction (LVEF) \<30% 4. Patient has received a heart transplant or any other organ transplant or is on a waiting list for any organ transplant 5. Patient is receiving or scheduled to receive chemotherapy or radiation therapy within 30 days prior to or after the procedure. 6. Patient is receiving immunosuppression therapy or has known immunosuppressive or autoimmune disease (e.g. human immunodeficiency virus, systemic lupus erythematosus etc.) 7. Patient is receiving chronic anticoagulation therapy (e.g. coumadin) 8. Patient has a known hypersensitivity or contraindication to aspirin, paclitaxel, either heparin or bivalirudin, clopidogrel or ticlopidine, everolimus, cobalt, chromium, nickel, tungsten, acrylic and fluoro polymers or contrast sensitivity that cannot be adequately pre-medicated 9. Elective surgery is planned within the first 9 months (+/- 14 days) after the procedure that will require discontinuing either aspirin or clopidogrel 10. Patient has a platelet count \<100,000 cells/mm3 or \>700,000 cells/mm3, a WBC of \<3,000 cells/mm3, or documented or suspected liver disease (including laboratory evidence of hepatitis) 11. Patient has known renal insufficiency (e.g., serum creatinine level of more than 2.5 mg/dl, patient on dialysis) 12. Patient has a history of bleeding diathesis or coagulopathy or will refuse blood transfusions 13. Patient has had a cerebrovascular accident (CVA) or transient ischemic neurological attack (TIA) within the past six months 14. Patient has had a significant GI or urinary bleed within the past six months 15. Patient has other medical illness (e.g., cancer or congestive heart failure) or known history of substance abuse (alcohol, cocaine, heroin etc.) that may cause non-compliance with the protocol, confound the data interpretation or is associated with a limited life expectancy (i.e. less than one year) 16. Patient is already participating in another investigational use device or drug study or has completed the follow-up phase of another study within the last 30 days. Angiographic
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Composite endpoint of all Death, MI (Q-wave and non Q-wave), and ischemia-driven Target Vessel Revascularization (TVR) . | 12 months | Composite endpoints are endpoints made up of a range of statistical parameters. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Revascularizations (TLR/TVR/any revascularization) | 30 days | — |
| Composite endpoint of cardiac death, MI (Q-wave and non Q-wave), and ischemia-driven TLR. | 30 days | — |
| Composite endpoint of all death, MI (Q-wave and non Q-wave), and TVR. | 30 days | — |
| Adjudicated stent thrombosis | 30 days | — |
| Lesion success | At time of index procedure | Attainment of \< 30% residual in-stent stenosis (by visual assessment) using any percutaneous method. |
| Procedural success defined as: residual in-stent %DS of < 30% using a percutaneous method, without cardiac death, Q-wave MI, non Q-wave MI, or repeat revasc of the target during hospitalization. | At time of index procedure | — |
| Device success | At time of index procedure | Achievement of a final residual in-stent diameter stenosis of \< 30% (visual assessment) using the assigned device only. |
Countries
Italy
Outcome results
None listed