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A Study of the TAXUS Liberté Stent for the Treatment of Long De Novo Coronary Artery Lesions

Primary Purpose

Coronary Artery Disease

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
TAXUS Liberté-SR
TAXUS™ Express
Sponsored by
Boston Scientific Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Coronary Artery Disease

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

General Inclusion Criteria:

  1. Patient is at least 18 years old.
  2. Eligible for percutaneous coronary intervention (PCI)
  3. Documented stable angina pectoris or unstable angina pectoris with documented ischemia, or documented silent ischemia
  4. Left ventricular ejection fraction (LVEF) of at least 25%
  5. Acceptable candidate for coronary artery bypass grafting (CABG)
  6. Patient or legal guardian understands the study requirements and the treatment procedures and provides written Informed Consent before any study-specific tests or procedures are performed
  7. Willing to comply with all specified follow-up evaluations

Angiographic Inclusion Criteria:

  1. Only one lesion (target lesion) may be treated with the study stent.However, one additional lesion in a non-target vessel may be treated during the index procedure with a commercially available bare metal stent, heparin-coated stent or TAXUS Express stent.
  2. Successful predilation is mandatory for entry into study
  3. Target lesion located within a single native coronary artery
  4. Target lesion enrolled for treatment may be composed of multiple lesions (not more than 10mm between diseased segments) but must be completely covered by one study stent.
  5. Cumulative target lesion length is greater than or equal to 26 mm and less than or equal to 34 mm (visual estimate)
  6. Target lesion RVD is greater than or equal to 2.7 mm and less than or equal to 4.0 mm (visual estimate)
  7. Target lesion diameter stenosis at least 50% (visual estimate)
  8. Target lesion is de novo (i.e., a coronary lesion not previously treated)

General Exclusion Criteria:

  1. Known hypersensitivity to paclitaxel
  2. Any previous, concurrent or planned treatment with a non-study anti-restenotic drug-coated or drug-eluting coronary stent.
  3. Planned use of both the study stent and a non-study stent (i.e., commercial stent) in the treatment of the target vessel
  4. Previous or planned treatment with intravascular brachytherapy in the target vessel
  5. Planned CABG within 9-months post-index procedure
  6. MI within 72 hours prior to the index procedure and/or creatine kinase(CK) >2x the local laboratory's ULN unless CK-MB is <2x ULN
  7. Cerebrovascular Accident (CVA) within the past 6 months
  8. Cardiogenic Shock
  9. Acute or chronic renal dysfunction
  10. Contraindication to ASA, or to both clopidogrel and ticlopidine
  11. Leukopenia
  12. Thrombocytopenia or thrombocytosis
  13. Active peptic ulcer or active gastrointestinal (GI) bleeding
  14. Known allergy to stainless steel
  15. Any prior true anaphylactic reaction to contrast agents
  16. Patient is currently, or has been treated with paclitaxel or other chemotherapeutic agents within 12-months of the index procedure
  17. Anticipated treatment with paclitaxel or oral rapamycin during any period in the 9-months after the index procedure
  18. Male or female with known intention to procreate within 3 months after the index procedure
  19. Female of childbearing potential with a positive pregnancy test within 7 days before the index procedure, or lactating
  20. Life expectancy of less than 24 months due to other medical condition
  21. Co-morbid condition(s) that could limit the patient's ability to participate in the study, compliance with follow-up requirements or impact the scientific integrity of the study
  22. Currently participating in another investigational drug or device study that has not completed the primary endpoint or that clinically interferes with the endpoints of this study

Angiographic Exclusion Criteria:

  1. Unprotected and protected left main coronary artery disease (patient with protected left main disease can be enrolled ONLY if the target lesion is in the RCA)
  2. Target lesion is ostial in location (within 3.0 mm of vessel origin)
  3. Target lesion and/or target vessel proximal to the target lesion is moderately or severely calcified by visual estimate
  4. Target lesion and/or target vessel proximal to the target lesion is tortuous
  5. Target lesion is located within or distal to a >60 degree bend in the vessel
  6. Target lesion involves a bifurcation with a side branch vessel >2.0mm in diameter
  7. Target lesion is totally occluded (TIMI flow <1), either at baseline or predilation
  8. Angiographic presence of probable or definite thrombus
  9. Pre-treatment of the target vessel at the index procedure is not allowed with any device except for predilation with balloon angioplasty or cutting balloon.
  10. A previously treated lesion within the target vessel:

    • <15mm from the target lesion (visual estimate)
    • Performed </= 6 months from index procedure
    • >30% residual stenosis after previous treatment

Sites / Locations

  • Mercy General Hospital
  • Christiana Hospital
  • Florida Hospital
  • St. John's Hospital
  • The Heart Center
  • Maine Medical Center
  • Washington Adventist Hospital
  • Northern Michigan Hospital
  • St. Mary's Duluth Clinic Regional Heart Center
  • North Mississippi Medical Center
  • Columbia University Medical Center
  • Wake Medical Center
  • Riverside Methodist Hospital
  • North Ohio Research Elyria Memorial Hospital
  • Oklahoma Foundation for Cardiovascular Research
  • The Pennsylvania State University Milton S Hershey Medical Center
  • Wellmont Holston Valley Medical Center
  • Methodist DeBakey Heart Center
  • Scott & White Memorial Hospital
  • Mercy Angiography Unit, 98 Mountain Road, First Floor
  • Auckland City Hospital
  • Christchurch Hospital
  • Dunedin Hospital
  • National Heart Centre
  • National University Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Other

Arm Label

Arm 1

Arm 2

Arm Description

Historical Comparator: control data derived from the TAXUS IV and TAXUS V clinical trials

Outcomes

Primary Outcome Measures

Percent diameter stenosis of the analysis segment at 9-months

Secondary Outcome Measures

Clinical procedural and technical success
Utilization parameters (equipment utilization; catheters, guidewires and balloons, procedure time, fluoroscopic time and amount of contrast used)
MACE rates at discharge, 1, 4 and 9-months and 1, 2, 3, 4, and 5 years post-index procedure.
Stent thrombosis rate
Target Vessel Failure (TVF)
Target Vessel Revascularization (TVR)
QCA parameters (binary restenosis rate, in-stent %DS, MLD and late loss)
IVUS parameters (percent net volume obstruction, incomplete apposition, stent areas and volume, vessel areas and volume, lumen areas and volume, neointimal area volume)

Full Information

First Posted
September 1, 2006
Last Updated
February 1, 2012
Sponsor
Boston Scientific Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT00371475
Brief Title
A Study of the TAXUS Liberté Stent for the Treatment of Long De Novo Coronary Artery Lesions
Official Title
TAXUS ATLAS LONG LESION: A Multi-center, Single-arm Study of the TAXUS Liberté™-SR Stent for the Treatment of Patients With Long de Novo Coronary Artery Lesions
Study Type
Interventional

2. Study Status

Record Verification Date
February 2012
Overall Recruitment Status
Completed
Study Start Date
March 2005 (undefined)
Primary Completion Date
February 2007 (Actual)
Study Completion Date
May 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Boston Scientific Corporation

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
TAXUS ATLAS is a global, multi-center, single-arm, non-inferiority trial comparing results from patients treated with the TAXUS Liberté 38 mm stent to an historical TAXUS Express control. The control group is a case-matched, blended, long lesion subset population of TAXUS Express patients from the TAXUS IV and TAXUS V de novo clinical trials. The objective of the study is to evaluate clinical outcomes of TAXUS Liberté-SR 38 mm stent in de novo lesions and to assess the non-inferiority of TAXUS Liberté versus TAXUS Express. The TAXUS Liberté-SR stent is hypothesized to have comparable safety and efficacy to the TAXUS Express stent.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Artery Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
150 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm 1
Arm Type
Experimental
Arm Title
Arm 2
Arm Type
Other
Arm Description
Historical Comparator: control data derived from the TAXUS IV and TAXUS V clinical trials
Intervention Type
Device
Intervention Name(s)
TAXUS Liberté-SR
Intervention Description
Paclitaxel-Eluting Coronary 38 mm Stent
Intervention Type
Device
Intervention Name(s)
TAXUS™ Express
Intervention Description
Paclitaxel-Eluting Coronary Stent System
Primary Outcome Measure Information:
Title
Percent diameter stenosis of the analysis segment at 9-months
Time Frame
9 Months
Secondary Outcome Measure Information:
Title
Clinical procedural and technical success
Time Frame
5 Years
Title
Utilization parameters (equipment utilization; catheters, guidewires and balloons, procedure time, fluoroscopic time and amount of contrast used)
Time Frame
9 Months
Title
MACE rates at discharge, 1, 4 and 9-months and 1, 2, 3, 4, and 5 years post-index procedure.
Time Frame
5 Years
Title
Stent thrombosis rate
Time Frame
5 Years
Title
Target Vessel Failure (TVF)
Time Frame
5 Years
Title
Target Vessel Revascularization (TVR)
Time Frame
5 Years
Title
QCA parameters (binary restenosis rate, in-stent %DS, MLD and late loss)
Time Frame
9 Months
Title
IVUS parameters (percent net volume obstruction, incomplete apposition, stent areas and volume, vessel areas and volume, lumen areas and volume, neointimal area volume)
Time Frame
9 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
General Inclusion Criteria: Patient is at least 18 years old. Eligible for percutaneous coronary intervention (PCI) Documented stable angina pectoris or unstable angina pectoris with documented ischemia, or documented silent ischemia Left ventricular ejection fraction (LVEF) of at least 25% Acceptable candidate for coronary artery bypass grafting (CABG) Patient or legal guardian understands the study requirements and the treatment procedures and provides written Informed Consent before any study-specific tests or procedures are performed Willing to comply with all specified follow-up evaluations Angiographic Inclusion Criteria: Only one lesion (target lesion) may be treated with the study stent.However, one additional lesion in a non-target vessel may be treated during the index procedure with a commercially available bare metal stent, heparin-coated stent or TAXUS Express stent. Successful predilation is mandatory for entry into study Target lesion located within a single native coronary artery Target lesion enrolled for treatment may be composed of multiple lesions (not more than 10mm between diseased segments) but must be completely covered by one study stent. Cumulative target lesion length is greater than or equal to 26 mm and less than or equal to 34 mm (visual estimate) Target lesion RVD is greater than or equal to 2.7 mm and less than or equal to 4.0 mm (visual estimate) Target lesion diameter stenosis at least 50% (visual estimate) Target lesion is de novo (i.e., a coronary lesion not previously treated) General Exclusion Criteria: Known hypersensitivity to paclitaxel Any previous, concurrent or planned treatment with a non-study anti-restenotic drug-coated or drug-eluting coronary stent. Planned use of both the study stent and a non-study stent (i.e., commercial stent) in the treatment of the target vessel Previous or planned treatment with intravascular brachytherapy in the target vessel Planned CABG within 9-months post-index procedure MI within 72 hours prior to the index procedure and/or creatine kinase(CK) >2x the local laboratory's ULN unless CK-MB is <2x ULN Cerebrovascular Accident (CVA) within the past 6 months Cardiogenic Shock Acute or chronic renal dysfunction Contraindication to ASA, or to both clopidogrel and ticlopidine Leukopenia Thrombocytopenia or thrombocytosis Active peptic ulcer or active gastrointestinal (GI) bleeding Known allergy to stainless steel Any prior true anaphylactic reaction to contrast agents Patient is currently, or has been treated with paclitaxel or other chemotherapeutic agents within 12-months of the index procedure Anticipated treatment with paclitaxel or oral rapamycin during any period in the 9-months after the index procedure Male or female with known intention to procreate within 3 months after the index procedure Female of childbearing potential with a positive pregnancy test within 7 days before the index procedure, or lactating Life expectancy of less than 24 months due to other medical condition Co-morbid condition(s) that could limit the patient's ability to participate in the study, compliance with follow-up requirements or impact the scientific integrity of the study Currently participating in another investigational drug or device study that has not completed the primary endpoint or that clinically interferes with the endpoints of this study Angiographic Exclusion Criteria: Unprotected and protected left main coronary artery disease (patient with protected left main disease can be enrolled ONLY if the target lesion is in the RCA) Target lesion is ostial in location (within 3.0 mm of vessel origin) Target lesion and/or target vessel proximal to the target lesion is moderately or severely calcified by visual estimate Target lesion and/or target vessel proximal to the target lesion is tortuous Target lesion is located within or distal to a >60 degree bend in the vessel Target lesion involves a bifurcation with a side branch vessel >2.0mm in diameter Target lesion is totally occluded (TIMI flow <1), either at baseline or predilation Angiographic presence of probable or definite thrombus Pre-treatment of the target vessel at the index procedure is not allowed with any device except for predilation with balloon angioplasty or cutting balloon. A previously treated lesion within the target vessel: <15mm from the target lesion (visual estimate) Performed </= 6 months from index procedure >30% residual stenosis after previous treatment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
John A Ormiston, MD
Organizational Affiliation
Mercy Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Mark A Turco, MD
Organizational Affiliation
Washington Adventist Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Peter Maurer, MPH
Organizational Affiliation
Boston Scientific Corporation
Official's Role
Study Director
Facility Information:
Facility Name
Mercy General Hospital
City
Sacramento
State/Province
California
ZIP/Postal Code
95819
Country
United States
Facility Name
Christiana Hospital
City
Newark
State/Province
Delaware
ZIP/Postal Code
19718-0002
Country
United States
Facility Name
Florida Hospital
City
Orlando
State/Province
Florida
ZIP/Postal Code
32803
Country
United States
Facility Name
St. John's Hospital
City
Springfield
State/Province
Illinois
ZIP/Postal Code
62701
Country
United States
Facility Name
The Heart Center
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46290
Country
United States
Facility Name
Maine Medical Center
City
Portland
State/Province
Maine
ZIP/Postal Code
04102
Country
United States
Facility Name
Washington Adventist Hospital
City
Takoma Park
State/Province
Maryland
ZIP/Postal Code
20912
Country
United States
Facility Name
Northern Michigan Hospital
City
Petoskey
State/Province
Michigan
ZIP/Postal Code
49770
Country
United States
Facility Name
St. Mary's Duluth Clinic Regional Heart Center
City
Duluth
State/Province
Minnesota
ZIP/Postal Code
55805
Country
United States
Facility Name
North Mississippi Medical Center
City
Tupelo
State/Province
Mississippi
ZIP/Postal Code
38801
Country
United States
Facility Name
Columbia University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Wake Medical Center
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27610
Country
United States
Facility Name
Riverside Methodist Hospital
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43214
Country
United States
Facility Name
North Ohio Research Elyria Memorial Hospital
City
Elyria
State/Province
Ohio
ZIP/Postal Code
44035
Country
United States
Facility Name
Oklahoma Foundation for Cardiovascular Research
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73120
Country
United States
Facility Name
The Pennsylvania State University Milton S Hershey Medical Center
City
Hershey
State/Province
Pennsylvania
ZIP/Postal Code
17033-0850
Country
United States
Facility Name
Wellmont Holston Valley Medical Center
City
Kingsport
State/Province
Tennessee
ZIP/Postal Code
37660
Country
United States
Facility Name
Methodist DeBakey Heart Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030-2767
Country
United States
Facility Name
Scott & White Memorial Hospital
City
Temple
State/Province
Texas
ZIP/Postal Code
76508
Country
United States
Facility Name
Mercy Angiography Unit, 98 Mountain Road, First Floor
City
Auckland
State/Province
Epsom
ZIP/Postal Code
1003
Country
New Zealand
Facility Name
Auckland City Hospital
City
Auckland
ZIP/Postal Code
1023
Country
New Zealand
Facility Name
Christchurch Hospital
City
Christchurch
ZIP/Postal Code
8001
Country
New Zealand
Facility Name
Dunedin Hospital
City
Dunedin
Country
New Zealand
Facility Name
National Heart Centre
City
Singapore
ZIP/Postal Code
168752
Country
Singapore
Facility Name
National University Hospital
City
Singapore
Country
Singapore

12. IPD Sharing Statement

Citations:
PubMed Identifier
23232250
Citation
Ormiston JA, Charles O, Mann T, Hall JJ, McGarry T, Cannon LA, Webster MW, Mishkel GJ, Underwood PL, Dawkins KD. Final 5-year results of the TAXUS ATLAS, TAXUS ATLAS Small Vessel, and TAXUS ATLAS Long Lesion clinical trials of the TAXUS Liberte paclitaxel-eluting stent in de-novo coronary artery lesions. Coron Artery Dis. 2013 Jan;24(1):61-8. doi: 10.1097/MCA.0b013e32835b3932.
Results Reference
derived
PubMed Identifier
20129555
Citation
Doi H, Maehara A, Mintz GS, Yu A, Wang H, Mandinov L, Popma JJ, Ellis SG, Grube E, Dawkins KD, Weissman NJ, Turco MA, Ormiston JA, Stone GW. Impact of post-intervention minimal stent area on 9-month follow-up patency of paclitaxel-eluting stents: an integrated intravascular ultrasound analysis from the TAXUS IV, V, and VI and TAXUS ATLAS Workhorse, Long Lesion, and Direct Stent Trials. JACC Cardiovasc Interv. 2009 Dec;2(12):1269-75. doi: 10.1016/j.jcin.2009.10.005.
Results Reference
derived
PubMed Identifier
19463432
Citation
Mahmud E, Ormiston JA, Turco MA, Popma JJ, Weissman NJ, O'Shaughnessy CD, Mann T, Hall JJ, McGarry TF, Cannon LA, Webster MW, Mandinov L, Baim DS. TAXUS Liberte attenuates the risk of restenosis in patients with medically treated diabetes mellitus: results from the TAXUS ATLAS program. JACC Cardiovasc Interv. 2009 Mar;2(3):240-52. doi: 10.1016/j.jcin.2008.12.009.
Results Reference
derived
PubMed Identifier
19463387
Citation
Turco MA, Ormiston JA, Popma JJ, Hall JJ, Mann T, Cannon LA, Webster MW, Mishkel GJ, O'Shaughnessy CD, McGarry TF, Mandinov L, Dawkins KD, Baim DS. Reduced risk of restenosis in small vessels and reduced risk of myocardial infarction in long lesions with the new thin-strut TAXUS Liberte stent: 1-year results from the TAXUS ATLAS program. JACC Cardiovasc Interv. 2008 Dec;1(6):699-709. doi: 10.1016/j.jcin.2008.09.007.
Results Reference
derived

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A Study of the TAXUS Liberté Stent for the Treatment of Long De Novo Coronary Artery Lesions

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