Safety and Performance Evaluation of WIRION™ EPD in Patients Undergoing Carotid Artery Stenting (WISE)

This is an interventional prevention trial for Carotid Artery Diseases focused on measuring Carotid, Carotid artery stenting, Stent, Embolic protection, Atherosclerotic Disease Read More

Inclusion Criteria:

• 18 years of age
• Anticipated patient life expectancy of at least 1 year
• Patient or authorized representative, signed a written Informed Consent form
• Patient is willing to comply with the protocol requirements
• Candidate for catheter-based therapy of a single stenosis located in the internal carotid artery (ICA) or the carotid bifurcation, suitable for treatment with a single FDA-approved stent with a carotid use indication
• Reference vessel diameter for intended filter location between 3.5mm and 6.0mm
• An adequate "landing zone" of at least 30mm
• Patients with severe symptomatic or asymptomatic carotid artery stenosis, to be ≥ 50% for symptomatic patients OR ≥ 80% for asymptomatic patients
• At least one high surgical risk criteria, either anatomical or co-morbid risk factors, as listed below:

Category I - Anatomical high risk factors

• Recurrent stenosis after endarterectomy
• Previous radical neck surgery or radiation therapy to the neck
• High cervical ICA lesions or CCA lesions at or above C2 or below the clavicle
• Spinal immobility of the neck
• Tracheostomy or tracheal stoma
• Any laryngeal nerve palsy and bilateral carotid artery stenosis

Category II - Co-morbid risk factors

• Contralateral carotid occlusion
• Unstable angina (Canadian Cardiovascular Society class III/IV)
• Congestive Heart Failure (New York Heart Association functional class III/IV) and/or known severe left ventricular dysfunction LVEF<30%
• Requires coronary artery bypass surgery, cardiac valve surgery, major vascular surgery, or abdominal aortic aneurysm repair 31-60 days post carotid stent procedure
• Recent MI (>72 hr and <4 weeks)
• Severe pulmonary disease with FEV1 of <30%
• CAD in ≥2 unrevascularized vessels with stenosis ≥70%
• Age ≥75 years
• Uncontrolled diabetes - Female patient with no child bearing potential or has negative pregnancy test within the previous 7 days and agrees to remain on birth control throughout the study

Exclusion Criteria:

• Total occlusion or near-occlusion of the target vessel
• Severe lesion calcification
• Presence of an alternate source of emboli
• Presence of a filling defect, or angiographically visible thrombus, at target site
• A greater than 50% CCA lesion proximal to the target or a distal (intracranial) lesion more severe than the target lesion
• Evolving, acute or recent stroke within the last 30 days
• Major stroke with a residual neurological deficit that would confound neurologic assessment
• Vertebrobasilar insufficiency symptoms only
• Major operation 30 days before or after the index procedure
• Ipsilateral intracranial stenosis that requires treatment
• Any pre-existing stent in ipsilateral carotid artery, or placement of a stent in contralateral carotid within 30 days of the index procedure
• History of intracranial hemorrhage within 12 months
• Any condition that precludes proper angiographic assessment or prevents femoral arterial access
• Uncontrolled hypertension
• Contraindication to heparin and bivalirudin, aspirin, thienopyridines
• Known sensitivity to radiographic contrast media which cannot be controlled with pre-medication
• History or current indication of bleeding diathesis or coagulopathy
• Chronic renal insufficiency
• Carotid artery dissection or aortic arch anatomical anomalies
• Dementia or a neurological illness
• Patient is enrolled in another drug or device study protocol that has not reached its primary endpoint
• Severe pulmonary hypertension
• Intra-cranial pathology (e.g., tumor, AVM. aneurysm, etc) that would make study participation inappropriate or confound neurologic assessment