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Boston Scientific Embolic Protection, Inc. (EPI): A Carotid Stenting Trial for High-Risk Surgical Patients (BEACH) (BEACH)

Primary Purpose

Carotid Artery Diseases, Stroke, Cerebral Arteriosclerosis

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
WALLSTENT® Endoprosthesis™
Sponsored by
Boston Scientific Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Carotid Artery Diseases focused on measuring Carotid, Carotid Artery Stenting, Stent, Carotid Endarterectomy, Stroke, Transient Ischemic Attack, Stenosis, Atherosclerotic Disease

Eligibility Criteria

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

Key General Inclusion Criteria: Patient must meet criteria for either A or B: A. Symptomatic: Carotid stenosis of greater than or equal to 50% via angiography with associated cerebral or retinal TIA or ischemic stroke symptoms within 180 days of the procedure, which are determined to have occurred in the cerebral hemisphere or eye ipsilateral to the target carotid artery lesion and to be reasonably attributable to that lesion; or B. Asymptomatic: Carotid stenosis greater than or equal to 80% via angiography without associated cerebral or retinal TIA or ischemic stroke symptoms within 180 days of the procedure. Target lesion is in the native common carotid artery (CCA), internal carotid artery (ICA), or carotid bifurcation. Target arterial segment to be stented has a diameter of greater than or equal to 4.0 mm to less than or equal to 9.0 mm. Vessel diameter distal to the target lesion is greater than or equal to 3.5 mm and less than or equal to 5.5 mm as an optimal "landing zone" for placement of the FilterWire EZ System with visual angiographic recommendations as described in the instructions for use (IFU). Key High-Risk Eligibility Inclusion Criteria: Patients must qualify in at least one high-risk category. The high-risk categories are defined as: Anatomical conditions [one (1) criterion qualifies] Co-morbid conditions Class I [one (1) criterion qualifies] Co-morbid conditions Class II [two (2) criteria qualify] Exclusion Criteria: Patient has experienced an evolving, acute, or recent stroke within 21 days of study evaluation. A total occlusion of the ipsilateral carotid artery. (Only for Roll-In and Pivotal patients.) A total occlusion of the contralateral carotid artery. (Only for Bilateral Registry patients.) Pre-existing stent(s): Roll-In and Pivotal Patients: located within the ipsilateral carotid distribution; a stent was placed in a contralateral vessel within the previous 30 days of the study enrollment. Bilateral Registry Patients: located within the carotid distribution. A target lesion which is expected to require more than one stent. Known cardiac sources of emboli of a type likely to be associated with cerebral ischemic events [e.g. endocarditis, intracardiac thrombus, embolic-associated cardiovascular lesions, or any current arrhythmia (e.g. atrial fibrillation, atrial flutter, etc.)]. Myocardial infarction (MI) within 72 hours prior to the index procedure, defined as creatine kinase (CK)-MB > 2 X the local laboratory's upper limit of normal (ULN). Any surgery requiring general anesthesia (e.g. coronary artery bypass graft [CABG], valve replacement, or abdominal aortic aneurysm) less than or equal to 30 days preceding the stent procedure. The patient is enrolled in another investigational study protocol and has not completed the required follow-up period of the evaluation. The patient may not participate in another investigational study that may confound the treatment or outcomes of the BEACH protocol.

Sites / Locations

  • Bapatist Medical Center
  • University of Alabama at Birmingham
  • Arizona Heart Institute
  • St. Joseph's Hospital & Medical Center
  • El Camino Hospital
  • Hoag Memorial Hospital
  • St. Joseph's Medical Center
  • Washington Hospital Center
  • Holy Cross Hospital
  • Lakeland Regional Medical Center
  • University of Miami School of Medicine - Jackson Memorial Hospital
  • Miami Cardiac and Vascular Institute
  • Northwest Medical Center
  • Piedmont Hospital
  • St. Joseph's Hospital of Atlanta/American Cardiovascular Research Institute
  • Rush Presbyterian-St. Luke's Medical Center
  • St. Francis Medical Center
  • St. John's Hospital - Prairie Heart Institute
  • Central Baptist Hospital
  • Ochsner Clinic Foundation
  • Massachusetts General Hospital
  • Cape Cod Hospital
  • Wayne State University- Detroit Medical Center
  • William Beaumont Hospital
  • St. Luke's Hospital of Kansas City
  • Montefiore Medical Center
  • Kaleida Health/Millard Fillmore Hospital
  • Lenox Hill Heart and Vascular Institute
  • New York Presbyterian Hospital/Columbia Vascular Interventional Radiology
  • Strong Memorial Hospital
  • St. Francis Hospital
  • Duke University Medical Center
  • Cleveland Clinic & Foundation
  • Riverside Methodist Hospital
  • Medical College of Ohio
  • Oregon Health Sciences University
  • Hahnemann University/ Tenet Healthcare Corporation
  • UPMC-Shadyside Hospital Pittsburgh Vascular Institute
  • Pinnacle Health at Harrisburg Hospital
  • Providence Hospital South Carolina Heart Center
  • Baptist Hospital of East Tennessee
  • Skyline Medical Center/ Howell Allen Clinic
  • St. Luke's Episcopal Hospital Texas Heart Institute
  • University of Texas-Houston Medical School
  • Texas Tech University Health Sciences Center
  • Baptist Hospital
  • LDS Hospital
  • St. Mary's Hospital
  • Deaconess Medical Center
  • Aurora St. Luke's Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Arm 1

Arm Description

Outcomes

Primary Outcome Measures

The primary endpoint is one-year morbidity and mortality, defined as the cumulative incidence of any non Q-wave myocardial infarction within the 24 hours following carotid stenting
peri-procedural (within 30 days of procedure) death, stroke, Q-wave myocardial infarction
late ipsilateral stroke or death due to neurologic events from 31 days up to and including twelve-month follow-up.

Secondary Outcome Measures

Peri-procedural morbidity and mortality
FilterWire EX and EZ System technical success
Carotid Wallstent technical success
system technical success
angiographic success
procedural success
30-day clinical success
peri-procedural overall morbidity
one-year clinical success
late stroke, transient ischemic attack (TIA) and death.

Full Information

First Posted
April 18, 2006
Last Updated
August 26, 2014
Sponsor
Boston Scientific Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT00316108
Brief Title
Boston Scientific Embolic Protection, Inc. (EPI): A Carotid Stenting Trial for High-Risk Surgical Patients (BEACH)
Acronym
BEACH
Official Title
Boston Scientific EPI: A Carotid Stenting Trial for High-Risk Surgical Patients
Study Type
Interventional

2. Study Status

Record Verification Date
August 2014
Overall Recruitment Status
Completed
Study Start Date
February 2002 (undefined)
Primary Completion Date
May 2005 (Actual)
Study Completion Date
November 2007 (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
The purpose of this study is to determine whether morbidity and mortality for high-risk surgical patients treated with the Carotid Wallstent in conjunction with the FilterWire EX and EZ System distal protection device will be less than or equal to that of objective performance criteria (OPC) derived from historic controls undergoing surgical intervention with a carotid endarterectomy (CEA).
Detailed Description
Stroke is the third leading cause of death in this country with approximately 600,000 new stroke cases each year. Mortality rates as high as 40 percent have been reported for stroke as a result of ischemia associated with the carotid distribution. Currently, the primary therapy for carotid artery occlusive disease is carotid endarterectomy (CEA) or the surgical removal of atheromatous material from inside the artery. Although CEA is an effective treatment for the majority of patients with carotid occlusive disease, there remains a need for a treatment option for those patients with significant surgical risk factors. These patients have been shown to have much higher rates of morbidity and mortality. There are approximately 50,000-70,000 patients each year who are considered poor surgical candidates. These patients present with either one or more anatomical or co-morbid conditions and have a one-year stroke and death rate of up to 15% with traditional surgical treatment. Carotid artery stenting (CAS) has been reported by numerous single-center trials to be feasible in the treatment of carotid artery stenosis. Moreover, the risk benefit ratio has been suggested to be the largest in those patients with a higher risk profile for the CEA treatment option. This trial will study the effects of percutaneous intervention using the Monorail™ Carotid Wallstent® Endoprosthesis (Carotid Wallstent) in conjunction with the FilterWire System distal protection device (FilterWire EX and EZ) on rates of common peri-procedural complications as well as on long-term outcomes as compared to historical outcomes of patients undergoing CEA.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Carotid Artery Diseases, Stroke, Cerebral Arteriosclerosis
Keywords
Carotid, Carotid Artery Stenting, Stent, Carotid Endarterectomy, Stroke, Transient Ischemic Attack, Stenosis, Atherosclerotic Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
747 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm 1
Arm Type
Experimental
Intervention Type
Device
Intervention Name(s)
WALLSTENT® Endoprosthesis™
Intervention Description
Carotid Artery Stent
Primary Outcome Measure Information:
Title
The primary endpoint is one-year morbidity and mortality, defined as the cumulative incidence of any non Q-wave myocardial infarction within the 24 hours following carotid stenting
Time Frame
1 year
Title
peri-procedural (within 30 days of procedure) death, stroke, Q-wave myocardial infarction
Time Frame
Within 30 days of Procedure
Title
late ipsilateral stroke or death due to neurologic events from 31 days up to and including twelve-month follow-up.
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Peri-procedural morbidity and mortality
Time Frame
Within 30 Days of procedure
Title
FilterWire EX and EZ System technical success
Time Frame
Post procedure
Title
Carotid Wallstent technical success
Time Frame
Post Procedure
Title
system technical success
Time Frame
Post Procedure
Title
angiographic success
Time Frame
Post Procedure
Title
procedural success
Time Frame
Post Procedure
Title
30-day clinical success
Time Frame
30 days post procedure
Title
peri-procedural overall morbidity
Time Frame
30 days post procedure
Title
one-year clinical success
Time Frame
1 Year post procedure
Title
late stroke, transient ischemic attack (TIA) and death.
Time Frame
1 year post procedure

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Key General Inclusion Criteria: Patient must meet criteria for either A or B: A. Symptomatic: Carotid stenosis of greater than or equal to 50% via angiography with associated cerebral or retinal TIA or ischemic stroke symptoms within 180 days of the procedure, which are determined to have occurred in the cerebral hemisphere or eye ipsilateral to the target carotid artery lesion and to be reasonably attributable to that lesion; or B. Asymptomatic: Carotid stenosis greater than or equal to 80% via angiography without associated cerebral or retinal TIA or ischemic stroke symptoms within 180 days of the procedure. Target lesion is in the native common carotid artery (CCA), internal carotid artery (ICA), or carotid bifurcation. Target arterial segment to be stented has a diameter of greater than or equal to 4.0 mm to less than or equal to 9.0 mm. Vessel diameter distal to the target lesion is greater than or equal to 3.5 mm and less than or equal to 5.5 mm as an optimal "landing zone" for placement of the FilterWire EZ System with visual angiographic recommendations as described in the instructions for use (IFU). Key High-Risk Eligibility Inclusion Criteria: Patients must qualify in at least one high-risk category. The high-risk categories are defined as: Anatomical conditions [one (1) criterion qualifies] Co-morbid conditions Class I [one (1) criterion qualifies] Co-morbid conditions Class II [two (2) criteria qualify] Exclusion Criteria: Patient has experienced an evolving, acute, or recent stroke within 21 days of study evaluation. A total occlusion of the ipsilateral carotid artery. (Only for Roll-In and Pivotal patients.) A total occlusion of the contralateral carotid artery. (Only for Bilateral Registry patients.) Pre-existing stent(s): Roll-In and Pivotal Patients: located within the ipsilateral carotid distribution; a stent was placed in a contralateral vessel within the previous 30 days of the study enrollment. Bilateral Registry Patients: located within the carotid distribution. A target lesion which is expected to require more than one stent. Known cardiac sources of emboli of a type likely to be associated with cerebral ischemic events [e.g. endocarditis, intracardiac thrombus, embolic-associated cardiovascular lesions, or any current arrhythmia (e.g. atrial fibrillation, atrial flutter, etc.)]. Myocardial infarction (MI) within 72 hours prior to the index procedure, defined as creatine kinase (CK)-MB > 2 X the local laboratory's upper limit of normal (ULN). Any surgery requiring general anesthesia (e.g. coronary artery bypass graft [CABG], valve replacement, or abdominal aortic aneurysm) less than or equal to 30 days preceding the stent procedure. The patient is enrolled in another investigational study protocol and has not completed the required follow-up period of the evaluation. The patient may not participate in another investigational study that may confound the treatment or outcomes of the BEACH protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Christopher White, MD
Organizational Affiliation
Ochsner Health System
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Sriram Iyer, MD
Organizational Affiliation
Lenox Hill Heart and Vascular Institute
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Pamela G Grady, Ph.D
Organizational Affiliation
Boston Scientific Corporation
Official's Role
Study Director
Facility Information:
Facility Name
Bapatist Medical Center
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35211
Country
United States
Facility Name
University of Alabama at Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States
Facility Name
Arizona Heart Institute
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85006
Country
United States
Facility Name
St. Joseph's Hospital & Medical Center
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85013
Country
United States
Facility Name
El Camino Hospital
City
Mountain View
State/Province
California
ZIP/Postal Code
94040
Country
United States
Facility Name
Hoag Memorial Hospital
City
Newport Beach
State/Province
California
ZIP/Postal Code
92658
Country
United States
Facility Name
St. Joseph's Medical Center
City
Stockton
State/Province
California
ZIP/Postal Code
95204
Country
United States
Facility Name
Washington Hospital Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20010
Country
United States
Facility Name
Holy Cross Hospital
City
Ft. Lauderdale
State/Province
Florida
ZIP/Postal Code
33308
Country
United States
Facility Name
Lakeland Regional Medical Center
City
Lakeland
State/Province
Florida
ZIP/Postal Code
33805
Country
United States
Facility Name
University of Miami School of Medicine - Jackson Memorial Hospital
City
Miami
State/Province
Florida
ZIP/Postal Code
33101
Country
United States
Facility Name
Miami Cardiac and Vascular Institute
City
Miami
State/Province
Florida
ZIP/Postal Code
33176
Country
United States
Facility Name
Northwest Medical Center
City
Plantation
State/Province
Florida
ZIP/Postal Code
33324
Country
United States
Facility Name
Piedmont Hospital
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30309
Country
United States
Facility Name
St. Joseph's Hospital of Atlanta/American Cardiovascular Research Institute
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30342
Country
United States
Facility Name
Rush Presbyterian-St. Luke's Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
St. Francis Medical Center
City
Peoria
State/Province
Illinois
ZIP/Postal Code
61637
Country
United States
Facility Name
St. John's Hospital - Prairie Heart Institute
City
Springfield
State/Province
Illinois
ZIP/Postal Code
62701
Country
United States
Facility Name
Central Baptist Hospital
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40504
Country
United States
Facility Name
Ochsner Clinic Foundation
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70121
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Cape Cod Hospital
City
Hyannis
State/Province
Massachusetts
ZIP/Postal Code
02601
Country
United States
Facility Name
Wayne State University- Detroit Medical Center
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48034
Country
United States
Facility Name
William Beaumont Hospital
City
Royal Oak
State/Province
Michigan
ZIP/Postal Code
48073
Country
United States
Facility Name
St. Luke's Hospital of Kansas City
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64111
Country
United States
Facility Name
Montefiore Medical Center
City
Bronx
State/Province
New York
ZIP/Postal Code
10467
Country
United States
Facility Name
Kaleida Health/Millard Fillmore Hospital
City
Buffalo
State/Province
New York
ZIP/Postal Code
14209
Country
United States
Facility Name
Lenox Hill Heart and Vascular Institute
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
New York Presbyterian Hospital/Columbia Vascular Interventional Radiology
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Strong Memorial Hospital
City
Rochester
State/Province
New York
ZIP/Postal Code
14603
Country
United States
Facility Name
St. Francis Hospital
City
Roslyn
State/Province
New York
ZIP/Postal Code
11576
Country
United States
Facility Name
Duke University Medical Center
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Cleveland Clinic & Foundation
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Riverside Methodist Hospital
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43202
Country
United States
Facility Name
Medical College of Ohio
City
Toledo
State/Province
Ohio
ZIP/Postal Code
43614
Country
United States
Facility Name
Oregon Health Sciences University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97201
Country
United States
Facility Name
Hahnemann University/ Tenet Healthcare Corporation
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19102
Country
United States
Facility Name
UPMC-Shadyside Hospital Pittsburgh Vascular Institute
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15232
Country
United States
Facility Name
Pinnacle Health at Harrisburg Hospital
City
Wormleysburg
State/Province
Pennsylvania
ZIP/Postal Code
17101
Country
United States
Facility Name
Providence Hospital South Carolina Heart Center
City
Columbia
State/Province
South Carolina
ZIP/Postal Code
29204
Country
United States
Facility Name
Baptist Hospital of East Tennessee
City
Knoxville
State/Province
Tennessee
ZIP/Postal Code
37920
Country
United States
Facility Name
Skyline Medical Center/ Howell Allen Clinic
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37207
Country
United States
Facility Name
St. Luke's Episcopal Hospital Texas Heart Institute
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
University of Texas-Houston Medical School
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Texas Tech University Health Sciences Center
City
Lubbock
State/Province
Texas
ZIP/Postal Code
79430
Country
United States
Facility Name
Baptist Hospital
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78201
Country
United States
Facility Name
LDS Hospital
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84143
Country
United States
Facility Name
St. Mary's Hospital
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23226
Country
United States
Facility Name
Deaconess Medical Center
City
Spokane
State/Province
Washington
ZIP/Postal Code
99204
Country
United States
Facility Name
Aurora St. Luke's Medical Center
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53215
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
18222352
Citation
Iyer SS, White CJ, Hopkins LN, Katzen BT, Safian R, Wholey MH, Gray WA, Ciocca R, Bachinsky WB, Ansel G, Joye JD, Russell ME; BEACH Investigators. Carotid artery revascularization in high-surgical-risk patients using the Carotid WALLSTENT and FilterWire EX/EZ: 1-year outcomes in the BEACH Pivotal Group. J Am Coll Cardiol. 2008 Jan 29;51(4):427-34. doi: 10.1016/j.jacc.2007.09.045.
Results Reference
derived

Learn more about this trial

Boston Scientific Embolic Protection, Inc. (EPI): A Carotid Stenting Trial for High-Risk Surgical Patients (BEACH)

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