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Evaluation of a New Nanotechnology Based Drug-Eluting Stent for Opening of Narrowed Arteries of the Heart

Primary Purpose

Coronary Stenosis

Status
Unknown status
Phase
Not Applicable
Locations
India
Study Type
Interventional
Intervention
drug eluting nonpolymeric nanoporous stent
Sponsored by
All India Institute of Medical Sciences, New Delhi
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Coronary Stenosis focused on measuring coronary stenting, drug eluting stents, paclitaxel, nanoporous

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or non-pregnant female 2: 18 years of age (note: females of child bearing potential must have a negative pregnancy test within 7 days of treatment and must use effective pregnancy avoidance until the 6 month angiogram is completed)
  2. Have chest pain consistent with angina pectoris or a history of documented myocardial infarction or documented silent ischemia
  3. Treatment of a native vessel de novo coronary lesion (only 1 single study lesion/patient)
  4. Target vesseI2.5mm-4.0mm in diameter (visual estimate)
  5. Target lesion length::: 12mm (visual estimate)
  6. Target lesion stenosis> 50% and < 100% (visual estimate)
  7. At least TIMI grade II coronary flow
  8. Acceptable candidate for CABG surgery
  9. Patient is willing to come back for a follow-up evaluations including repeat cardiac catheterization 5-7 months after treatment
  10. Patient must provide written informed consent prior to the index procedure using a form that is approved by the local Ethics Committee

Exclusion Criteria:

  1. Patient has experienced an acute myocardial infarction (Q wave or non-Q wave) within 72 hours prior to the index procedure with CK enzymes 2: 2x the local laboratory upper limit of normal, with the presence of CK- MB levels elevated above the local laboratory upper limit of normal;
  2. Unprotected left main coronary disease with> 50% stenosis;
  3. Significant (> 50%) stenosis proximal or distal to the target lesion that might require revascularization or impede runoff;
  4. Ostial location of the target lesion;
  5. Angiographic evidence of thrombus within the target lesion;
  6. Severely calcified'lesion which cannot be successfully predilated;
  7. Documented L VEF < 25%, or clinically significant congestive cardiac failure;
  8. Totally occluded vessel;
  9. Impaired renal function (creatinine> 0.27mmol/L) at the time of treatment;
  10. Pretreatment with devices other than balloon angioplasty;
  11. Excessive tortuosity proximal to the lesion which makes stent delivery and deployment uncertain;
  12. Target lesion involves a bifurcation including a diseased side branch> 2.5mm in diameter that would require treatment;
  13. Prior stenting within 5mm of the target lesion;
  14. Patient is a recipient of a heart transplant;
  15. Patient has a life expectancy < 12 months;
  16. Known allergies to clopidogrel bisulfate (Plavix@), ticlopidine (Ticlid@), Cobalt Chromium alloy and Paclitaxol that cannot be medically managed;
  17. In the investigator's opinion, any significant medical condition which may interfere with the patient's optimal participation in this study;
  18. Currently participating in an investigational drug or device study that has not completed the primary endpoint;
  19. Intervention of another coronary lesion has occurred within 30 days before or is planned within 30 days after the index procedure.
  20. In the investigator's opinion, the lesion is not suitable for stenting

Sites / Locations

  • All India Institute of Medical SciencesRecruiting

Outcomes

Primary Outcome Measures

In-stent late loss as compared historically to other DES, within the stented segment post-procedure and at 6-9-month follow-up

Secondary Outcome Measures

Major adverse cardiac events
Stent thrombosis rate (acute, subacute, or chornic)

Full Information

First Posted
January 29, 2007
Last Updated
January 29, 2007
Sponsor
All India Institute of Medical Sciences, New Delhi
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1. Study Identification

Unique Protocol Identification Number
NCT00428662
Brief Title
Evaluation of a New Nanotechnology Based Drug-Eluting Stent for Opening of Narrowed Arteries of the Heart
Official Title
Clinical and Angiographic Evaluation of Paclitaxel Eluting, Non-Polymeric, Nanoporous Carbon-Carbon Coated, Cobalt-Chromium Stent
Study Type
Interventional

2. Study Status

Record Verification Date
January 2007
Overall Recruitment Status
Unknown status
Study Start Date
January 2007 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
October 2007 (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
All India Institute of Medical Sciences, New Delhi

4. Oversight

5. Study Description

Brief Summary
Coronary artery disease (CAD) is the largest cause of death and disability in the world. Besides medicines, the principle treatment of this condition requires opening of the narrowed arteries, responsible for angina and other symptoms of the disease, by angioplasty or surgery. Introduction of metal scaffolds called 'stents' in the past few decades revolutionised the angioplasty technique, and has made it the most popular treatment today for CAD. However these stents are prone to becomin narrow and obstructed after implanataion, causing symptoms and non-fatal heart attacks in some patients. Introduction of stents that slowly release drugs locally to minimize this process, called 'drug-eluting stents'(DES)he past few years has been one of the biggest breakthroughs in the field of cardiology. However ven the current available DES are still prone to narrowing in high-risk patients, like those with diabetes, and also have a higher chance for sudden blockage by a blood clot even many years later after insertion. Thus it is important to develop technology for more efficacious and safer DES.This includes safer drugs, better stent design and delivery, and more inert platforms for drug release We hypothesise that a new stent made with nanoporous particle with better polymer for drug release will prove to be safer and more efficacious alternative to currently available DES.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Stenosis
Keywords
coronary stenting, drug eluting stents, paclitaxel, nanoporous

7. Study Design

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

8. Arms, Groups, and Interventions

Intervention Type
Device
Intervention Name(s)
drug eluting nonpolymeric nanoporous stent
Primary Outcome Measure Information:
Title
In-stent late loss as compared historically to other DES, within the stented segment post-procedure and at 6-9-month follow-up
Secondary Outcome Measure Information:
Title
Major adverse cardiac events
Title
Stent thrombosis rate (acute, subacute, or chornic)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or non-pregnant female 2: 18 years of age (note: females of child bearing potential must have a negative pregnancy test within 7 days of treatment and must use effective pregnancy avoidance until the 6 month angiogram is completed) Have chest pain consistent with angina pectoris or a history of documented myocardial infarction or documented silent ischemia Treatment of a native vessel de novo coronary lesion (only 1 single study lesion/patient) Target vesseI2.5mm-4.0mm in diameter (visual estimate) Target lesion length::: 12mm (visual estimate) Target lesion stenosis> 50% and < 100% (visual estimate) At least TIMI grade II coronary flow Acceptable candidate for CABG surgery Patient is willing to come back for a follow-up evaluations including repeat cardiac catheterization 5-7 months after treatment Patient must provide written informed consent prior to the index procedure using a form that is approved by the local Ethics Committee Exclusion Criteria: Patient has experienced an acute myocardial infarction (Q wave or non-Q wave) within 72 hours prior to the index procedure with CK enzymes 2: 2x the local laboratory upper limit of normal, with the presence of CK- MB levels elevated above the local laboratory upper limit of normal; Unprotected left main coronary disease with> 50% stenosis; Significant (> 50%) stenosis proximal or distal to the target lesion that might require revascularization or impede runoff; Ostial location of the target lesion; Angiographic evidence of thrombus within the target lesion; Severely calcified'lesion which cannot be successfully predilated; Documented L VEF < 25%, or clinically significant congestive cardiac failure; Totally occluded vessel; Impaired renal function (creatinine> 0.27mmol/L) at the time of treatment; Pretreatment with devices other than balloon angioplasty; Excessive tortuosity proximal to the lesion which makes stent delivery and deployment uncertain; Target lesion involves a bifurcation including a diseased side branch> 2.5mm in diameter that would require treatment; Prior stenting within 5mm of the target lesion; Patient is a recipient of a heart transplant; Patient has a life expectancy < 12 months; Known allergies to clopidogrel bisulfate (Plavix@), ticlopidine (Ticlid@), Cobalt Chromium alloy and Paclitaxol that cannot be medically managed; In the investigator's opinion, any significant medical condition which may interfere with the patient's optimal participation in this study; Currently participating in an investigational drug or device study that has not completed the primary endpoint; Intervention of another coronary lesion has occurred within 30 days before or is planned within 30 days after the index procedure. In the investigator's opinion, the lesion is not suitable for stenting
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Balram Bhargava, MD, DM
Phone
91-11-26588663
Email
balrambhargava@yahoo.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Balram Bhargava, MD, DM
Organizational Affiliation
All India Institute of Medical Sciences, New Delhi
Official's Role
Principal Investigator
Facility Information:
Facility Name
All India Institute of Medical Sciences
City
New Delhi
State/Province
Delhi
ZIP/Postal Code
110029
Country
India
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Balram Bhargava, MD, DM

12. IPD Sharing Statement

Citations:
PubMed Identifier
12050336
Citation
Morice MC, Serruys PW, Sousa JE, Fajadet J, Ban Hayashi E, Perin M, Colombo A, Schuler G, Barragan P, Guagliumi G, Molnar F, Falotico R; RAVEL Study Group. Randomized Study with the Sirolimus-Coated Bx Velocity Balloon-Expandable Stent in the Treatment of Patients with de Novo Native Coronary Artery Lesions. A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. N Engl J Med. 2002 Jun 6;346(23):1773-80. doi: 10.1056/NEJMoa012843.
Results Reference
background
PubMed Identifier
14724301
Citation
Stone GW, Ellis SG, Cox DA, Hermiller J, O'Shaughnessy C, Mann JT, Turco M, Caputo R, Bergin P, Greenberg J, Popma JJ, Russell ME; TAXUS-IV Investigators. A polymer-based, paclitaxel-eluting stent in patients with coronary artery disease. N Engl J Med. 2004 Jan 15;350(3):221-31. doi: 10.1056/NEJMoa032441.
Results Reference
background
PubMed Identifier
16575925
Citation
Bhargava B, Reddy NK, Karthikeyan G, Raju R, Mishra S, Singh S, Waksman R, Virmani R, Somaraju B. A novel paclitaxel-eluting porous carbon-carbon nanoparticle coated, nonpolymeric cobalt-chromium stent: evaluation in a porcine model. Catheter Cardiovasc Interv. 2006 May;67(5):698-702. doi: 10.1002/ccd.20698.
Results Reference
background
PubMed Identifier
8840862
Citation
van der Giessen WJ, Lincoff AM, Schwartz RS, van Beusekom HM, Serruys PW, Holmes DR Jr, Ellis SG, Topol EJ. Marked inflammatory sequelae to implantation of biodegradable and nonbiodegradable polymers in porcine coronary arteries. Circulation. 1996 Oct 1;94(7):1690-7. doi: 10.1161/01.cir.94.7.1690.
Results Reference
background

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Evaluation of a New Nanotechnology Based Drug-Eluting Stent for Opening of Narrowed Arteries of the Heart

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