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Optical Coherence Tomography Comparison of Neointimal Coverage Between CRE8 DES and BMS (DEMONSTRATE)

Primary Purpose

Stable Angina, Unstable Angina, NSTEMI

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Amphilimus Eluting Stent
Bare Metal Stent
Sponsored by
CID - Carbostent & Implantable Devices
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Stable Angina focused on measuring Coronary artery disease, Optical Coherence Tomography, Tissue coverage, DES

Eligibility Criteria

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

Inclusion Criteria:

  • Age > 18 years;
  • Patients with symptoms of stable or unstable angina and/or presence of a positive functional test for ischemia;
  • Patient is eligible for percutaneous coronary intervention (PCI) and is an acceptable candidate for surgical revascularization (CABG);
  • Left ventricular ejection fraction > 30%;
  • Patients presenting with at least two vessels disease requiring a staged procedure within 3 months, according to the operator judgement;
  • Target de-novo lesion;
  • Target lesion located in a target vessel with a diameter ranging from 2.5 to 3.75 mm;
  • Target lesion diameter stenosis > 50% and < 100% by visual estimate, with a TIMI flow of >=1;
  • Discrete lesion with a length ranging from 13 to 25 mm;
  • The target lesion must be appropriately covered (margin of 2.5 mm on both sides of the stent) by one study stent (Cre8 or Vision/Multilink 8), according to the randomization arm;
  • Patient has been informed of the nature of the study and agrees to its provisions and has provided written informed consent as approved by the Ethical Committee of the respective clinical site.

Exclusion Criteria:

  • Female with childbearing potential or lactating;
  • Patient presenting with acute myocardial infarction with ST elevation;
  • Known allergies to antiplatelets, anticoagulants, contrast media, sirolimus or cobalt chromium;
  • Cerebrovascular accident within the past 6 months;
  • Acute or chronic renal dysfunction (defined as creatinine greater than 2.0 mg/dl);
  • Thrombocytopenia (platelet count less than 100,000/mm³);
  • Known bleeding or hypercoagulable disorder;
  • Currently under immunosuppressant therapy;
  • Co-morbidities that could interfere with completion of study procedures, or life expectancy less than 1 year;
  • Participating in another investigational drug or device trial that has not completed the primary endpoint or would interfere with the endpoints of this study;
  • Patient underwent target vessel revascularization with a DES;
  • Heavily calcified vessel and/or lesion which cannot be successfully predilated or imaged by OCT
  • Target lesion is located or supplied by an arterial or venous bypass graft;
  • Lesion located very distally, difficult to be imaged by OCT;
  • Lesion located in angulated (>70°), sharp take-off vessel;
  • Target lesion involving a bifurcation with a side branch ≥2.0 mm in diameter;
  • Target lesion located in the left main stem;
  • Ostial lesion location;
  • Target lesion has TIMI 0 flow;
  • Target vessel with angiographically visible thrombus or unsuitable for proper stent delivery and deployment.

Sites / Locations

  • Azienda Ospedaliero - Universitaria S.Anna
  • Policlinico Universitario "Agostino Gemelli"
  • Azienda Ospedaliera S. Giovanni - Addolorata
  • Presidio Ospedaliero Umberto I - Azienda Ospedaliera "Ordine Mauriziano di Torino"
  • ULSS n°3 - Ospedale Civile
  • University Medical Centre Utrecht

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

CRE8 arm

Vision/Multilik8 arm

Arm Description

Outcomes

Primary Outcome Measures

Ratio of Uncovered to Total Stent Struts Per Cross Section (RUTTS) score of ≤ 0.3, determined by OCT
1 month for the BMS arm; 3 months for the DES arm

Secondary Outcome Measures

Percentage of malapposed stent struts
Percentage of malapposed and uncovered stent struts
Neointimal growth and neointimal thickness
Angiographic in-stent and in-segment endpoints
reference vessel diameter; minimal lumen diameter; % diameter stenosis; binary restenosis; late lumen loss
Clinical composite endpoints
Cardiac death/Target vessel MI/Clinically indicated TLR All death/All MI/All TVR (including TLR)
Stent Thrombosis

Full Information

First Posted
February 20, 2012
Last Updated
April 27, 2018
Sponsor
CID - Carbostent & Implantable Devices
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1. Study Identification

Unique Protocol Identification Number
NCT01543373
Brief Title
Optical Coherence Tomography Comparison of Neointimal Coverage Between CRE8 DES and BMS
Acronym
DEMONSTRATE
Official Title
Randomized Comparison Between a DES and a BMS to Assess Neointimal Coverage by OCT Evaluation
Study Type
Interventional

2. Study Status

Record Verification Date
April 2018
Overall Recruitment Status
Completed
Study Start Date
January 2012 (Actual)
Primary Completion Date
August 2013 (Actual)
Study Completion Date
April 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CID - Carbostent & Implantable Devices

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of the study is to demonstrate the non-inferiority of Cre8 (CID) Drug Eluting Stent, studied 3 months after implant, compared to Vision/Multilink8 Bare Metal Stent (Abbott) studied at 1 month, in terms of neointimal coverage, determined by Optical Coherence Tomography (OCT), as percentage of cross-sections with RUTTS (Ratio of Uncovered to Total Stent Struts Per Cross Section) score ≤ 0.3.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stable Angina, Unstable Angina, NSTEMI
Keywords
Coronary artery disease, Optical Coherence Tomography, Tissue coverage, DES

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
38 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CRE8 arm
Arm Type
Experimental
Arm Title
Vision/Multilik8 arm
Arm Type
Active Comparator
Intervention Type
Device
Intervention Name(s)
Amphilimus Eluting Stent
Intervention Description
Sirolimus formulated coronary eluting stent
Intervention Type
Device
Intervention Name(s)
Bare Metal Stent
Intervention Description
Bare metal coronary stent
Primary Outcome Measure Information:
Title
Ratio of Uncovered to Total Stent Struts Per Cross Section (RUTTS) score of ≤ 0.3, determined by OCT
Description
1 month for the BMS arm; 3 months for the DES arm
Time Frame
within 3 months from index procedure
Secondary Outcome Measure Information:
Title
Percentage of malapposed stent struts
Time Frame
Immediately post index procedure, 1 month (BMS arm) / 3 months (DES arm)
Title
Percentage of malapposed and uncovered stent struts
Time Frame
1 month (BMS arm) / 3 months (DES arm)
Title
Neointimal growth and neointimal thickness
Time Frame
1 month (BMS arm) / 3 months (DES arm)
Title
Angiographic in-stent and in-segment endpoints
Description
reference vessel diameter; minimal lumen diameter; % diameter stenosis; binary restenosis; late lumen loss
Time Frame
immediately pre and post index procedure, 1 month (BMS arm) / 3 months (DES arm)
Title
Clinical composite endpoints
Description
Cardiac death/Target vessel MI/Clinically indicated TLR All death/All MI/All TVR (including TLR)
Time Frame
At 1, 3 and 12 months
Title
Stent Thrombosis
Time Frame
during index procedure, immediately after index procedure, 1 month, 3 months, 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age > 18 years; Patients with symptoms of stable or unstable angina and/or presence of a positive functional test for ischemia; Patient is eligible for percutaneous coronary intervention (PCI) and is an acceptable candidate for surgical revascularization (CABG); Left ventricular ejection fraction > 30%; Patients presenting with at least two vessels disease requiring a staged procedure within 3 months, according to the operator judgement; Target de-novo lesion; Target lesion located in a target vessel with a diameter ranging from 2.5 to 3.75 mm; Target lesion diameter stenosis > 50% and < 100% by visual estimate, with a TIMI flow of >=1; Discrete lesion with a length ranging from 13 to 25 mm; The target lesion must be appropriately covered (margin of 2.5 mm on both sides of the stent) by one study stent (Cre8 or Vision/Multilink 8), according to the randomization arm; Patient has been informed of the nature of the study and agrees to its provisions and has provided written informed consent as approved by the Ethical Committee of the respective clinical site. Exclusion Criteria: Female with childbearing potential or lactating; Patient presenting with acute myocardial infarction with ST elevation; Known allergies to antiplatelets, anticoagulants, contrast media, sirolimus or cobalt chromium; Cerebrovascular accident within the past 6 months; Acute or chronic renal dysfunction (defined as creatinine greater than 2.0 mg/dl); Thrombocytopenia (platelet count less than 100,000/mm³); Known bleeding or hypercoagulable disorder; Currently under immunosuppressant therapy; Co-morbidities that could interfere with completion of study procedures, or life expectancy less than 1 year; Participating in another investigational drug or device trial that has not completed the primary endpoint or would interfere with the endpoints of this study; Patient underwent target vessel revascularization with a DES; Heavily calcified vessel and/or lesion which cannot be successfully predilated or imaged by OCT Target lesion is located or supplied by an arterial or venous bypass graft; Lesion located very distally, difficult to be imaged by OCT; Lesion located in angulated (>70°), sharp take-off vessel; Target lesion involving a bifurcation with a side branch ≥2.0 mm in diameter; Target lesion located in the left main stem; Ostial lesion location; Target lesion has TIMI 0 flow; Target vessel with angiographically visible thrombus or unsuitable for proper stent delivery and deployment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Francesco Prati, MD
Organizational Affiliation
Ospedale S. Giovanni - Addolorata
Official's Role
Principal Investigator
Facility Information:
Facility Name
Azienda Ospedaliero - Universitaria S.Anna
City
Ferrara
State/Province
FE
ZIP/Postal Code
44121
Country
Italy
Facility Name
Policlinico Universitario "Agostino Gemelli"
City
Roma
State/Province
RM
ZIP/Postal Code
00168
Country
Italy
Facility Name
Azienda Ospedaliera S. Giovanni - Addolorata
City
Roma
State/Province
RM
ZIP/Postal Code
00184
Country
Italy
Facility Name
Presidio Ospedaliero Umberto I - Azienda Ospedaliera "Ordine Mauriziano di Torino"
City
Torino
State/Province
TO
ZIP/Postal Code
10128
Country
Italy
Facility Name
ULSS n°3 - Ospedale Civile
City
Bassano del Grappa
State/Province
VI
ZIP/Postal Code
36061
Country
Italy
Facility Name
University Medical Centre Utrecht
City
Utrecht
Country
Netherlands

12. IPD Sharing Statement

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Optical Coherence Tomography Comparison of Neointimal Coverage Between CRE8 DES and BMS

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