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Safety and Efficacy Study of Kaname Coronary Stent System for the Treatment of Patients With Coronary Artery Disease (KARE)

Primary Purpose

Coronary Artery Disease, Angioplasty, Transluminal, Percutaneous Coronary

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
implantation of Kaname Cobalt-Chromium coronary stent
Sponsored by
Terumo Europe N.V.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Coronary Artery Disease focused on measuring stents, bare metal stents

Eligibility Criteria

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

Inclusion Criteria:

  • Patient is ≥ 18 years old.
  • Patient is eligible for PCI and acceptable candidate for CABG.
  • Clinical evidence of ischemic heart disease and/or a positive functional study. Documented stable angina pectoris (CCS 1, 2, 3 or 4) or unstable angina pectoris with documented ischemia (Braunwald Class IB-C, IIB-C, or IIIB-C), or documented silent ischemia.
  • The target lesion or target vessel meets all the following criteria;a) is a single de novo lesion or restenotic post-PTCA (non-stented) lesion in one native coronary artery.b)The stenosis of target lesion is ≥ 50% and < 100% c)The target lesion length must be ≤ 25 mm d)The target reference vessel diameter must be suitable for treatment with stents between 2.5 and 4.0 mm long
  • Patient has been informed of the nature of the study, understands the study requirements and agrees to its provisions and has provided written informed consent as approved by the Institutional Review Board/Ethics Committee of the respective clinical site.
  • The patient is able to comply with all specified follow-up evaluations.

Exclusion Criteria:

  • Most recent LVEF of the patient is < 25%.
  • Known allergies to the following: aspirin, Clopidogrel bisulfate, Prasugrel or Ticlopidine, heparin, cobalt, chromium, nickel, or contrast agent (that cannot be adequately premedicated).
  • A platelet count <100,000 cells/mm3 or >700,000 cells/mm3.
  • WBC count < 3500 cells/mm3.
  • Evidence of MI with positive Troponin within 72 hours of the intended treatment.
  • Previous PCI (<30 days) anywhere within the target vessel.
  • Planned interventional treatment of any non-target vessel <30 days post-procedure will be required. Planned intervention on the target vessel or on a significant lesion of > 50% stenosis anywhere within the target vessel after the index procedure will be required.
  • The target lesion requires treatment with a device other than PTCA balloon prior to stent placement. (e.g. but not limited to directional coronary atherectomy, excimer laser, rotational atherectomy, etc.).
  • Previous stenting anywhere within the target vessel.
  • Target vessel has evidence of thrombus.
  • Excessive tortuousity (> 60°) of the target vessel proximal to the target lesion (visual estimate).
  • Either of the following characteristics in the target lesion (visual estimate): a)Ostial target lesion or bifurcation lesion b)Target lesion involves a side branch > 2mm in diameter c) Target lesion has excessive tortuousity (> 45°)d)Moderate to severely calcified lesion which can not be successfully predilated e)Target lesion is located in or supplied by an arterial or venous bypass graft f)Significant (> 40%) stenosis proximal or distal to the target lesion. g) A complete occlusion (TIMI flow 0 or 1).
  • Target lesion located in left main trunk.
  • Stroke or transient ischemic attack < prior 180 days.
  • Active peptic ulcer or upper GI bleeding < prior 180 days.
  • The patient has bleeding hemorrhagic diathesis or coagulopathy. The patient will refuse a blood transfusion.
  • The patient has a widespread peripheral vascular disease.
  • Acute or chronic renal dysfunction (creatinine > 2.0 mg/dl).
  • The patient requires multiple stent implantations for a tandem lesion.
  • Life expectancy < 1 year.
  • Patient is currently participating in an investigational drug or device study that has not completed the primary endpoint or that clinically interferes with the current study endpoints. Note: Trials requiring extended follow-up for products that were investigational, but have become commercially available since then, are not considered investigational trials.
  • In the investigators opinion patient has a 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.
  • Patient is in cardiogenic shock.
  • Female of child-bearing potential.

Sites / Locations

  • Hopital Cardiovasculaire et Pneumologie Louis Pradel
  • CHU NORD
  • Clinique les Franciscaines
  • Hopital d'Instructions des Armées du Val de Grace
  • CHU Rangeuil
  • Klinikum Fulda gAG
  • Klinikum Ludwigshafen
  • Klinikum des Johannes Gutenberg Universität
  • Ospedale Careggi
  • Policlinico Milano
  • Ospedale Civico Palermo
  • Clinical Centre of serbia
  • Clinical Hospital Center Zemun
  • Institute for Cardiovascular Disease Dedinje
  • Hospital Clinico San Carlos
  • Hospital La Paz
  • Hospital Meixoeiro

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Kaname

Arm Description

patients that are treated by implanting Kaname Cobalt-Chromium coronary stent

Outcomes

Primary Outcome Measures

Freedom from Target vessel failure TVF
Freedom from Target vessel failure TVF defined as composite of clinically driven target vessel revascularization (TVR)myocardial infarction or cardiac death that could not be clearly attributed to a vessel other than the target vessel.

Secondary Outcome Measures

Freedom from TVF for patients treated with ≥ 3 mm stents.
Freedom from Target Vessel Failure (composite of clinically driven TVR, myocardial infarction or cardiac death that could not be clearly attributed to a vessel other than the target vessel) for patients treated with ≥ 3 mm stents.
Freedom from TVF for patients treated with 2.5 and 2.75 mm stents
Freedom from Target Vessel Failure (composite of clinically driven TVR, myocardial infarction or cardiac death that could not be clearly attributed to a vessel other than the target vessel) for patients treated with 2.5 and 2.75 mm stents
Freedom from TVF
Freedom from Target Vessel Failure (composite of clinically driven TVR, myocardial infarction or cardiac death that could not be clearly attributed to a vessel other than the target vessel)
Clinically driven target lesion revascularization (TLR) free rate .
Clinically driven target lesion revascularization (TLR) free rate
Clinically driven target vessel revascularization (TVR) free rate.
Clinically driven target vessel revascularization (TVR) free rate.
Device success
Device success defined as achievement of a residual diameter stenosis of < 50% by QCA or < 30% by visual estimate, using the assigned device only.
Lesion success
Lesion success defined as the attainment of residual diameter stenosis of < 50% by QCA or < 30% by visual estimate, using any percutaneous method.
Procedure success
Procedure success defined as achievement of a final diameter stenosis of < 50% by QCA or < 30% by visual estimate, using any percutaneous method, without MACE (composite of cardiac death, MI and TLR) .
Angiographic in-stent acute gain
Angiographic in-stent acute gain at the end of the procedure
Angiographic in-stent and in-segment binary restenosis rate (≥ 50%) diameter stenosis
Angiographic in-stent and in-segment binary restenosis rate (≥ 50%) diameter stenosis
Angiographic in-stent, in-segment, proximal, and distal minimum lumen diameter (MLD)
Angiographic in-stent, in-segment, proximal, and distal minimum lumen diameter (MLD)
In-stent late-loss
In-stent late-loss (as measured by QCA) defined as the difference between the post-procedure minimal lumen diameter (MLD) and the follow-up MLD.
% Diameter Stenosis, in-stent and in-segment .
% Diameter Stenosis, in-stent and in-segment.
Neointimal hyperplasia volume as measured by intravascular ultrasound.
Neointimal hyperplasia volume as measured by intravascular ultrasound at 6 months post-procedure
Major adverse cardiac events (MACEs) rate .
Major adverse cardiac events (MACEs: composite of cardiac death,, myocardial infarction and TLR) rate.
Serious adverse event rate .
Serious adverse event rate.
Device failure .
Any device failure

Full Information

First Posted
October 29, 2009
Last Updated
October 6, 2019
Sponsor
Terumo Europe N.V.
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1. Study Identification

Unique Protocol Identification Number
NCT01004575
Brief Title
Safety and Efficacy Study of Kaname Coronary Stent System for the Treatment of Patients With Coronary Artery Disease
Acronym
KARE
Official Title
Clinical Evaluation of Kaname Cobalt-Chromium Coronary Stent System in the Treatment of Patients With Coronary Artery Disease
Study Type
Interventional

2. Study Status

Record Verification Date
October 2019
Overall Recruitment Status
Completed
Study Start Date
October 2009 (undefined)
Primary Completion Date
July 2011 (Actual)
Study Completion Date
June 30, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Terumo Europe N.V.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to assess whether the new Kaname coronary stent is safe and effective for the treatment of patients with coronary artery disease.
Detailed Description
Current treatments for coronary artery disease include conservative treatment (drug therapies) and invasive techniques that help increase blood flow to ischemic or oxygen-deprived regions of the heart. Among the invasive techniques the most frequently used are coronary artery bypass graft surgery (CABG), and percutaneous transluminal coronary angioplasty (PTCA) without or with stents (bare metal stents (BMS) or drug eluting stents (DES)) implantation. However, all of those treatments have limitations and their effectiveness is diminished under certain circumstances. Therefore, it is essential to tailor therapy for each individual patient considering the overall patient's condition, disease severity and progression as well as concomitant diseases. The question of selection of appropriate stent for each individual patient is still unresolved and most of the physicians either follow international or national guidelines or scientific wisdom. Although the efficacy of DES is undisputable in restenosis prevention, because some patients could have adverse outcomes from a DES, they should be used selectively in those who are most likely to benefit, and in that decision process several important issues should be addressed such as:Patients' adherence to post-stenting therapy, Bleeding risk, Need for elective surgery, Risk for restenosis, Risk for stent thrombosis. It is still believed that many patients will do well with BMSs and that this technology requires further refinements to improve outcome. For the above reasons Terumo has designed the new coronary BMS, Kaname™, a balloon expandable Cobalt-Chromium (CoCr) stent pre-mounted onto a high pressure, semi-compliant balloon on a rapid exchange delivery catheter. The Kaname stent is the subject of the current prospective, multi-centre KARE study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Artery Disease, Angioplasty, Transluminal, Percutaneous Coronary
Keywords
stents, bare metal stents

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
282 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Kaname
Arm Type
Experimental
Arm Description
patients that are treated by implanting Kaname Cobalt-Chromium coronary stent
Intervention Type
Device
Intervention Name(s)
implantation of Kaname Cobalt-Chromium coronary stent
Other Intervention Name(s)
Kaname, Cobalt-chromium, coronary stent
Intervention Description
implantation of Kaname Cobalt-Chromium coronary stent
Primary Outcome Measure Information:
Title
Freedom from Target vessel failure TVF
Description
Freedom from Target vessel failure TVF defined as composite of clinically driven target vessel revascularization (TVR)myocardial infarction or cardiac death that could not be clearly attributed to a vessel other than the target vessel.
Time Frame
6 months post-procedure
Secondary Outcome Measure Information:
Title
Freedom from TVF for patients treated with ≥ 3 mm stents.
Description
Freedom from Target Vessel Failure (composite of clinically driven TVR, myocardial infarction or cardiac death that could not be clearly attributed to a vessel other than the target vessel) for patients treated with ≥ 3 mm stents.
Time Frame
6 months post-procedure
Title
Freedom from TVF for patients treated with 2.5 and 2.75 mm stents
Description
Freedom from Target Vessel Failure (composite of clinically driven TVR, myocardial infarction or cardiac death that could not be clearly attributed to a vessel other than the target vessel) for patients treated with 2.5 and 2.75 mm stents
Time Frame
6 months post-procedure
Title
Freedom from TVF
Description
Freedom from Target Vessel Failure (composite of clinically driven TVR, myocardial infarction or cardiac death that could not be clearly attributed to a vessel other than the target vessel)
Time Frame
30 days,12 months and 3 and 5 years post-procedure
Title
Clinically driven target lesion revascularization (TLR) free rate .
Description
Clinically driven target lesion revascularization (TLR) free rate
Time Frame
30 days, 6 and 12 months, 3 and 5 years post-procedure
Title
Clinically driven target vessel revascularization (TVR) free rate.
Description
Clinically driven target vessel revascularization (TVR) free rate.
Time Frame
30 days, 6 and 12 months, 3 and 5 years post-procedure
Title
Device success
Description
Device success defined as achievement of a residual diameter stenosis of < 50% by QCA or < 30% by visual estimate, using the assigned device only.
Time Frame
Baseline procedure
Title
Lesion success
Description
Lesion success defined as the attainment of residual diameter stenosis of < 50% by QCA or < 30% by visual estimate, using any percutaneous method.
Time Frame
Baseline procedure
Title
Procedure success
Description
Procedure success defined as achievement of a final diameter stenosis of < 50% by QCA or < 30% by visual estimate, using any percutaneous method, without MACE (composite of cardiac death, MI and TLR) .
Time Frame
During baseline hospital stay
Title
Angiographic in-stent acute gain
Description
Angiographic in-stent acute gain at the end of the procedure
Time Frame
Baseline procedure
Title
Angiographic in-stent and in-segment binary restenosis rate (≥ 50%) diameter stenosis
Description
Angiographic in-stent and in-segment binary restenosis rate (≥ 50%) diameter stenosis
Time Frame
6 months post-procedure
Title
Angiographic in-stent, in-segment, proximal, and distal minimum lumen diameter (MLD)
Description
Angiographic in-stent, in-segment, proximal, and distal minimum lumen diameter (MLD)
Time Frame
6 months post-procedure
Title
In-stent late-loss
Description
In-stent late-loss (as measured by QCA) defined as the difference between the post-procedure minimal lumen diameter (MLD) and the follow-up MLD.
Time Frame
6 months post-procedure
Title
% Diameter Stenosis, in-stent and in-segment .
Description
% Diameter Stenosis, in-stent and in-segment.
Time Frame
6 months post-procedure
Title
Neointimal hyperplasia volume as measured by intravascular ultrasound.
Description
Neointimal hyperplasia volume as measured by intravascular ultrasound at 6 months post-procedure
Time Frame
6 months post-procedure
Title
Major adverse cardiac events (MACEs) rate .
Description
Major adverse cardiac events (MACEs: composite of cardiac death,, myocardial infarction and TLR) rate.
Time Frame
30 days, 6 and 12 months, 3 and 5 years post-procedure
Title
Serious adverse event rate .
Description
Serious adverse event rate.
Time Frame
30 days, 6 and 12 months, 3 and 5 years post-procedure
Title
Device failure .
Description
Any device failure
Time Frame
Baseline procedure

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient is ≥ 18 years old. Patient is eligible for PCI and acceptable candidate for CABG. Clinical evidence of ischemic heart disease and/or a positive functional study. Documented stable angina pectoris (CCS 1, 2, 3 or 4) or unstable angina pectoris with documented ischemia (Braunwald Class IB-C, IIB-C, or IIIB-C), or documented silent ischemia. The target lesion or target vessel meets all the following criteria;a) is a single de novo lesion or restenotic post-PTCA (non-stented) lesion in one native coronary artery.b)The stenosis of target lesion is ≥ 50% and < 100% c)The target lesion length must be ≤ 25 mm d)The target reference vessel diameter must be suitable for treatment with stents between 2.5 and 4.0 mm long Patient has been informed of the nature of the study, understands the study requirements and agrees to its provisions and has provided written informed consent as approved by the Institutional Review Board/Ethics Committee of the respective clinical site. The patient is able to comply with all specified follow-up evaluations. Exclusion Criteria: Most recent LVEF of the patient is < 25%. Known allergies to the following: aspirin, Clopidogrel bisulfate, Prasugrel or Ticlopidine, heparin, cobalt, chromium, nickel, or contrast agent (that cannot be adequately premedicated). A platelet count <100,000 cells/mm3 or >700,000 cells/mm3. WBC count < 3500 cells/mm3. Evidence of MI with positive Troponin within 72 hours of the intended treatment. Previous PCI (<30 days) anywhere within the target vessel. Planned interventional treatment of any non-target vessel <30 days post-procedure will be required. Planned intervention on the target vessel or on a significant lesion of > 50% stenosis anywhere within the target vessel after the index procedure will be required. The target lesion requires treatment with a device other than PTCA balloon prior to stent placement. (e.g. but not limited to directional coronary atherectomy, excimer laser, rotational atherectomy, etc.). Previous stenting anywhere within the target vessel. Target vessel has evidence of thrombus. Excessive tortuousity (> 60°) of the target vessel proximal to the target lesion (visual estimate). Either of the following characteristics in the target lesion (visual estimate): a)Ostial target lesion or bifurcation lesion b)Target lesion involves a side branch > 2mm in diameter c) Target lesion has excessive tortuousity (> 45°)d)Moderate to severely calcified lesion which can not be successfully predilated e)Target lesion is located in or supplied by an arterial or venous bypass graft f)Significant (> 40%) stenosis proximal or distal to the target lesion. g) A complete occlusion (TIMI flow 0 or 1). Target lesion located in left main trunk. Stroke or transient ischemic attack < prior 180 days. Active peptic ulcer or upper GI bleeding < prior 180 days. The patient has bleeding hemorrhagic diathesis or coagulopathy. The patient will refuse a blood transfusion. The patient has a widespread peripheral vascular disease. Acute or chronic renal dysfunction (creatinine > 2.0 mg/dl). The patient requires multiple stent implantations for a tandem lesion. Life expectancy < 1 year. Patient is currently participating in an investigational drug or device study that has not completed the primary endpoint or that clinically interferes with the current study endpoints. Note: Trials requiring extended follow-up for products that were investigational, but have become commercially available since then, are not considered investigational trials. In the investigators opinion patient has a 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. Patient is in cardiogenic shock. Female of child-bearing potential.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Didier Carrie, Prof Dr
Organizational Affiliation
CHU Rangeuil, 31059 Toulouse, France
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hopital Cardiovasculaire et Pneumologie Louis Pradel
City
Lyon
ZIP/Postal Code
69677
Country
France
Facility Name
CHU NORD
City
Nantes
ZIP/Postal Code
44035
Country
France
Facility Name
Clinique les Franciscaines
City
Nimes
ZIP/Postal Code
30000
Country
France
Facility Name
Hopital d'Instructions des Armées du Val de Grace
City
Paris CEDEX 05
ZIP/Postal Code
75230
Country
France
Facility Name
CHU Rangeuil
City
Toulouse CEDEX 9
ZIP/Postal Code
31059
Country
France
Facility Name
Klinikum Fulda gAG
City
Fulda
ZIP/Postal Code
36043
Country
Germany
Facility Name
Klinikum Ludwigshafen
City
Ludwigshafen
ZIP/Postal Code
67063
Country
Germany
Facility Name
Klinikum des Johannes Gutenberg Universität
City
Mainz
ZIP/Postal Code
55131
Country
Germany
Facility Name
Ospedale Careggi
City
Florence
ZIP/Postal Code
50141
Country
Italy
Facility Name
Policlinico Milano
City
Milan
ZIP/Postal Code
20122
Country
Italy
Facility Name
Ospedale Civico Palermo
City
Palermo
ZIP/Postal Code
90100
Country
Italy
Facility Name
Clinical Centre of serbia
City
Belgrade
ZIP/Postal Code
11000
Country
Serbia
Facility Name
Clinical Hospital Center Zemun
City
Belgrade
ZIP/Postal Code
11000
Country
Serbia
Facility Name
Institute for Cardiovascular Disease Dedinje
City
Belgrade
ZIP/Postal Code
11040
Country
Serbia
Facility Name
Hospital Clinico San Carlos
City
Madrid
ZIP/Postal Code
28040
Country
Spain
Facility Name
Hospital La Paz
City
Madrid
ZIP/Postal Code
28046
Country
Spain
Facility Name
Hospital Meixoeiro
City
Vigo
ZIP/Postal Code
36214
Country
Spain

12. IPD Sharing Statement

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Safety and Efficacy Study of Kaname Coronary Stent System for the Treatment of Patients With Coronary Artery Disease

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