OCT Evaluation of Healing of COMBO Stent (EGO-COMBO)
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Purpose
All subjects requiring percutaneous coronary intervention (PCI) and stenting are eligible to participate in the study. Restudy coronary angiogram with Optical Coherence Tomography (OCT) would be performed between 1 to 5 months at the time of a staged PCI procedure (for remaining coronary disease) or as clinically indicated, and then at 9 months. At the time of the 9-month restudy (a proper time window for drug eluting stent to develop into restenosis should it occur), any new disease detected or restenosis will be treated. The reported incidence of drug eluting stent restenosis is around 10% in simple lesions and is expected to be higher in diabetic patients, long lesions and multi-vessel diseases; a restudy at 9 months actually confers better protection to the patients with advanced disease and any restenosis can be treated timely. All data on clinical events and progress will be monitored and regular follow-ups will be carried out.
| Condition | Intervention | Phase |
|---|---|---|
|
Coronary Restenosis Coronary Thrombosis |
Device: COMBO Stent (OrbusNeich Medical, Fort Lauderdale, Florida) |
Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Evaluation of Neointimal Healing of Endothelial Progenitor Cell Capturing Sirolimus-Eluting (COMBO) Stent by Optical Coherence Tomography: the EGO-COMBO Pilot Study |
- Primary end-point: OCT findings on percentage stent strut coverage in the 2nd to the 5th months (4 monthly groups). [ Time Frame: On 2nd, 3rd, 4th, and 5th months ] [ Designated as safety issue: No ]Primary end-point: OCT findings on percentage stent strut coverage, malapposition, and neointimal thickness in the 2nd to the 5th months (4 monthly groups).
- OCT findings on late loss (neointimal thickness and neointimal area) at 9 months restudy. [ Time Frame: 9 months ] [ Designated as safety issue: No ]OCT findings on late loss (neointimal thickness, neointimal area, percentage plaque volume, lumen area, and late loss in lumen area) at 9 months restudy.
- Major Adverse Cardiac Events [ Time Frame: Initial OCT follow up, 9 months follow up and one year follow up ] [ Designated as safety issue: No ]
Major Adverse Cardiac Events (MACE) which defined as:
- Death from all cause including cardiac death
- Any Myocardial Infarction (Q wave and non Q-wave)
Elevation of post-procedure CK levels to greater 2 times normal without new Q waves is considered a non Q-wave MI.
Development of new, pathological Q waves in 2 or more contiguous leads,as assessed by the investigator and confirmed by the Clinical Endpoint Committee and elevation of cardiac enzymes. In the absence of ECG data the CEC may adjudicate Q wave MI based on the clinical scenario and appropriate cardiac enzyme data.
- Major Adverse Cardiac Events [ Time Frame: Initial OCT follow up, 9 months OCT follow up and one year follow up ] [ Designated as safety issue: No ]3. Target Lesion Revascularization requiring repeat PCI or CABG to the target lesion. Clinically driven Revascularization at the target lesion associated with positive functional ischemia study or ischemic symptoms AND an angiographic minimal lumen diameter stenosis ≥50% by QCA, or revascularization of a target lesion with diameter stenosis ≥ 70% by QCA without either angina or a positive functional study.
- Any Stent Thrombosis according the Academic Research Consortium [ Time Frame: Initial OCT follow up, 9 months OCT follow up and one year follow up ] [ Designated as safety issue: No ]
- Stroke [ Time Frame: Initial OCT follow up, 9 months OCT follow up and one year follow up ] [ Designated as safety issue: No ]Stroke defined as sudden onset of vertigo, numbness, dysphasia, weakness, visual field defects, dysarthria or other focal neurological deficits due to vascular lesions of the brain such as hemorrhage, embolism, thrombosis, or rupturing aneurysm, that persists more than 24 hours.
- Bleeding complication [ Time Frame: Initial OCT follow up, 9 months OCT follow up and one year follow up ] [ Designated as safety issue: No ]Bleeding complication defined as a procedure related hemorrhagic event that requires a transfusion or surgical repair. These may include a hematoma requiring treatment of retroperitoneal bleed.
| Enrollment: | 61 |
| Study Start Date: | October 2010 |
| Study Completion Date: | June 2012 |
| Primary Completion Date: | June 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: COMBO Stent
COMBO Stent
|
Device: COMBO Stent (OrbusNeich Medical, Fort Lauderdale, Florida)
The COMBO Stent is a hybrid version of the GENOUS Stent. Upon implantation to the coronary artery, the stent will deliver a drug (sirolimus) to the wall of the treated segment to suppress neointimal growth, in addition to the anti-CD34 antibody coating which will in theory attract circulatory endothelial progenitor cells to hasten endothelialization and promote healing of the stented segment, and thereby may reduce late stent thrombosis.
Other Name: COMBO Stent
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years to 85 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- patient aged 18-85 years old,
- patient with coronary stenosis requiring percutaneous coronary intervention without contraindications to implantation of drug eluting stents
- patient who consents to receive follow-up coronary angiogram and OCT examination.
Exclusion Criteria:
- patient who refuses to consent to follow-up coronary angiogram or OCT examination.
Contacts and Locations| Hong Kong | |
| Division of Cardiology, Queen Mary Hospital, The University of Hong Kong | |
| Hong Kong, Hong Kong | |
| Principal Investigator: | Stephen Lee, MD FRCP FACC | Queen Mary Hospital, The Unversity of Hong Kong |
More Information
Publications:
| Responsible Party: | Prof. Stephen Lee, Professor and Chief, The University of Hong Kong |
| ClinicalTrials.gov Identifier: | NCT01274234 History of Changes |
| Other Study ID Numbers: | UW 10-342 (IRB HKU) |
| Study First Received: | December 28, 2010 |
| Last Updated: | February 27, 2013 |
| Health Authority: | Hong Kong: Ethics Committee |
Keywords provided by The University of Hong Kong:
|
EPC capturing sirolimus eluting COMBO stent Optical coherence tomography (OCT) Early neointimal healing and stent coverage Late neointimal thickness, neointimal area, and lumen loss |
Additional relevant MeSH terms:
|
Coronary Thrombosis Thrombosis Coronary Restenosis Coronary Disease Myocardial Ischemia Heart Diseases Cardiovascular Diseases Embolism and Thrombosis Vascular Diseases Coronary Stenosis Sirolimus |
Antibiotics, Antineoplastic Antineoplastic Agents Therapeutic Uses Pharmacologic Actions Antifungal Agents Anti-Infective Agents Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Anti-Bacterial Agents |
ClinicalTrials.gov processed this record on May 16, 2013