Carotid With Bivalirudin Angioplasty (COBRA)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT00812383
Recruitment Status : Recruiting
First Posted : December 22, 2008
Last Update Posted : September 6, 2018
Information provided by (Responsible Party):
Medstar Health Research Institute

December 18, 2008
December 22, 2008
September 6, 2018
August 2003
July 2019   (Final data collection date for primary outcome measure)
To evaluate clinical success (<50% residual stenosis at all treatment sites without death, myocardial infarction, stroke or major bleed) [ Time Frame: 30 days ]
Same as current
Complete list of historical versions of study NCT00812383 on Archive Site
  • To assess for complications including death, myocardial infarction, major or minor stroke, major or minor bleeding, and vascular complications. [ Time Frame: In hospital and 30 days ]
  • To assess stent patency , and occurence of death or recurrent neurological events [ Time Frame: 12 months ]
Same as current
Not Provided
Not Provided
Carotid With Bivalirudin Angioplasty
Carotid With Bivalirudin Angioplasty
Single center randomized clinical trial, to evaluate the safety and efficacy of carotid artery stenting using the RX ACCULINK™ Carotid Stent System with RX ACCUNET™ Embolic Protection System or PercuSurge GuardWire® 3-6 Temporary Occlusion and Aspiration System using Angiomax (bivalirudin)versus heparin as the anticoagulant for treatment of occlusive carotid artery disease in low and high risk patient cohorts.
Not Provided
Phase 2
Phase 3
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Carotid Artery Disease
Device: RX ACCULINK™ Carotid Stent System; RX ACCUNET™ Embolic Protection System; PercuSurge GuardWire® 3-6 Temporary Occlusion and Aspiration System
Angiomax (bivalirudin) versus standard anticoagulation with heparin during carotid artery stenting with distal protection clinical endpoint evaluation
  • Experimental: Bivalirudin
    Intervention: Device: RX ACCULINK™ Carotid Stent System; RX ACCUNET™ Embolic Protection System; PercuSurge GuardWire® 3-6 Temporary Occlusion and Aspiration System
  • Active Comparator: Heparin
    Intervention: Device: RX ACCULINK™ Carotid Stent System; RX ACCUNET™ Embolic Protection System; PercuSurge GuardWire® 3-6 Temporary Occlusion and Aspiration System
Not Provided

*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
Not Provided
July 2019
July 2019   (Final data collection date for primary outcome measure)

Inclusion Criteria:

  • The patient must be at least 18 years of age.
  • The patient must have a significant diameter reduction of the extracranial or intracranial internal or common carotid artery, defined as ≥50% stenosis for symptomatic patients or ≥80% stenosis for asymptomatic patients determined by carotid duplex ultrasound scan and/or carotid angiography.
  • Female patients with child bearing potential must have a negative pregnancy test.
  • The patient and the patient's physician must agree to have the patient return for a 30-day and one-year clinical and ultrasound imaging follow-up evaluations as indicated in the protocol.
  • Reference vessel diameter ≥ 3.5 mm - ≤ 9.0 mm diameter.

Exclusion Criteria:

  • The patient has had a recent (<4 weeks) disabling stroke or dementia with major neurologic deficit (stroke scales: Barthel <60, NIH >15, or Rankin >3) at pre-procedure neuro exam.
  • The patient has had within four weeks of the treatment procedure an intracranial hemorrhage, hemorrhage stroke, major stroke, or any stroke with mass effect demonstrated on MRI or CT.
  • The patient has a known allergy to heparin, bivalirudin, aspirin or to anti-platelet agents that prevents taking aspirin plus ticlopidine or aspirin plus clopidogrel.
  • The patient has received fractionated or unfractionated heparin within 8 hours prior to the procedure.
  • The patient has a history of prior life-threatening radiocontrast reaction that cannot be pre-treated.
  • The patient has a history of bleeding diathesis or coagulopathy within 3 months.
  • The patient is currently participating in another study protocol that may influence either procedure results or follow-up evaluations.
  • Plasma/serum creatinine > 3.0 mg/dl at time of intervention.
  • Hemodynamic instability at the time of intervention.
  • Previous stent placement in the ipsilateral carotid distribution.

Angiographic Exclusion Criteria

  • The patient has an intracranial tumor, or cerebral arterio-venous malformation(s) > 5mm, aneurysms or severe intracranial stenosis distal to target lesion.
  • The patient has inaccessible intracranial arterial stenosis greater in severity than the extracranial internal carotid artery lesion.
  • There is angiographic evidence of significant intra-luminal thrombus burden with presumed increased risk of plaque fragmentation and consequent distal embolization.
  • There is total occlusion of the ipsilateral carotid artery treatment site with TIMI 0 flow characteristics.
  • The reference segment diameter (internal carotid artery segment cephalad to the lesion) is less than 3 millimeters by operator visual estimate.
  • The patient has peripheral vascular, supra-aortic or internal carotid artery tortuosity precluding use of catheter-based techniques required for successful CSSA
Sexes Eligible for Study: All
18 Years and older   (Adult, Older Adult)
Contact: Lowell Satler, M.D. 202-877-5975
United States
Not Provided
Not Provided
Not Provided
Medstar Health Research Institute
Medstar Health Research Institute
Not Provided
Principal Investigator: Lowell Satler, MD Medstar Washington Hospital Center
Medstar Health Research Institute
September 2018

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP