- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01133925
Optical Coherence Tomography in Long Lesions (LONG OCT)
Optical Coherence Tomography in Long Native Coronary Artery Lesions Treated With Multiple Novel Zotarolimus-eluting Stents: LONG OCT STUDY
Study Overview
Status
Conditions
Detailed Description
It is not unknown whether overlapping drug-eluting stents provide increased vessel toxicity. Given the association of delayed healing and incomplete endothelialization observed in animal and human autopsy studies at overlapping sites it is unclear why most patients do well with multiple DES implanted. OCT detects smaller degrees of in-stent neointima more accurately than IVUS and might be a useful method for identify strut coverage and/or malapposition.
Patients if eligible on the basis of clinical and angiographic criteria, are assigned to receive multiple Resolute Sprint™. Stent implantation are done accordingly to the normal interventional practice. QCA and IVUS are performed at the end of optimal stents placement per visual judgement (residual stenosis < 10%, TIMI 3 flow). Stent, lumen size and volume as well as complete stent strut apposal will be determined by IVUS analysis. Clinical follow-up will take place at 1 month (±1 week), 6 months (±2 weeks) and 1 year (±2 weeks). At 6-months follow-up all patients will undergo a quantitative coronary angiography (QCA), IVUS and Optical Coherence Tomography (LightLab OCT Imaging M2, automated pull back and flushing combination)assessments.
OCT images will be acquired at 15-30 frames per second. Blind corelab quantitative strut by strut analysis will be performed using a novel dedicated software at each 0.5 mm section. The following OCT variables will be evaluated:number of visualized strut per section, mean-max neointimal thickness per section, % struts well apposed with neointima at overlapping vs non overlapping sites, % struts without neointima, % struts malapposed, rate of > 30% uncovered struts/total number of struts per section.
Obtained data will be compared with the data from a historical comparator (ODESSA trial that presented results from TAXUS Libertè™ vs Cypher Select™ vs Endeavor™ stents implanted in overlap to treat long lesions.
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
BG
-
Bergamo, BG, Italy, 24128
- Cardiovascular Department Ospedali Riuniti di Bergamo
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patient must be at least 18 years of age
- Patient must have evidence of myocardial ischemia (e.g., stable or unstable angina, silent ischemia, positive functional study or a reversible change in the electrocardiogram (ECG) consistent with ischemia)
- Native coronary artery disease with >75% diameter stenosis (no prior stent implant, no prior brachytherapy)
- Lesion length > 20 mm
- Vessel size between 2.5 and 3.5 mm
- Multiple, overlapped Endeavor Resolute stents placement (intention to overlap > 4 mm).
Exclusion Criteria:
- Left main coronary artery disease
- Lesions in coronary artery bypass grafts
- Acute myocardial infarction
- Killip class IV
- Recent major bleeding (6 months)
- Renal failure with creatinine value > 2.5 mg/dl
- Left ventricular global ejection fraction ≤ 30%.
- Allergy to aspirin and or clopidogrel/ticlopidine
- Patient in anticoagulant therapy
- No suitable anatomy for OCT scan: (only ostial location, very tortuous anatomy, very distal or large vessels [> 3.5 mm in diameter])
- Target lesion(s) located in a major epicardial vessel or a side branch that has been previously treated with any type of percutaneous intervention (e.g., balloon angioplasty, cutting balloon, atherectomy) < 9 months prior to index procedure
- Target lesion restenotic from previous stent implantation
- Any lesion (target or non-target) that has been previously treated with brachytherapy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: ODESSA
ODESSA trial (NCT 00693030)Patients were randomized (2:2:2:1) to receive multiple TAXUS Libertè™ vs Cypher Select™ vs Endeavor™ vs Libertè BM stents, in overlap.
At 6-months follow-up coronary angiography (QCA), IVUS and Optical Coherence Tomography assessments were made.
Data reported in J. Am.
Coll.
Cardiol.
Intv.
2010;3;531-539.
DOI 10.1016/j.jcin.2010.02.008.
|
Cypher stents implanted in overlap
Taxus stents implanted in overlap
Endeavor stents implanted in overlap
|
Experimental: Resolute Sprint arm
Zotarolimus Eluting stents (Resolute Sprint) implanted in overlap to treat long coronary lesions
|
Zotarolimus Eluting Stent (Resolute Sprint) implanted in overlap
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
In stent NIH at overlapping vs non overlapping sites
Time Frame: 6 month
|
In-stent neointimal hyperplasia (NIH) thickness at 6 months, as measured by OCT, at overlapping vs non overlapping sites: superiority of Endeavor Resolute stent compared to Endeavor Sprint
|
6 month
|
Percent uncovered and malapposed struts in OCT
Time Frame: 6 month
|
Proportion of stent struts uncovered and/or malapposed at 6 months, as measured by OCT, at overlapping vs non overlapping sites: non inferiority of Endeavor Resolute compared to Endeavor Sprint.
|
6 month
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Rate of > 30% uncovered struts/total number of struts per section.
Time Frame: 6 months
|
6 months
|
|
MACE Rates
Time Frame: 1-6 and 12 months
|
All specific components of MACE (cardiac death, myocardial infarction (Q wave and non Q wave), and target vessel revascularization) will be summarized.
MACE shall be assessed at, discharge (or within 7 days, whichever comes first), 1, 6 and 12 months post index procedure.
|
1-6 and 12 months
|
IVUS parameters
Time Frame: 6 months
|
Based on IVUS Core Lab analysis including:
|
6 months
|
QCA Parameters
Time Frame: 6 months
|
Based on Angiographic Core Lab analysis utilizing Quantitative Coronary Angiography (QCA) including: Mean lumen diameter, acute gain, late loss through 6 months, and binary restenosis (≥ 50% diameter stenosis) rate at 6 months post index procedure. |
6 months
|
Collaborators and Investigators
Publications and helpful links
General Publications
- Guagliumi G, Musumeci G, Sirbu V, Bezerra HG, Suzuki N, Fiocca L, Matiashvili A, Lortkipanidze N, Trivisonno A, Valsecchi O, Biondi-Zoccai G, Costa MA; ODESSA Trial Investigators. Optical coherence tomography assessment of in vivo vascular response after implantation of overlapping bare-metal and drug-eluting stents. JACC Cardiovasc Interv. 2010 May;3(5):531-9. doi: 10.1016/j.jcin.2010.02.008.
- Guagliumi G, Ikejima H, Sirbu V, Bezerra H, Musumeci G, Lortkipanidze N, Fiocca L, Tahara S, Vassileva A, Matiashvili A, Valsecchi O, Costa M. Impact of drug release kinetics on vascular response to different zotarolimus-eluting stents implanted in patients with long coronary stenoses: the LongOCT study (Optical Coherence Tomography in Long Lesions). JACC Cardiovasc Interv. 2011 Jul;4(7):778-85. doi: 10.1016/j.jcin.2011.04.007.
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Heart Diseases
- Cardiovascular Diseases
- Vascular Diseases
- Arteriosclerosis
- Arterial Occlusive Diseases
- Coronary Artery Disease
- Myocardial Ischemia
- Coronary Disease
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Antineoplastic Agents, Phytogenic
- Anti-Bacterial Agents
- Antibiotics, Antineoplastic
- Antifungal Agents
- Paclitaxel
- Sirolimus
Other Study ID Numbers
- BG-003-08
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Coronary Artery Disease
-
Elixir Medical CorporationIstituto Clinico HumanitasActive, not recruitingCoronary Artery Disease | Chronic Total Occlusion of Coronary Artery | Multi Vessel Coronary Artery Disease | Bifurcation of Coronary Artery | Long Lesions Coronary Artery DiseaseItaly
-
Fundación EPICActive, not recruitingCoronary Artery Disease | Left Main Coronary Artery Disease | Left Main Coronary Artery Stenosis | Restenosis, CoronarySpain
-
Peking Union Medical College HospitalNot yet recruitingCoronary Artery Disease | Inflammation | Coronary Artery Disease Progression | Coronary Artery Stenosis | Coronary Artery Restenosis | Inflammatory Disease | Inflammation VascularChina
-
Peking Union Medical College HospitalRecruitingCoronary Artery Disease | Inflammation | Coronary Artery Disease Progression | Coronary Artery Stenosis | Coronary Artery Restenosis | Inflammatory Disease | Inflammation VascularChina
-
IGLESIAS Juan FernandoUniversity of BernNot yet recruiting
-
National Institutes of Health Clinical Center (CC)National Heart, Lung, and Blood Institute (NHLBI)CompletedCoronary Arteriosclerosis | Coronary Artery Disease (CAD) | Obstructive Coronary Artery DiseaseUnited States
-
Barts & The London NHS TrustImperial College London; Brunel UniversityNot yet recruitingCORONARY ARTERY DISEASE
-
Fundación EPICRecruitingCoronary Artery Disease | Coronary Disease | Coronary Occlusion | Left Main Coronary Artery Disease | Coronary Artery StenosisSpain
-
Abbott Medical DevicesCompletedCoronary Artery Disease | Coronary Disease | Coronary Occlusion | Chronic Total Occlusion of Coronary Artery | Coronary Restenosis | Coronary Artery Stenosis | Coronary Artery RestenosisBelgium
-
China National Center for Cardiovascular DiseasesRecruitingLeft Main Coronary Artery DiseaseChina
Clinical Trials on Sirolimus Eluting Stent
-
Meril Life Sciences Pvt. Ltd.UnknownCoronary Artery DiseaseUnited Kingdom, Brazil, Spain, Macedonia, The Former Yugoslav Republic of, Belgium, Czechia, Latvia, Netherlands, Poland
-
Instituto Nacional de Cardiologia Ignacio ChavezRecruitingCoronary Artery Disease | Percutaneous Coronary Intervention | High Bleeding RiskMexico
-
Odense University HospitalUnknownCoronary Artery Disease | Ischemic Heart DiseaseDenmark
-
Paul S Teirstein, MDCordis CorporationCompletedCoronary Artery Disease | Coronary Thrombosis | Coronary RestenosisUnited States
-
OrbusNeichCCRF Inc., Beijing, China; OrbusNeich Medical (Shenzhen), Co. Ltd.Completed
-
Nanjing First Hospital, Nanjing Medical UniversityWithdrawnCoronary Artery Disease
-
Catholic University of the Sacred HeartCompletedCoronary Artery Disease | Coronary StenosisItaly
-
Yonsei UniversityCompletedCoronary Artery DiseaseKorea, Republic of
-
Centro de estudios en Cardiologia IntervencionistaCompletedCoronary Heart Disease | Coronary RestenosisArgentina
-
Xijing HospitalAir Force Military Medical University, China; Shanghai MicroPort Medical (Group)... and other collaboratorsUnknown