STENTYS Self-expanding Versus Balloon-expandable Stent in Acute Myocardial Infarction (AMI) (APPOSITION ll)
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Purpose
Study hypothesis: the Stentys self-expandable Stent results into a better alignment of the struts to the vessel wall than a balloon-expandable stent within a few days after the procedure in acute myocardial infarction patients.
| Condition | Intervention | Phase |
|---|---|---|
|
STEMI |
Device: Stentys coronary stent Device: Balloon-expandable stent |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Randomized Comparison Between the STENTYS Self-expanding Coronary Stent and a Balloon-expandable Stent in Acute Myocardial Infarction - APPOSITION II |
- Stent strut apposition measured by optical coherence tomography (OCT) [ Time Frame: 3 days after procedure ] [ Designated as safety issue: No ]
- Stent thrombosis [ Time Frame: 30 days and 6 months ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 80 |
| Study Start Date: | November 2009 |
| Study Completion Date: | December 2010 |
| Primary Completion Date: | June 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Self-expanding stent
Stentys stent
|
Device: Stentys coronary stent
Self-expanding Nitinol stent
Other Name: Self-expanding stent
|
|
Active Comparator: Balloon-expandable stent
VISION/Driver
|
Device: Balloon-expandable stent
VISION/Driver
Other Name: VISION/Driver
|
Detailed Description:
Stent strut malapposition and stent underexpansion are a common phenomenon in AMI as a result of the changing anatomy after an AMI has occurred (thrombus dissolution, resolution of spasm) with the traditional balloon-expandable stent treatment. A self-expanding stent might lead to better stent strut apposition as it follows the contours of the vessel wall due to its self-expanding properties. This might result into better long term clinical outcomes like lower thrombosis rates.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Subject 18 years old.
Acute Myocardial Infarction defined as presence of at least two of the three items below:
- Detection of rise of cardiac biomarkers with a least one value above the 99th percentile of the upper reference limit (URL)
- Symptoms of ischaemia (chest pain) >20 minutes
- ECG changes indicative of new ischaemia: new ST-T changes (ST deviation ≥0.2mV precordial leads and/or ≥0.1mV limb leads) or new LBBB)
- Reperfusion expected to be achieved within 12 hours from the onset of symptoms
- Subject understands the nature of the procedure and provides written informed consent prior to the catheterization procedure.
- Subject is willing to comply with specified follow-up evaluation and can be contacted by telephone.
- Acceptable candidate for coronary artery bypass graft (CABG) surgery.
- Male or non-pregnant female subject.
Angiographic Inclusion Criteria:
- Reference vessel diameter >2.5mm and <4.0mm by visual estimate.
- Target lesion <30mm in length by visual estimate
Exclusion Criteria:
- Currently enrolled in another investigational device or drug study that has not completed the primary endpoint or that clinically interferes with the current study endpoints.
- Coronary or cardiac intervention or major surgery of any kind within 30 days prior to the procedure.
- Target vessel supplied by by-pass vessel
- Patients on anticoagulation therapy (Coumadin)
- Patient received thrombolytic therapy.
- Myocardial infarction due to stent thrombosis, or infarct lesion at the side of a previously implanted stent
- Cardiogenic shock
- Any previous stent placement within 10mm (proximal or distal) of the target lesion.
- Co-morbid condition(s) that could limit the subject's ability to participate in the study or to comply with follow-up requirements, or impact the scientific integrity of the study.
- Concurrent medical condition with a life expectancy of less than 6 months.
- Left ventricular ejection fraction (LVEF) <30% at the most recent evaluation.
- Cerebrovascular accident or transient ischemic attack in the last 6 months.
- Known hypersensitivity or contraindication to aspirin, heparin or bivalirudin, clopidogrel or ticlopidine, cobalt, nickel, or sensitivity to contrast media, which cannot be adequately pre-medicated.
- Known serum creatinine level >2.5mg/dl or presence or history of renal failure
Angiographic Exclusion Criteria:
- Unprotected left main coronary artery disease (obstruction greater than 50% in the left main coronary artery that is not protected by at least one non-obstructed bypass graft to the left anterior descending (LAD) or left circumflex (LCX) artery or a branch thereof).
- Target vessel is excessively tortuous (two bends >90˚ to reach the target lesion).
- Lesion location that is aorto-ostial or within 5mm of the origin of the LAD or LCX.
- Target lesion is severely calcified.
Contacts and Locations
More Information
No publications provided by Stentys
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Rene Spaargaren, Chief Medical Officer, STENTYS |
| ClinicalTrials.gov Identifier: | NCT01008085 History of Changes |
| Other Study ID Numbers: | ST2009-02 |
| Study First Received: | November 4, 2009 |
| Last Updated: | January 21, 2011 |
| Health Authority: | Belgium: Federal Agency for Medicinal Products and Health Products Germany: Federal Institute for Drugs and Medical Devices Netherlands: Dutch Health Care Inspectorate France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis) Italy: Ministry of Health Poland: Ministry of Health Switzerland: Swissmedic |
Keywords provided by Stentys:
|
STEMI self-expandable balloon-expandable |
Additional relevant MeSH terms:
|
Infarction Myocardial Infarction Ischemia Pathologic Processes Necrosis |
Myocardial Ischemia Heart Diseases Cardiovascular Diseases Vascular Diseases |
ClinicalTrials.gov processed this record on May 23, 2013