Boston Scientific Embolic Protection, Inc. (EPI): A Carotid Stenting Trial for High-Risk Surgical Patients (BEACH)

NCT ID: NCT00316108

Last Updated: 2014-08-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

747 participants

Study Classification

INTERVENTIONAL

Study Start Date

2002-02-28

Study Completion Date

2007-11-30

Brief Summary

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The purpose of this study is to determine whether morbidity and mortality for high-risk surgical patients treated with the Carotid Wallstent in conjunction with the FilterWire EX and EZ System distal protection device will be less than or equal to that of objective performance criteria (OPC) derived from historic controls undergoing surgical intervention with a carotid endarterectomy (CEA).

Detailed Description

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Stroke is the third leading cause of death in this country with approximately 600,000 new stroke cases each year. Mortality rates as high as 40 percent have been reported for stroke as a result of ischemia associated with the carotid distribution. Currently, the primary therapy for carotid artery occlusive disease is carotid endarterectomy (CEA) or the surgical removal of atheromatous material from inside the artery.

Although CEA is an effective treatment for the majority of patients with carotid occlusive disease, there remains a need for a treatment option for those patients with significant surgical risk factors. These patients have been shown to have much higher rates of morbidity and mortality. There are approximately 50,000-70,000 patients each year who are considered poor surgical candidates. These patients present with either one or more anatomical or co-morbid conditions and have a one-year stroke and death rate of up to 15% with traditional surgical treatment.

Carotid artery stenting (CAS) has been reported by numerous single-center trials to be feasible in the treatment of carotid artery stenosis. Moreover, the risk benefit ratio has been suggested to be the largest in those patients with a higher risk profile for the CEA treatment option.

This trial will study the effects of percutaneous intervention using the Monorail™ Carotid Wallstent® Endoprosthesis (Carotid Wallstent) in conjunction with the FilterWire System distal protection device (FilterWire EX and EZ) on rates of common peri-procedural complications as well as on long-term outcomes as compared to historical outcomes of patients undergoing CEA.

Conditions

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Carotid Artery Diseases Stroke Cerebral Arteriosclerosis

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Arm 1

Group Type EXPERIMENTAL

WALLSTENT® Endoprosthesis™

Intervention Type DEVICE

Carotid Artery Stent

Interventions

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WALLSTENT® Endoprosthesis™

Carotid Artery Stent

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patient must meet criteria for either A or B:

A. Symptomatic: Carotid stenosis of greater than or equal to 50% via angiography with associated cerebral or retinal TIA or ischemic stroke symptoms within 180 days of the procedure, which are determined to have occurred in the cerebral hemisphere or eye ipsilateral to the target carotid artery lesion and to be reasonably attributable to that lesion; or

B. Asymptomatic: Carotid stenosis greater than or equal to 80% via angiography without associated cerebral or retinal TIA or ischemic stroke symptoms within 180 days of the procedure.

* Target lesion is in the native common carotid artery (CCA), internal carotid artery (ICA), or carotid bifurcation.
* Target arterial segment to be stented has a diameter of greater than or equal to 4.0 mm to less than or equal to 9.0 mm.
* Vessel diameter distal to the target lesion is greater than or equal to 3.5 mm and less than or equal to 5.5 mm as an optimal "landing zone" for placement of the FilterWire EZ System with visual angiographic recommendations as described in the instructions for use (IFU).


* Patients must qualify in at least one high-risk category. The high-risk categories are defined as:

* Anatomical conditions \[one (1) criterion qualifies\]
* Co-morbid conditions Class I \[one (1) criterion qualifies\]
* Co-morbid conditions Class II \[two (2) criteria qualify\]

Exclusion Criteria

* Patient has experienced an evolving, acute, or recent stroke within 21 days of study evaluation.
* A total occlusion of the ipsilateral carotid artery. (Only for Roll-In and Pivotal patients.)
* A total occlusion of the contralateral carotid artery. (Only for Bilateral Registry patients.)
* Pre-existing stent(s):

* Roll-In and Pivotal Patients: located within the ipsilateral carotid distribution; a stent was placed in a contralateral vessel within the previous 30 days of the study enrollment.
* Bilateral Registry Patients: located within the carotid distribution.
* A target lesion which is expected to require more than one stent.
* Known cardiac sources of emboli of a type likely to be associated with cerebral ischemic events \[e.g. endocarditis, intracardiac thrombus, embolic-associated cardiovascular lesions, or any current arrhythmia (e.g. atrial fibrillation, atrial flutter, etc.)\].
* Myocardial infarction (MI) within 72 hours prior to the index procedure, defined as creatine kinase (CK)-MB \> 2 X the local laboratory's upper limit of normal (ULN).
* Any surgery requiring general anesthesia (e.g. coronary artery bypass graft \[CABG\], valve replacement, or abdominal aortic aneurysm) less than or equal to 30 days preceding the stent procedure.
* The patient is enrolled in another investigational study protocol and has not completed the required follow-up period of the evaluation. The patient may not participate in another investigational study that may confound the treatment or outcomes of the BEACH protocol.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Boston Scientific Corporation

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Christopher White, MD

Role: PRINCIPAL_INVESTIGATOR

Ochsner Health System

Sriram Iyer, MD

Role: PRINCIPAL_INVESTIGATOR

Lenox Hill Heart and Vascular Institute

Pamela G Grady, Ph.D

Role: STUDY_DIRECTOR

Boston Scientific Corporation

Locations

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Bapatist Medical Center

Birmingham, Alabama, United States

Site Status

University of Alabama at Birmingham

Birmingham, Alabama, United States

Site Status

Arizona Heart Institute

Phoenix, Arizona, United States

Site Status

St. Joseph's Hospital & Medical Center

Phoenix, Arizona, United States

Site Status

El Camino Hospital

Mountain View, California, United States

Site Status

Hoag Memorial Hospital

Newport Beach, California, United States

Site Status

St. Joseph's Medical Center

Stockton, California, United States

Site Status

Washington Hospital Center

Washington D.C., District of Columbia, United States

Site Status

Holy Cross Hospital

Fort Lauderdale, Florida, United States

Site Status

Lakeland Regional Medical Center

Lakeland, Florida, United States

Site Status

University of Miami School of Medicine - Jackson Memorial Hospital

Miami, Florida, United States

Site Status

Miami Cardiac and Vascular Institute

Miami, Florida, United States

Site Status

Northwest Medical Center

Plantation, Florida, United States

Site Status

Piedmont Hospital

Atlanta, Georgia, United States

Site Status

St. Joseph's Hospital of Atlanta/American Cardiovascular Research Institute

Atlanta, Georgia, United States

Site Status

Rush Presbyterian-St. Luke's Medical Center

Chicago, Illinois, United States

Site Status

St. Francis Medical Center

Peoria, Illinois, United States

Site Status

St. John's Hospital - Prairie Heart Institute

Springfield, Illinois, United States

Site Status

Central Baptist Hospital

Lexington, Kentucky, United States

Site Status

Ochsner Clinic Foundation

New Orleans, Louisiana, United States

Site Status

Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status

Cape Cod Hospital

Hyannis, Massachusetts, United States

Site Status

Wayne State University- Detroit Medical Center

Detroit, Michigan, United States

Site Status

William Beaumont Hospital

Royal Oak, Michigan, United States

Site Status

St. Luke's Hospital of Kansas City

Kansas City, Missouri, United States

Site Status

Kaleida Health/Millard Fillmore Hospital

Buffalo, New York, United States

Site Status

Lenox Hill Heart and Vascular Institute

New York, New York, United States

Site Status

New York Presbyterian Hospital/Columbia Vascular Interventional Radiology

New York, New York, United States

Site Status

Strong Memorial Hospital

Rochester, New York, United States

Site Status

St. Francis Hospital

Roslyn, New York, United States

Site Status

Montefiore Medical Center

The Bronx, New York, United States

Site Status

Duke University Medical Center

Durham, North Carolina, United States

Site Status

Cleveland Clinic & Foundation

Cleveland, Ohio, United States

Site Status

Riverside Methodist Hospital

Columbus, Ohio, United States

Site Status

Medical College of Ohio

Toledo, Ohio, United States

Site Status

Oregon Health Sciences University

Portland, Oregon, United States

Site Status

Hahnemann University/ Tenet Healthcare Corporation

Philadelphia, Pennsylvania, United States

Site Status

UPMC-Shadyside Hospital Pittsburgh Vascular Institute

Pittsburgh, Pennsylvania, United States

Site Status

Pinnacle Health at Harrisburg Hospital

Wormleysburg, Pennsylvania, United States

Site Status

Providence Hospital South Carolina Heart Center

Columbia, South Carolina, United States

Site Status

Baptist Hospital of East Tennessee

Knoxville, Tennessee, United States

Site Status

Skyline Medical Center/ Howell Allen Clinic

Nashville, Tennessee, United States

Site Status

St. Luke's Episcopal Hospital Texas Heart Institute

Houston, Texas, United States

Site Status

University of Texas-Houston Medical School

Houston, Texas, United States

Site Status

Texas Tech University Health Sciences Center

Lubbock, Texas, United States

Site Status

Baptist Hospital

San Antonio, Texas, United States

Site Status

LDS Hospital

Salt Lake City, Utah, United States

Site Status

St. Mary's Hospital

Richmond, Virginia, United States

Site Status

Deaconess Medical Center

Spokane, Washington, United States

Site Status

Aurora St. Luke's Medical Center

Milwaukee, Wisconsin, United States

Site Status

Countries

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United States

References

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Iyer SS, White CJ, Hopkins LN, Katzen BT, Safian R, Wholey MH, Gray WA, Ciocca R, Bachinsky WB, Ansel G, Joye JD, Russell ME; BEACH Investigators. Carotid artery revascularization in high-surgical-risk patients using the Carotid WALLSTENT and FilterWire EX/EZ: 1-year outcomes in the BEACH Pivotal Group. J Am Coll Cardiol. 2008 Jan 29;51(4):427-34. doi: 10.1016/j.jacc.2007.09.045.

Reference Type DERIVED
PMID: 18222352 (View on PubMed)

Other Identifiers

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COR2000001U

Identifier Type: -

Identifier Source: secondary_id

S5385

Identifier Type: -

Identifier Source: org_study_id

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