Direct Stenting of TAXUS Liberté™-SR Stent for the Treatment of Patients With de Novo Coronary Artery Lesions

NCT ID: NCT00371423

Last Updated: 2012-02-02

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

PHASE3

Total Enrollment

247 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-03-31

Study Completion Date

2010-09-30

Brief Summary

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TAXUS ATLAS Direct Stent is a global, multi-center, single-arm, noninferiority trial comparing results from patients in whom the TAXUS Liberté stent was directly implanted (direct stenting) versus results from patients in whom implantation with the TAXUS Liberté stent was preceded by balloon angioplasty (pre-dilatation). The Control group consists of patients in the main TAXUS ATLAS trial, in which pre-dilatation was mandatory. The primary objective is to compare outcomes of direct stenting with balloon catheter pre-dilatation. The primary hypothesis is that late outcomes with direct stenting of the TAXUS™ Liberté Paclitaxel-Eluting Coronary Stent System will be non-inferior to conventional implantation with balloon catheter pre-dilatation

Detailed Description

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Conditions

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Coronary Artery Disease

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

TAXUS Liberté™-SR

Intervention Type DEVICE

Paclitaxel-Eluting Coronary Stent System

Arm 2

Control data derived from ATLAS Workhorse Trial

Group Type OTHER

TAXUS Liberté™-SR

Intervention Type DEVICE

Paclitaxel-Eluting Coronary Stent System

Interventions

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TAXUS Liberté™-SR

Paclitaxel-Eluting Coronary Stent System

Intervention Type DEVICE

TAXUS Liberté™-SR

Paclitaxel-Eluting Coronary Stent System

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Patient is ≥18 years old.
2. Eligible for percutaneous coronary intervention (PCI)
3. Documented stable angina pectoris or unstable angina pectoris with documented ischemia, or documented silent ischemia
4. Left ventricular ejection fraction (LVEF) of ≥25%
5. Acceptable candidate for coronary artery bypass grafting (CABG)
6. Patient or legal guardian understands the study requirements and the treatment procedures and provides written Informed Consent before any study-specific tests or procedures are performed
7. Willing to comply with all specified follow-up evaluations


1. Only one lesion appropriate for direct stenting (typically covered by one 24 mm stent or shorter), may be treated with the study stent. However, one additional lesion in a non-target vessel may be treated during the index procedure with a commercially available bare metal stent, heparin-coated stent or TAXUS Express stent.
2. Target lesion located within a single native coronary vessel
3. Target lesion enrolled for treatment may be composed of multiple lesions(not more than 10mm between diseased segments) but must be completely covered by one study stent.
4. Cumulative target lesion length is ≥10 mm and ≤28 mm (visual estimate) and is typically considered appropriate for direct stenting
5. RVD of ≥2.5 mm to ≤4.0 mm (visual estimate)
6. Target lesion diameter stenosis ≥50% (visual estimate)
7. Target lesion is de novo (i.e., a coronary lesion not previously treated)

Exclusion Criteria

1. Known hypersensitivity to paclitaxel
2. Any previous, concurrent or planned treatment with a non-study anti-restenotic drug-coated or drug-eluting coronary stent.
3. Previous or planned use of both the study stent and a non-study stent (i.e., commercial stent) in the treatment of the target vessel
4. Previous or planned treatment with intravascular brachytherapy in the target vessel
5. Planned CABG ≤9-months post-index procedure
6. MI within 72 hours prior to the index procedure and/or creatine kinase(CK) \>2x the local laboratory's ULN unless CK-MB is \<2x ULN.
7. Cerebrovascular Accident (CVA) within the past 6 months
8. Cardiogenic Shock
9. Acute or chronic renal dysfunction
10. Contraindication to ASA, or to both clopidogrel and ticlopidine
11. Patient is currently on warfarin or it is anticipated that treatment with warfarin will be required during any period within 6 months after the index procedure.
12. Leukopenia
13. Thrombocytopenia
14. Active peptic ulcer or active gastrointestinal (GI) bleeding
15. Known allergy to stainless steel
16. Any prior true anaphylactic reaction to contrast agents
17. Patient is currently, or has been treated with paclitaxel or other chemotherapeutic agents within 12-months of the index procedure
18. Anticipated treatment with paclitaxel or oral rapamycin during any period in the 9-months after the index procedure
19. Male or female with known intention to procreate within 3 months after the index procedure
20. Female of childbearing potential with a positive pregnancy test within 7 days before the index procedure, or lactating
21. Life expectancy of less than 24-months due to other medical condition
22. Co-morbid condition(s) that could limit the patient's ability to participate in the study, compliance with follow-up requirements or impact the scientific integrity of the study
23. Currently participating in another investigational drug or device study that has not completed the primary endpoint or that clinically interferes with the endpoints of this study.


1. Unprotected left main coronary artery disease (patient with protected left main disease can be enrolled only if the target lesion is in the RCA)
2. Target lesion is ostial in location (within 3.0 mm of vessel origin)
3. Target lesion and/or target vessel proximal to the target lesion is moderately or severely calcified by visual estimate
4. Target lesion and/or target vessel proximal to the target lesion is tortuous
5. Target lesion is located within or distal to a \>60 degree bend in the vessel
6. Target lesion involves a bifurcation with a diseased (\>50% stenotic)branch vessel \>2.0 mm in diameter
7. Target lesion is totally occluded (TIMI flow\<1) at baseline
8. Angiographic presence of probable or definite thrombus
9. Pre-treatment of the target vessel at the index procedure is not allowed with any device
10. A previously treated lesion within the target vessel:

* \<15 mm from the target lesion (visual estimate)
* Performed \</= 6 months from index procedure
* \>30% residual stenosis after previous treatment
11. Predilation with a balloon catheter of the target lesion and/or target vessel is not allowed.
Minimum Eligible Age

18 Years

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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John A Ormiston, MD

Role: PRINCIPAL_INVESTIGATOR

Mercy Hospital

Mark A Turco, MD

Role: PRINCIPAL_INVESTIGATOR

Washington Adventist Hospital

Peter Maurer, MPH

Role: STUDY_DIRECTOR

Boston Scientific Corporation

Locations

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University of Arkansas for Medical Sciences/Central Arkansas Veterans Healthcare Systems

Little Rock, Arkansas, United States

Site Status

Mercy General Hospital

Sacramento, California, United States

Site Status

University of California San Diego Medical Center

San Diego, California, United States

Site Status

The Medical Center of Aurora

Aurora, Colorado, United States

Site Status

Florida Hospital

Orlando, Florida, United States

Site Status

St. Anthony's Medical Center

Rockford, Illinois, United States

Site Status

St. John's Hospital

Springfield, Illinois, United States

Site Status

The Heart Center

Indianapolis, Indiana, United States

Site Status

Maine Medical Center

Portland, Maine, United States

Site Status

Washington Adventist Hospital

Takoma Park, Maryland, United States

Site Status

Genesys Regional Medical Center

Grand Blanc, Michigan, United States

Site Status

Northern Michigan Hospital

Petoskey, Michigan, United States

Site Status

St. Mary's Duluth Clinic Regional Heart Center

Duluth, Minnesota, United States

Site Status

Wake Medical Center

Raleigh, North Carolina, United States

Site Status

Oklahoma Foundation for Cardiovascular Research

Oklahoma City, Oklahoma, United States

Site Status

The Pennsylvania State University Milton S Hershey Medical Center

Hershey, Pennsylvania, United States

Site Status

Wellmont Holston Valley Medical Center

Kingsport, Tennessee, United States

Site Status

Northwest Cardiovascular Research Institute

Spokane, Washington, United States

Site Status

Mercy Angiography Unit, 98 Mountain Road, First Floor

Auckland, Epsom, New Zealand

Site Status

Auckland City Hospital

Auckland, , New Zealand

Site Status

Christchurch Hospital

Christchurch, , New Zealand

Site Status

Dunedin Hospital

Dunedin, , New Zealand

Site Status

National University Hospital

Singapore, , Singapore

Site Status

National Heart Centre

Singapore, , Singapore

Site Status

Shin Kong Memorial Hospital

Shih Lin Taipei, , Taiwan

Site Status

Countries

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United States New Zealand Singapore Taiwan

References

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Ormiston JA, Charles O, Mann T, Hall JJ, McGarry T, Cannon LA, Webster MW, Mishkel GJ, Underwood PL, Dawkins KD. Final 5-year results of the TAXUS ATLAS, TAXUS ATLAS Small Vessel, and TAXUS ATLAS Long Lesion clinical trials of the TAXUS Liberte paclitaxel-eluting stent in de-novo coronary artery lesions. Coron Artery Dis. 2013 Jan;24(1):61-8. doi: 10.1097/MCA.0b013e32835b3932.

Reference Type DERIVED
PMID: 23232250 (View on PubMed)

Doi H, Maehara A, Mintz GS, Yu A, Wang H, Mandinov L, Popma JJ, Ellis SG, Grube E, Dawkins KD, Weissman NJ, Turco MA, Ormiston JA, Stone GW. Impact of post-intervention minimal stent area on 9-month follow-up patency of paclitaxel-eluting stents: an integrated intravascular ultrasound analysis from the TAXUS IV, V, and VI and TAXUS ATLAS Workhorse, Long Lesion, and Direct Stent Trials. JACC Cardiovasc Interv. 2009 Dec;2(12):1269-75. doi: 10.1016/j.jcin.2009.10.005.

Reference Type DERIVED
PMID: 20129555 (View on PubMed)

Mahmud E, Ormiston JA, Turco MA, Popma JJ, Weissman NJ, O'Shaughnessy CD, Mann T, Hall JJ, McGarry TF, Cannon LA, Webster MW, Mandinov L, Baim DS. TAXUS Liberte attenuates the risk of restenosis in patients with medically treated diabetes mellitus: results from the TAXUS ATLAS program. JACC Cardiovasc Interv. 2009 Mar;2(3):240-52. doi: 10.1016/j.jcin.2008.12.009.

Reference Type DERIVED
PMID: 19463432 (View on PubMed)

Ormiston JA, Mahmud E, Turco MA, Popma JJ, Weissman N, Cannon LA, Mann T, Lucca MJ, Lim ST, Hall JJ, McClean D, Dobies D, Mandinov L, Baim DS. Direct stenting with the TAXUS Liberte drug-eluting stent: results from the Taxus Atlas Direct Stent Study. JACC Cardiovasc Interv. 2008 Apr;1(2):150-60. doi: 10.1016/j.jcin.2008.01.003.

Reference Type DERIVED
PMID: 19463293 (View on PubMed)

Other Identifiers

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TAXUS ATLAS Direct Stent

Identifier Type: -

Identifier Source: secondary_id

S2032

Identifier Type: -

Identifier Source: org_study_id

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