SCRIPPS V: Intracoronary Brachytherapy for Recurrent Restenosis After Multiple Drug-Eluting Stents

NCT ID: NCT00714545

Last Updated: 2020-10-22

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

PHASE4

Total Enrollment

65 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-04-30

Study Completion Date

2013-11-30

Brief Summary

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This study is a prospective study of patients treated at Scripps Clinic with intracoronary brachytherapy for recurrent restenosis within drug eluting stents.

Detailed Description

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This is an investigator-initiated protocol examining the effectiveness of intracoronary brachytherapy using the Novoste beta-emitting catheter for recurrent stenosis after treatment with multiple drug-eluting stents. While intracoronary brachytherapy has been used for this purpose by clinicians for some time, data supporting this clinical decision-making is lacking.

Currently, when cardiologists find restenosis after implanting a drug-eluting stent, they often place a stent that elutes a different drug within that stent. If a patient presents with restenosis in the segment that has already been treated with both sirolimus and paclitaxel-eluting stents, further options are limited. Intracoronary brachytherapy is often used in this scenario, but the efficacy of this approach has not been well studied. The investigators recently reviewed the clinical outcomes of five patients who underwent intracoronary radiation after drug-eluting stents. They discovered only one episode of target vessel revascularization and no episodes of stent thrombosis. While this sample is small, investigators believe that a prospective study will provide important information regarding this approach.

Conditions

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Coronary Artery Disease Coronary Restenosis

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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prospective study

This study is a prospective study of patients treated at Scripps Clinic with intracoronary brachytherapy for recurrent restenosis within drug-eluting stents. Beta irradiation with a 40-mm strontium/yttrium-90 source. No placebo will be used in this trial.

Group Type NO_INTERVENTION

Intracoronary brachytherapy

Intervention Type RADIATION

Beta irradiation with a 40-mm strontium/lytrium-90 source

Interventions

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Intracoronary brachytherapy

Beta irradiation with a 40-mm strontium/lytrium-90 source

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

1. Age 18 years or older.
2. Eligible for percutaneous coronary intervention.
3. Target lesion with recurrent restenosis (\>50% by visual estimate) previously treated with any 2 or more combination of DES stents.
4. Signs or symptoms of ischemia attributable to the target lesion, or stenosis \> 50% by visual estimation of the lesion during angiography.
5. Target lesion is located within a native coronary artery or bypass graft.
6. Be reliable, cooperative and willing to comply with all protocol-specified procedures and follow-up.
7. Able to understand and sign informed consent.

Exclusion Criteria

1. Confirmed pregnancy at the time of index PCI.
2. Has known allergies to aspirin, and to both clopidogrel (Plavix ®) and ticlopidine (Ticlid ®).
3. Has known allergies or contraindication to heparin and Bivalirudin (Angiomax ®).
4. Has a significant medical condition which in the investigator's opinion may interfere with the patient's optimal participation in the study.
5. Any serious disease condition with life expectancy of less than 1 year.
6. Unsuccessful coronary revascularization procedure (residual stenosis \> 30%).
7. Angiographic evidence of thrombus.
8. No Previous intracoronary radiation to the target artery.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Scripps Health

OTHER

Sponsor Role lead

Responsible Party

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Paul S Teirstein, MD

Director, Scripps Cardiovascular Institute

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Paul S. Teirstein, MD

Role: PRINCIPAL_INVESTIGATOR

Scripps Clinic

Locations

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Scripps Green Hospital/Scripps Clinic

La Jolla, California, United States

Site Status

Countries

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United States

Other Identifiers

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004408

Identifier Type: -

Identifier Source: org_study_id

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