The eSVS (TM) Mesh External Saphenous Vein Support Trial

NCT ID: NCT00777777

Last Updated: 2008-10-22

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

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-08-31

Study Completion Date

2009-09-30

Brief Summary

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Prospective, multi-center, randomized, controlled (patients as their own control) trial on an external mesh device (eSVS™, Kips Bay Medical) supporting saphenous vein grafts for coronary bypass graft surgery in patients with multi-vessel coronary heart disease.

Detailed Description

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The objective of the eSVS™ Mesh Saphenous Vein Support Trial is to prospectively evaluate the clinical safety and efficacy of the eSVS™ Mesh for the treatment of Saphenous Vein Graft (SVG) Coronary artery bypass grafting (CABG) versus SVG CABG without an eSVS™ Mesh.

The eSVS™ Mesh External Saphenous Vein Support Trial is a prospective, multi-center, randomized, controlled trial enrolling up to 120 patients with multi-vessel coronary artery disease who require SVG CABG of the Right Coronary Artery and the Circumflex Artery due to atherosclerotic coronary artery disease. Patients will serve as their own control (patients will be randomized to either:

1. SVG+eSVS™ Mesh at Right Coronary Artery and SVG at Circumflex Artery or
2. SVG at Right Coronary Artery and SVG+eSVS™ Mesh at Circumflex Artery).

Clinical follow-up assessments consisting of a physical exam, laboratory testing, medication review, and adverse event monitoring for all enrolled patients will be performed at 30 days, 6 months and 12 months. In addition, the 12 month follow-up assessment will include angiography.

The investigational device being evaluated in this clinical trial is an External Saphenous Vein Support device, the eSVS™ Mesh.

The eSVS™ Mesh is an extravascular prosthesis consisting of a highly flexible, semi-compliant knitted nitinol mesh tube that is placed over the patient's saphenous vein graft (SVG) during coronary artery bypass grafting (CABG). The eSVS™ Mesh is designed to:

* provide radial support to the vein to prevent graft dilatation
* reduce the vein graft diameter to more closely match target coronary artery diameter
* provide a more uniform lumen
* improve blood flow characteristics
* mitigate the development of intimal hyperplasia and graft stenosis

The eSVS™ Mesh has compliance characteristics comparable to native internal thoracic arteries. Since the eSVS™ Mesh vascular prosthesis is made of nitinol, it is highly kink resistant.

Conditions

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Coronary Artery Disease

Keywords

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multi-vessel, therapy, surgery, CABG

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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1

Either the Circumflex Coronary Artery or the Right Coronary Artery will receive the mesh supported vein graft and the native saphenous vein as second and control graft.

Group Type EXPERIMENTAL

eSVS, saphenous vein supporting mesh

Intervention Type DEVICE

Surgical coronary artery bypass grafting to the right coronary artery and the circumflex coronary artery with saphenous vein grafts, one will be supported by the eSVS(TM).

Interventions

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eSVS, saphenous vein supporting mesh

Surgical coronary artery bypass grafting to the right coronary artery and the circumflex coronary artery with saphenous vein grafts, one will be supported by the eSVS(TM).

Intervention Type DEVICE

Other Intervention Names

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eSVS™; Kips Bay Medical

Eligibility Criteria

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Inclusion Criteria

1. require on-pump SVG CABG of the Right Coronary Artery and the Circumflex Artery due to atherosclerotic coronary artery disease, with ≥ 75% stenosis in each of these vessels
2. have appropriately sized and accessible target coronary arteries, with a minimum diameter of 1.5 mm and a lack of calcification at the anastomotic site
3. are able to give their informed written consent
4. are ≥ 21 years of age

Exclusion Criteria

1. no appropriate target coronary vessel
2. discreet attachment of each SVG to the aorta is not possible (non-consecutive or "jump" grafts are excluded)
3. concomitant non-CABG cardiac procedure
4. prior peripheral vascular or cardiac surgery
5. prior stroke
6. history of atrial fibrillation
7. diffuse peripheral vascular disease
8. age \> 80
9. LVEF \< 30% at time of enrollment
10. Insulin-dependent diabetes
11. concurrent participation in another trial
12. concomitant life-threatening disease likely to limit life expectancy to less than 2 years
13. contra-indications to on-pump CABG with cardioplegic arrest (calcified aorta, calcified coronaries, small target vessels)
14. emergency CABG surgery
15. inability to tolerate or comply with normal post-surgical drug regimen (antiplatelet plus statin)
16. taking warfarin or clopidogrel at the time of surgery
17. inability to comply with required follow-ups, including angiography imaging methods
18. patient is pregnant or intends on becoming pregnant in the next 12 months
Minimum Eligible Age

21 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Kips Bay Medical, Inc.

INDUSTRY

Sponsor Role collaborator

Transmedic Pte Ltd, Singapore

UNKNOWN

Sponsor Role collaborator

National University Hospital, Singapore

OTHER

Sponsor Role lead

Responsible Party

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National University Hospital Singapore

Principal Investigators

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Uwe Klima, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Cardiac, Thoracic and Vascular Surgery, National University Hospital Singapore

Locations

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Department of Cardiac, Thoracic and Vascular Surgery, National University Hospital Singapore

Singapore, , Singapore

Site Status RECRUITING

Countries

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Singapore

Central Contacts

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Uwe Klima, MD, PhD

Role: CONTACT

Phone: 00656772

Email: [email protected]

Theodoros Kofidis, MD, PhD

Role: CONTACT

Phone: 00656772

Email: [email protected]

Facility Contacts

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Uwe Klima, MD, PhD

Role: primary

References

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Mehta D, George SJ, Jeremy JY, Izzat MB, Southgate KM, Bryan AJ, Newby AC, Angelini GD. External stenting reduces long-term medial and neointimal thickening and platelet derived growth factor expression in a pig model of arteriovenous bypass grafting. Nat Med. 1998 Feb;4(2):235-9. doi: 10.1038/nm0298-235.

Reference Type BACKGROUND
PMID: 9461200 (View on PubMed)

Klesius AA, Konerding MA, Knez P, Dzemali O, Schmitz-Rixen T, Ackermann H, Moritz A, Kleine P. External stenting with a new polyester mesh reduces neointimal hyperplasia of vein grafts in a sheep model. Int J Artif Organs. 2007 Oct;30(10):930-8. doi: 10.1177/039139880703001011.

Reference Type BACKGROUND
PMID: 17992655 (View on PubMed)

Other Identifiers

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DSRB-C/08/149

Identifier Type: -

Identifier Source: org_study_id