CANARY: Coronary Assessment by Near-infrared of Atherosclerotic Rupture-prone Yellow

NCT ID: NCT01268319

Last Updated: 2017-06-12

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

TERMINATED

Clinical Phase

NA

Total Enrollment

85 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-05-31

Study Completion Date

2016-11-30

Brief Summary

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The CANARY (Coronary Assessment by Near-infrared of Atherosclerotic Rupture-prone Yellow) Study is a pivotal trial to evaluate criteria for defining a Lipid Core Plaque (LCP) that is at high risk of rupturing during standard of care therapy and causing intra-procedural complications. If plaques that require treatment are at higher than normal risk of causing intra-procedural complications, some life threatening, the treating physician is better informed and may opt to take precautionary measures to mitigate the risk or result of a complication. The CANARY Study is also designed to evaluate the feasibility of using a distal embolization protection device (EPD) as a means to prevent heart attacks triggered by the embolization of plaque during standard care therapy. It is thought that the EPD will prevent plaque from going downstream during treatment and obstructing other heart vessels. These obstructions could cause heart attacks by preventing blood from reaching heart muscle tissue.

Detailed Description

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Conditions

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Coronary Atherosclerosis Myocardial Infarction Coronary Plaque Embolization

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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(+)HR-LCP and EPD

These subjects will meet all angiographic criteria.The target plaque will contain a LipiScan IVUS signal that meets the Higher Risk Lipid Core Plaque (HR-LCP) definition contained in the protocol. 27 Subjects who meet this criteria will be randomized to standard pre-dilation and stent implantation with an embolic protection device (EPD)in place prior to any angioplasty.

Group Type EXPERIMENTAL

Embolic Protection Device (EPD)

Intervention Type DEVICE

The embolic protection device consists of a protection wire, a delivery sheath, a retrieval sheath and various accessories (wire torque device, introducer, dilator tool). The wire of the EPD is used as a standard 0.014" steerable guide wire. The filter is designed for embolic debris capture while maintaining continuous blood flow. At the completion of the procedure, the filter and its contents are removed using the retrieval sheath and then removed from the patient.

Intracoronary Spectroscopy and Ultrasonic Evaluation

Intervention Type DEVICE

This intervention requires a near infrared imaging catheter equipped with an intravascular ultrasonic transducer be used to evaluate the coronary artery wall prior to treatment and after treatment. This system detects the lipid containing plaques that may be the source of embolic debris released during standard angioplasty and stent placement.

Angioplasty and Stent Implant

Intervention Type DEVICE

The target plaque will be treated with a pre-dilation with a standard angioplasty balloon sized to within 0.5mm of the diameter of the reference vessel diameter. The physician will then implant a coronary artery stent that is appropriately sized for the reference vessel diameter.

(+)HR-LCP and No EPD (standard of care)

These subjects will meet all angiographic criteria.The target plaque will contain a LipiScan IVUS signal that meets the Higher Risk Lipid Core Plaque (HR-LCP) definition contained in the protocol. 27 Subjects who meet this criteria will be randomized to standard pre-dilation and stent implantation without an embolic protection device (EPD)in place prior to any angioplasty.

Group Type PLACEBO_COMPARATOR

Intracoronary Spectroscopy and Ultrasonic Evaluation

Intervention Type DEVICE

This intervention requires a near infrared imaging catheter equipped with an intravascular ultrasonic transducer be used to evaluate the coronary artery wall prior to treatment and after treatment. This system detects the lipid containing plaques that may be the source of embolic debris released during standard angioplasty and stent placement.

Angioplasty and Stent Implant

Intervention Type DEVICE

The target plaque will be treated with a pre-dilation with a standard angioplasty balloon sized to within 0.5mm of the diameter of the reference vessel diameter. The physician will then implant a coronary artery stent that is appropriately sized for the reference vessel diameter.

(-)HR-LCP and No EPD (standard of care)

These subjects will meet all angiographic criteria.The target plaque will NOT contain a LipiScan IVUS signal that meets the Higher Risk Lipid Core Plaque (HR-LCP) definition contained in the protocol. 54 Subjects who meet this criteria will be assigned (not randomized) to standard pre-dilation and stent implantation without an embolic protection device (EPD)in place prior to any angioplasty.

Group Type PLACEBO_COMPARATOR

Intracoronary Spectroscopy and Ultrasonic Evaluation

Intervention Type DEVICE

This intervention requires a near infrared imaging catheter equipped with an intravascular ultrasonic transducer be used to evaluate the coronary artery wall prior to treatment and after treatment. This system detects the lipid containing plaques that may be the source of embolic debris released during standard angioplasty and stent placement.

Angioplasty and Stent Implant

Intervention Type DEVICE

The target plaque will be treated with a pre-dilation with a standard angioplasty balloon sized to within 0.5mm of the diameter of the reference vessel diameter. The physician will then implant a coronary artery stent that is appropriately sized for the reference vessel diameter.

Interventions

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Embolic Protection Device (EPD)

The embolic protection device consists of a protection wire, a delivery sheath, a retrieval sheath and various accessories (wire torque device, introducer, dilator tool). The wire of the EPD is used as a standard 0.014" steerable guide wire. The filter is designed for embolic debris capture while maintaining continuous blood flow. At the completion of the procedure, the filter and its contents are removed using the retrieval sheath and then removed from the patient.

Intervention Type DEVICE

Intracoronary Spectroscopy and Ultrasonic Evaluation

This intervention requires a near infrared imaging catheter equipped with an intravascular ultrasonic transducer be used to evaluate the coronary artery wall prior to treatment and after treatment. This system detects the lipid containing plaques that may be the source of embolic debris released during standard angioplasty and stent placement.

Intervention Type DEVICE

Angioplasty and Stent Implant

The target plaque will be treated with a pre-dilation with a standard angioplasty balloon sized to within 0.5mm of the diameter of the reference vessel diameter. The physician will then implant a coronary artery stent that is appropriately sized for the reference vessel diameter.

Intervention Type DEVICE

Other Intervention Names

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Filterwire LipiScan IVUS Coronary Imaging System LipiScan IVUS LipiScan Chemogram

Eligibility Criteria

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Inclusion Criteria

* Subject is at least 18 years of age
* Subject is scheduled for an elective coronary catheterization
* Subject is willing and able to provide informed written consent prior to the index catheterization
* LipiScan IVUS CIS use is not contra-indicated
* At least one submitted Chemogram is obtained entirely within a native coronary artery
* Patient has been diagnosed with: stable angina (CCS I or CCS II);a positive functional test for ischemia (within the preceding 30 days); OR Stabilized acute coronary syndrome (unstable angina (CCS III, or CCS IV), non STEMI, or STEMI with no chest pain or other cardiac symptoms for \>24 hours
* Blood cardiac biomarker (i.e. troponin I, CK-MB) levels less than the local laboratory ULN within 12 hours of the time of PCI guidewire placement.
* Subject is to undergo PCI of a single lesion in a single native coronary artery during the enrollment procedure.
* There is prior intent to treat the target lesion as part of the patient's clinical care.
* The target lesion angiographic stenosis visually estimated as \>=50% and \<100%
* The target lesion reference vessel diameter must be \>=2.5mm (visually estimated)
* Total target lesion length must be ≤60 mm (visually estimated)
* The minimum landing zone requirements for the FilterWire device can be met.
* There must be no major side branches (\>2.0 mm in diameter) within the target lesion.
* There must be no major side branches (\>2.0mm in diameter) between the target lesion and the filter nitinol loop landing zone.

Exclusion Criteria

* Subject is currently, or within the preceding 30 days, participating in a device or pharmaceutical treatment protocol.
* Subject life expectancy at time of enrollment is less than 2 years;
* Subject is pregnant or suspected to be pregnant at time of enrollment
* Prior coronary bypass graft surgery (CABG)
* PCI performed within the 24hours prior to the start of the study procedure
* A PCI is planned within the 30 days following the enrollment procedure.
* Unable to take aspirin and a thienopyridine for at least 30 days
* Patient experienced a STEMI or non STEMI within the past 24 hours
* Documented LVEF \<25%
* the patient has multi-lesion or multi-vessel disease requiring revascularization of multiple lesions during the enrollment catheterization
* Any angiographic evidence of thrombus in any coronary artery
* There is evidence of dissection or procedural complication prior to randomization
* Patient has unprotected left main (≥50% stenosis) or left main equivalent disease
* Target Lesion is located in the distal segment of the target native coronary artery
* Proximal bound of the target lesion is located within 3mm of the ostium of the target vessel or major side branch (\>2mm diameter by visual estimate)
* Target lesion is excessively calcified
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Infraredx

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Gregg W. Stone, M.D.

Role: PRINCIPAL_INVESTIGATOR

Columbia University

Locations

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Scottsdale Healthcare Shea

Scottsdale, Arizona, United States

Site Status

San Francisco Veterans Affairs Medical Center

San Francisco, California, United States

Site Status

Washington Hospital Center

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

Site Status

Spectrum Health System

Grand Rapids, Michigan, United States

Site Status

William Beaumont Hospital

Royal Oak, Michigan, United States

Site Status

Mount Sinai School of Medicine Hospital

New York, New York, United States

Site Status

Pinnacle Health Cardiovascular Insititute

Harrisburg, Pennsylvania, United States

Site Status

Medical University of South Carolina Hospital

Charleston, South Carolina, United States

Site Status

Veterans Affairs North Texas Health Care Systems

Dallas, Texas, United States

Site Status

Countries

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United States

Other Identifiers

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0114

Identifier Type: -

Identifier Source: org_study_id

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