TAXUS PERSEUS Workhorse

Phase 3

Completed

Conditions: Coronary Artery Disease

Interventions: Device: Percutaneous coronary intervention (PCI) with paclitaxel-eluting stent (TAXUS Express) placement
Device: Percutaneous coronary intervention (PCI) with paclitaxel-eluting stent (TAXUS Element) implantation

Registration Number: NCT00484315

Lead Sponsor: Boston Scientific Corporation

Brief Summary: The purpose of the TAXUS PERSEUS Workhorse trial is to evaluate the safety and efficacy of the next-generation Boston Scientific TAXUS paclitaxel-eluting coronary stent system (TAXUS® ElementTM) for the treatment of de novo atherosclerotic lesions of up to 28 mm in length in native coronary arteries of 2.75 mm to 4.0 mm diameter.

Detailed Description: This is a prospective, 3:1 randomization, multi-center trial to assess the TAXUS® Element™ Paclitaxel-Eluting Coronary Stent System for the treatment of de novo atherosclerotic lesions of up to 28 mm in length in native coronary arteries ≥ 2.75 mm and ≤ 4.0 mm in diameter, compared to a control group of TAXUS Express2 Paclitaxel-Eluting Coronary Stent System .

One thousand two hundred sixty-four (1264) subjects will be treated with either the TAXUS® Element™ stent or the TAXUS® Express2 ™stent at a maximum of 100 clinical sites. Randomization to treatment group will be unbalanced 3:1 towards the test group to gain maximum clinical experience with the new TAXUS® Element™ platform. Follow-up at 30 days, 9 months and 12 months will be completed in all subjects enrolled in the study. Angiographic follow-up at 9 months will be completed in a subset of three hundred thirty (330) subjects enrolled in the study. Subjects will be randomly allocated to the angiographic subset at participating sites through the Interactive Voice Response System (IVRS).

Eligible subjects will have annual follow-up until 5 years post-index procedure.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 1264

Inclusion Criteria

Subject is ≥ 18 years old
Eligible for percutaneous coronary intervention (PCI)
Documented stable angina pectoris (Canadian Cardiovascular Society [CCS] Classification 1, 2, 3, or 4) or unstable angina pectoris (Braunwald Class IB-C, IIB-C, or IIIB-C), or documented silent ischemia
Acceptable candidate for coronary artery bypass grafting (CABG)
Left ventricular ejection fraction (LVEF) is ≥ 30%
Subject (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
Subject willing to comply with all specified follow-up evaluations

Clinical

Exclusion Criteria

Contraindication to aspirin (ASA), or to both clopidogrel and ticlopidine
Known hypersensitivity to paclitaxel
Known allergy to stainless steel
Known allergy to platinum
Previous treatment of the target vessel with any anti-restenotic drug-coated or drug-eluting coronary stent
Previous treatment of the target vessel with a bare metal stent (BMS) within 9 months of the index procedure
Previous treatment of any non-target vessel with any anti-restenotic drug-coated or drug-eluting coronary stent within 9 months of the index procedure
Previous treatment with intravascular brachytherapy in the target vessel
Planned PCI or CABG post-index procedure
Planned or actual target vessel treatment with an unapproved device, directional or rotational coronary atherectomy, laser, cutting balloon or transluminal extraction catheter immediately prior to stent placement
Myocardial infarction (MI) within 72 hours prior to index procedure
Cerebrovascular accident (CVA) within the past 6 months
Cardiogenic shock
Acute or chronic renal dysfunction
Prior anaphylactic reaction to contrast agents
Leukopenia
Thrombocytopenia
Thrombocytosis
Active peptic ulcer or active gastrointestinal (GI) bleeding
Current treatment, or past-treatment within 12-months of the index procedure, with paclitaxel or other chemotherapeutic agents
Anticipated treatment with paclitaxel or oral rapamycin during any period in the 9-months after the index procedure
Known intention to procreate within 9 months after the index procedure
Positive pregnancy test within 7 days before the index procedure, or lactating
Life expectancy of less than 24 months due to other medical conditions
Co-morbid condition(s) that could limit subject's ability to comply with study follow-up requirements or impact study scientific integrity
Currently participating in another investigational drug or device study

Angiographic Inclusion Criteria:

Target Lesion
- Target lesion located in native coronary artery
- Target lesion must be de novo
- Target lesion diameter stenosis ≥ 50%
- Reference vessel diameter (RVD) ≥ 2.75 mm to ≤ 4.0 mm
- Cumulative target lesion length ≤ 28 mm (area to be treated may be composed of multiple lesions but must be completely coverable by one study stent)
- Target lesion is successfully pre-dilated
One non-target lesion may be treated in a non-target vessel as follows:
- Non-target lesion in non-target vessel must be treated with commercially available TAXUS stent if use of drug eluting stent required
- Treatment must be deemed a clinical angiographic success, without requiring use of unplanned additional stents(s)
- Treatment must be completed prior to treatment of target vessel

Angiographic Exclusion Criteria

Target lesion located in left main artery, whether protected or unprotected
Target lesion is a chronic total occlusion (TIMI flow ≤ 1)
Target lesion is restenotic
Target lesion is located in a saphenous vein graft or mammary artery graft
Target lesion is accessed via saphenous vein graft or mammary artery graft
Target lesion is < 5 mm from bare metal stent (BMS)
Target lesion < 5 mm from ostium
Target lesion < 5 mm from side branch vessel ≥ 2.0 mm in diameter (Exceptions: subject may be enrolled if side branch is 100% occluded or if side branch is protected with a patent graft)
Untreated lesions with ≥ 50% diameter stenosis or thought to impair flow remaining in target vessel at a location with ≥ 2.0mm RVD
Target lesion and/or target vessel proximal to target lesion moderately or severely calcified
Target lesion and/or target vessel proximal to target lesion severely tortuous
Target lesion located within or distal to a > 60° bend in target vessel
Target vessel with angiographic presence of probable or definite thrombus
Unprotected left main coronary artery disease
Protected left main coronary artery disease with target lesion in Left Anterior Descending artery (LAD) or Left Circumflex artery (LCx). Subject may be enrolled if only lesion is target lesion in Right Coronary Artery (RCA)

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
TAXUS Express	Percutaneous coronary intervention (PCI) with paclitaxel-eluting stent (TAXUS Express) placement	-
TAXUS Element	Percutaneous coronary intervention (PCI) with paclitaxel-eluting stent (TAXUS Element) implantation	-

Primary Outcome Measures

Name	Time	Method
Target Lesion Failure (TLF) at 12 Months Post-index Procedure. TLF is Defined as Any Ischemia-driven Revascularization of the Target Lesion, Myocardial Infarction (Q-wave and Non-Q-wave), or Death Related to the Target Vessel.	12 months post-index procedure	The number of participants who experience a TLF through 365 days post-procedure out of the participants who have either had a TLF within 365 days post-procedure or who were TLF-free with last follow-up at least 335 days post-procedure.

Secondary Outcome Measures

Name	Time	Method
In-segment Percent Diameter Stenosis at 9 Months Post-index Procedure	9 months post-index procedure	The minimum lumen diameter in the analysis segment at 9-months post-index procedure, divided by the reference vessel diameter at baseline. The analysis segment ("in-segment") is defined as the proximal edge, stented area, and the distal edge, where each edge segment contains up to 5mm immediately outside the stent.

Trial Locations

Locations (89): Baptist Medical Center Princeton
🇺🇸
Birmingham, Alabama, United States
Medical Center East
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Birmingham, Alabama, United States
Bakersfield Memorial Hospital
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Bakersfield, California, United States
Alvarado Hospital
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La Jolla, California, United States
Scripps Clinic
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La Jolla, California, United States
Scripps Memorial Hospital
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La Jolla, California, United States
University of California, Davis Medical Center
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Sacramento, California, United States
Mercy General Hospital
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Sacramento, California, United States
South Denver Cardiology Associates, PC
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Littleton, Colorado, United States
Christiana Hospital
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Newark, Delaware, United States
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Baptist Medical Center Princeton
🇺🇸Birmingham, Alabama, United States