MedPath

SPIRIT Small Vessel Registry

Not Applicable
Terminated
Conditions
Myocardial Ischemia
Coronary Artery Disease
Atherosclerosis
Interventions
Device: 2.25 mm XIENCE V® Everolimus Eluting Coronary Stent System
Registration Number
NCT00783796
Lead Sponsor
Abbott Medical Devices
Brief Summary

To evaluate the safety and effectiveness of the 2.25 mm XIENCE V® Everolimus Eluting Coronary Stent System (XIENCE V® EECSS) in improving coronary luminal diameter in subjects with ischemic heart disease due to a maximum of two de novo native coronary artery lesions in small vessels, each in a different epicardial vessel.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
150
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
2.25mm XIENCE V®2.25 mm XIENCE V® Everolimus Eluting Coronary Stent SystemPatients receiving the 2.25 mm XIENCE V® stent
Primary Outcome Measures
NameTimeMethod
Composite Rate of Cardiac Death, Target Vessel Myocardial Infarction (MI) (Per Protocol Definition) & Clinically Indicated Target Lesion Revascularization (CI-TLR).3 years

This endpoint is a composite of cardiac death, target vessel myocardial infarction per protocol definition, and clinically-indicated target lesion revascularization.

Secondary Outcome Measures
NameTimeMethod
Target Vessel MI - Q-wave and Non Q-wave (Per ARC)3 years

ARC defined target vessel MI (MI not clearly attributable to a non-target vessel): Myocardial Infarction as per Academic Research Consortium standardized definitions (Circulation 2007;115:2344- 2351).

Cardiac Death/MI3 years

This endpoint is a composite of cardiac death and all myocardial infarction per protocol definition.

All Coronary Revascularization (TVR and Non-TVR)3 years

Includes any revascularization intervention after the index procedure by any means (percutaneous or bypass surgery), including intervention to the target vessel, and intervention to a vessel other than the target vessel (per protocol).

Clinically Indicated Target Vessel Revascularization3 years

Includes clinically indicated repeat revascularization after the index procedure by any means (percutaneous or bypass surgery), of the target vessel. Classification as clinically indicated is done prospectively and verified by angiographic core lab measurement, and requires ≥50% diameter stenosis with ischemic signs or symptoms (positive history of angina pectoris or objective signs of ischemia at rest (ECG changes) or during exercise test or abnormal invasive cardiac functional diagnostic test), or ≥70% diameter stenosis in the absence of the above-mentioned ischemic signs or symptoms (per protocol).

In-Stent Late Loss240 days

In-stent minimum lumen diameter (MLD) post-procedure minus in-stent MLD at angiographic follow-up.

Device Success (Per Lesion Basis, for Target Lesions Treated by 2.25 mm XIENCE V EECS With or Without Planned Overlap)From start of index procedure to end of index procedure

Successful delivery and deployment of the first study stent intended to be implanted at the intended target lesion (or intended first and second investigational stents for overlapping stents), successful withdrawal of the stent delivery system, and attainment of final residual stenosis of \<50%.

Procedural Success (Per Subject Basis, for ALL Target and Non-target Lesions)From the start of index procedure to end of index procedure

Achievement of a final in-stent diameter stenosis of \<50% using the study device, without the occurence of cardiac death, target vessel myocardial infarction per protocol definition, or repeat revascularization of the target lesion during the hospital stay up to 7 days.

In-segment Late Loss (LL)240 Days

In-segment minimum lumen diameter (MLD) post-procedure minus in-segment MLD at angiographic follow-up.

Proximal Late Loss240 days

Proximal minimum lumen diameter (MLD) post-procedure minus proximal MLD at angiographic follow-up (proximal defined as 5 mm of healthy tissue proximal to stent placement).

Distal Late Loss240 days

Distal minimum lumen diameter (MLD) post-procedure minus distal MLD at angiographic follow-up (distal defined as 5 mm of healthy tissue distal to stent placement).

In-stent % Diameter Stenosis240 days

Value calculated as 100\*(1-MLD/RVD) where MLD is in-stent minimum lumen diameter and RVD is in-stent reference vessel diameter.

Proximal % Diameter Stenosis240 days

Value calculated as 100\*(1-MLD/RVD) where MLD is minimum lumen diameter and RVD is reference vessel diameter in 5 mm of healthy tissue proximal to stent placement.

In-stent Angiographic Binary Restenosis (ABR) Rate240 days

Percentage of patients with target lesions with ≥ 50% in-stent % diameter stenosis at angiographic follow-up.

Clinically Indicated Target Vessel Revascularization (TVR)30 days

Includes clinically indicated repeat revascularization after the index procedure by any means (percutaneous or bypass surgery), of the target vessel. Classification as clinically indicated is done prospectively and verified by angiographic core lab measurement, and requires ≥50% diameter stenosis with ischemic signs or symptoms (positive history of angina pectoris or objective signs of ischemia at rest (ECG changes) or during exercise test or abnormal invasive cardiac functional diagnostic test), or ≥70% diameter stenosis in the absence of the above-mentioned ischemic signs or symptoms.

Non Target Vessel MI- Q-wave, Non Q-wave (Per ARC)3 years

ARC defined non-target vessel MI (MI clearly attributable to a non-target vessel): Myocardial Infarction as per Academic Research Consortium standardized definitions (Circulation 2007;115:2344- 2351).

Target Vessel MI - Q-wave and Non Q-wave (Per Protocol)3 years

Target vessel myocardial infarction (MI) (MI not clearly attributable to a non-target vessel), including Q-wave MI (new pathologic Q waves) and Non Q-wave MI (elevation of CK to ≥ two times the upper limit normal with elevated CK-MB in the absence of new pathological Q waves).

All TVR (CI and Non-CI)3 years

Includes any repeat revascularization intervention after the index procedure by any means (percutaneous or bypass surgery) in the target vessel from the index procedure (per protocol).

All TLR (CI and Non-CI)3 years

Includes any repeat revascularization intervention after the index procedure by any means (percutaneous or bypass surgery) of the target lesion from the index procedure. This includes interventions classified as clinically indicated, and also includes interventions classified as not clinically indicated (per protocol).

In-segment % Diameter Stenosis240 days

Value calculated as 100\*(1-MLD/RVD) where MLD is in-segment minimum lumen diameter and RVD is in-segment reference vessel diameter.

Distal % Diameter Stenosis240 days

Value calculated as 100\*(1-MLD/RVD) where MLD is minimum lumen diameter and RVD is reference vessel diameter in 5 mm of healthy tissue distal to stent placement.

In-segment Angiographic Binary Restenosis (ABR) Rate240 days

Percentage of patients with target lesions with ≥ 50% in-segment % diameter stenosis at angiographic follow-up.

Stent Thrombosis (ARC Defined)Overall (0 - 1123 days)

Stent Thrombosis as per Academic Research Consortium standardized definitions (Circulation 2007;115:2344-2351). Result includes Definite/Probable/Possible.

Stent Thrombosis (Protocol Defined)Overall (0 - 1123 days)

Stent Thrombosis per protocol categorized as acute (≤1 day), subacute (\>1 day and ≤30 days), and late (\>30 days), and defined as clinical presentation of acute coronary syndrome with angiographic evidence of stent thrombosis, or in absence of angiography, any unexplained death at any time or acute myocardial infarction\* (ST segment elevation or new Q-wave) in the distribution of the target lesion within 30 days of the index procedure. (\*Non-specific ST/T changes and cardiac enzymes do not suffice.). Result includes Definite/Probable/Possible.

All Death/ All MI/All Coronary Revascularization3 years

This endpoint is a composite of all death, all myocardial infarction per protocol definition, and all revascularization.

Clinically Indicated Target Lesion Revascularization (CI-TLR)3 years

Includes clinically indicated repeat revascularization after the index procedure by any means (percutaneous or bypass surgery) of the target lesion. Classification as clinically indicated is done prospectively and verified by angiographic core lab measurement, and requires ≥50% diameter stenosis with ischemic signs or symptoms (positive history of angina pectoris or objective signs of ischemia at rest (ECG changes) or during exercise test or abnormal invasive cardiac functional diagnostic test), or ≥70% diameter stenosis in the absence of the above-mentioned ischemic signs or symptoms (per protocol).

Non Target Vessel MI (Q-wave, Non Q-wave)(Per Protocol)3 years

Non target vessel myocardial infarction (MI) (MI clearly attributable to a non-target vessel), including Q-wave MI (new pathologic Q waves) and Non Q-wave MI (elevation of CK to ≥ two times the upper limit normal with elevated CK-MB in the absence of new pathological Q waves).

Proximal Angiographic Binary Restenosis (ABR) Rate240 days

Percentage of patients with target lesions with ≥ 50% diameter stenosis in 5 mm of healthy tissue proximal to stent placement at angiographic follow-up.

Distal Angiographic Binary Restenosis (ABR) Rate240 days

Percentage of patients with target lesions with ≥ 50% diameter stenosis in 5 mm of healthy tissue distal to stent placement at angiographic follow-up.

All Death (Cardiac, Vascular, Non-cardiovascular)3 years

All death, including death from cardiac, vascular, and non-cardiovascular causes (per protocol).

Cardiac Death/ All MI /CI-TLR3 years

This endpoint is a composite of cardiac death, all myocardial infarction (MI)per protocol definition, and clinically-indicated target lesion revascularization (CI-TLR).

Trial Locations

Locations (34)

Riverside Methodist Hospital

🇺🇸

Columbus, Ohio, United States

St. Joseph Medical Center

🇺🇸

Towson, Maryland, United States

Northern Michigan Hospital

🇺🇸

Petoskey, Michigan, United States

Presbyterian Hospital

🇺🇸

Charlotte, North Carolina, United States

Mother Frances Hospital

🇺🇸

Tyler, Texas, United States

Gotham Cardiovascular Reasearch, PC. (St. Vincent's Medical Center-closing, pts moved)

🇺🇸

New York, New York, United States

St. Patrick Hospital

🇺🇸

Missoula, Montana, United States

University Hospitals Case Medical Center

🇺🇸

Cleveland, Ohio, United States

St. Joseph Mercy Hospital

🇺🇸

Ypsilanti, Michigan, United States

Hillcrest Medical Center

🇺🇸

Tulsa, Oklahoma, United States

EMH Regional Medical Center

🇺🇸

Elyria, Ohio, United States

Morton Plant Hospital

🇺🇸

Clearwater, Florida, United States

Washington Hospital Center

🇺🇸

Washington, District of Columbia, United States

Sacred Heart Hospital

🇺🇸

Pensacola, Florida, United States

St. Anthony Hospital

🇺🇸

Rockford, Illinois, United States

Union Memorial Hospital

🇺🇸

Baltimore, Maryland, United States

Johns Hopkins Hospital

🇺🇸

Baltimore, Maryland, United States

Carolinas Medical Center

🇺🇸

Charlotte, North Carolina, United States

WakeMed Hospital

🇺🇸

Raleigh, North Carolina, United States

Forsyth Medical Center

🇺🇸

Winston-Salem, North Carolina, United States

Geisinger Medical Center

🇺🇸

Danville, Pennsylvania, United States

Northwest Texas Healthcare System

🇺🇸

Amarillo, Texas, United States

St. Joseph Hospital

🇺🇸

Bellingham, Washington, United States

Overlake Hospital Medical Center

🇺🇸

Bellevue, Washington, United States

Arkansas Heart Hospital

🇺🇸

Little Rock, Arkansas, United States

Baptist West Hospital

🇺🇸

Knoxville, Tennessee, United States

Scottsdale Healthcare

🇺🇸

Scottsdale, Arizona, United States

Baystate Medical Center

🇺🇸

Springfield, Massachusetts, United States

Sanford USD Medical Center

🇺🇸

Sioux Falls, South Dakota, United States

Cooper Health System

🇺🇸

Camden, New Jersey, United States

The Christ Hospital

🇺🇸

Cincinnati, Ohio, United States

St. Vincent Mercy Medical Center

🇺🇸

Toledo, Ohio, United States

St. Cloud Hospital

🇺🇸

Saint Cloud, Minnesota, United States

St. John's Hospital / Prairie Education & Research Cooperative

🇺🇸

Springfield, Illinois, United States

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