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Treatment of Moderate Vein Graft Lesions With Paclitaxel Drug Eluting Stents: The VELETI Trial

L

Laval University

Status and phase

Completed
Phase 4

Conditions

Coronary Artery Bypass Grafting

Treatments

Device: Paclitaxel eluting stent

Study type

Interventional

Funder types

Other
Industry

Identifiers

NCT00289835
Laval-VG-01

Details and patient eligibility

About

HYPOTHESIS

  1. Sealing moderate SVG lesions with the TAXUS stent prevents SVG atherosclerosis progression as evaluated by IVUS.
  2. Sealing moderate SVG lesions with the TAXUS stent does not accelerate SVG atherosclerosis in the angiographically non-diseased segments of the SVG as evaluated by IVUS.

OBJECTIVES

  1. To determine the effect of stenting moderate SVG lesions with the paclitaxel-eluting stent in comparison with medical treatment on limiting SVG disease progression as evaluated by IVUS.
  2. To evaluate by IVUS the effect of stenting moderate SVG lesions with the paclitaxel-eluting stent in comparison with medical treatment on atherosclerosis progression in angiographically non-diseased SVGs segments.

Full description

This will be a prospective randomized study assessing the efficacy of stenting moderate SVG lesions with the taxus stent in the prevention of atherosclerosis progression of SVGs as evaluated by IVUS. Patients with previous coronary bypass surgery with SVG implantation undergoing coronary angiography by clinical indication will be screened. If the patient has a moderate lesion at any level of the SVGs it will be includable in the study. After inclusion, the patients will be randomized to either stenting the moderate SVG lesion with the taxus stent or standard medical treatment. The use of a filter wire during dilation will be strongly recommended. Following this procedure, all patients will have clinical controls at 1 month and at 6 months and an angiographic and IVUS control study at 1 year follow-up.

Enrollment

57 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Written and signed informed consent.
  • Patients ≥18 years old.
  • Clinical indication for cardiac catheterization and SVG angiography.
  • Presence of at least one SVG lesion of 30% to 70% diameter stenosis by visual estimation which is (are) not the culprit lesion (s) responsible for the clinical syndrome of the patient.

Exclusion criteria

  • Ejection fraction <20%.
  • Renal insufficiency with creatinine > 250 mg/dl.
  • Presence of more than 3 moderate SVG stenosis or significant diffuse SVG disease.
  • Unsuccessful angioplasty (residual stenosis >30% and/or TIMI flow <3) of any other lesion treated during the same procedure.
  • Coronary angioplasty of the target SVG in the past.
  • Cardiogenic shock .
  • Remaining lesion (s) with a treatment planned within the following year.
  • Pregnancy.
  • Contraindication to aspirin and/or clopidogrel treatment.
  • Allergy to paclitaxel.
  • Any disease with a limiting life-expectancy (to less than 2 years).
  • Definite presence or high suspicion of thrombus or ulceration in the target lesion.
  • Target lesion located in the same SVG than the culprit lesion (if present) and the distance between the target lesion and the most proximal or distal part of the stent implanted at the culprit lesion is < 4 cm.
  • Vein graft diameter < 2.5 mm.

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

57 participants in 2 patient groups

PCI-stenting
Experimental group
Description:
Stenting the moderate SVG lesion with the paclitaxel stent
Treatment:
Device: Paclitaxel eluting stent
Standard medical treatment
Other group
Treatment:
Device: Paclitaxel eluting stent

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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