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Sponsors and Collaborators: |
Boston Scientific Corporation Texas Health Resources |
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Information provided by: | North Texas Veterans' Healthcare System |
ClinicalTrials.gov Identifier: | NCT00827853 |
Despite recent advances in stent technology and its widespread application in the treatment of peripheral vascular disease (PVD), incidences of partial or complete blockage of stent lumen (in-stent restenosis) due to in growth of cells (neo-intimal proliferation) is unacceptably high.
In diabetics with long superficial femoral artery (SFA) lesions, in-stent restenosis rates are higher than in non-diabetics. Consequently interventional techniques that curtail in-stent restenosis have to be explored. Cryoplasty is a stent expansion method in which a balloon is expanded using pressurized nitrous oxide gas. As the nitrous oxide expands in the balloon it cools the surroundings to about -10 degrees C. This induces programed death (apoptosis) of the smooth muscle cells in arterial wall.
The investigators hypothesize that Cryoplasty, by inducing an apoptotic smooth muscle cell response, when applied to post-dilation of nitinol self-expanding stents in the Superficial Femoral Artery (SFA) of diabetics, would lead to decreased in-stent restenosis due to decreased neointimal proliferation.
Condition | Intervention |
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Peripheral Vascular Disease |
Procedure: Conventional angioplasty balloon Procedure: cryoplasty balloon |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Single Blind (Subject), Parallel Assignment, Efficacy Study |
Official Title: | PolarCath® Cryoplasty Versus Conventional Balloon Post-Dilation of Nitinol Stents for Peripheral Vascular Interventions (COBRA) |
Estimated Enrollment: | 132 |
Study Start Date: | November 2008 |
Estimated Study Completion Date: | December 2010 |
Estimated Primary Completion Date: | November 2010 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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1: Experimental
Conventional angioplasty balloon post-dilation
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Procedure: Conventional angioplasty balloon
Post-dilation of clinically indicated nitinol self-expanding stents in the SFA using conventional angioplasty balloon
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2: Experimental
Cryoplasty balloon post-dilation
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Procedure: cryoplasty balloon
Post-dilation of clinically indicated nitinol self-expanding stents in the SFA using cryoplasty balloon
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The pre-recruitment process would identify diabetics who have life-style limiting claudication in their legs. Based on the physicians decision such patients may have to undergo a peripheral vascular intervention of the SFA, with placement of self-expanding nitinol stents. If such a decision is made, the patient will be randomized to either cryoplasty balloon post-dilation of the stent or to conventional angioplasty balloon post-dilation after obtaining informed consent. At one year, in segment (stent + 10 mm beyond its proximal and distal edges) peak systolic velocity by duplex ultrasound will be measured in all subjects to assess the rate of binary resteosis defined as a > or = 2.5 times increase in peak systolic velocity (primary endpoint). A 6 month resting ankle brachial index, and binary restenosis may be assessed as a secondary endpoint of the study.
Ages Eligible for Study: | 21 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contact: Subhash Banerjee, MD | (214)857-1608 | subhash.banerjee@utsouthwestern.edu |
Contact: Cyril Varghese, MS | zcman84@yahoo.com |
United States, Texas | |
Dallas Veterans Hospital | Recruiting |
Dallas, Texas, United States, 75216 | |
Contact: Subhash Banerjee, MD subhash.banerjee@utsouthwestern.edu | |
Contact: Cyril Varghese zcman84@yahoo.com | |
Principal Investigator: Subhash Banerjee, MD | |
Dallas Presbyterian Hospital | Recruiting |
Dallas, Texas, United States, 75231 | |
Contact: Tony Das, MD 214-360-0869 | |
Contact: Victoria Skobel, RN,MS Vskobel@CIVADALLAS.COM | |
Principal Investigator: Tony Das, MD |
Principal Investigator: | Subhash Banerjee, MD | VA North Texas Healthcare Systen, Dallas, TX |
Study Director: | Emmanouil S Brilakis, MD, PhD | VA North Texas Healtcare System, Dallas, TX |
Study Director: | Tony S Das, MD | Texas Health Resources |
Responsible Party: | Dallas Veterans Hospital ( Dr. Subhash Banerjee, Acting chief of cardiology ) |
Study ID Numbers: | BOSTON SCI R&E 9-21-07#2 |
Study First Received: | January 22, 2009 |
Last Updated: | January 22, 2009 |
ClinicalTrials.gov Identifier: | NCT00827853 History of Changes |
Health Authority: | United States: Institutional Review Board; United States: Federal Government |
Diabetes Peripheral Vascular Disease (PVD) Superficial Femoral Artery (SFA) Cryoplasty Restenosis |
Peripheral Vascular Diseases Dilatation, Pathologic Diabetes Mellitus Vascular Diseases |
Peripheral Vascular Diseases Vascular Diseases Cardiovascular Diseases |