The purpose of this study is to determine whether morbidity and mortality for high-risk surgical patients treated with the Carotid Wallstent in conjunction with the FilterWire EX and EZ System distal protection device will be less than or equal to that of objective performance criteria (OPC) derived from historic controls undergoing surgical intervention with a carotid endarterectomy (CEA).
Stroke is the third leading cause of death in this country with approximately 600,000 new stroke cases each year. Mortality rates as high as 40 percent have been reported for stroke as a result of ischemia associated with the carotid distribution. Currently, the primary therapy for carotid artery occlusive disease is carotid endarterectomy (CEA) or the surgical removal of atheromatous material from inside the artery. Although CEA is an effective treatment for the majority of patients with carotid occlusive disease, there remains a need for a treatment option for those patients with significant surgical risk factors. These patients have been shown to have much higher rates of morbidity and mortality. There are approximately 50,000-70,000 patients each year who are considered poor surgical candidates. These patients present with either one or more anatomical or co-morbid conditions and have a one-year stroke and death rate of up to 15% with traditional surgical treatment. Carotid artery stenting (CAS) has been reported by numerous single-center trials to be feasible in the treatment of carotid artery stenosis. Moreover, the risk benefit ratio has been suggested to be the largest in those patients with a higher risk profile for the CEA treatment option. This trial will study the effects of percutaneous intervention using the Monorail™ Carotid Wallstent® Endoprosthesis (Carotid Wallstent) in conjunction with the FilterWire System distal protection device (FilterWire EX and EZ) on rates of common peri-procedural complications as well as on long-term outcomes as compared to historical outcomes of patients undergoing CEA.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Carotid Artery Stent
The primary endpoint is one-year morbidity and mortality, defined as the cumulative incidence of any non Q-wave myocardial infarction within the 24 hours following carotid stenting
Time frame: 1 year
peri-procedural (within 30 days of procedure) death, stroke, Q-wave myocardial infarction
Time frame: Within 30 days of Procedure
late ipsilateral stroke or death due to neurologic events from 31 days up to and including twelve-month follow-up.
Time frame: 1 year
Peri-procedural morbidity and mortality
Time frame: Within 30 Days of procedure
FilterWire EX and EZ System technical success
Time frame: Post procedure
Carotid Wallstent technical success
Time frame: Post Procedure
system technical success
Time frame: Post Procedure
angiographic success
Time frame: Post Procedure
procedural success
Time frame: Post Procedure
30-day clinical success
Time frame: 30 days post procedure
peri-procedural overall morbidity
Time frame: 30 days post procedure
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Enrollment
747
Bapatist Medical Center
Birmingham, Alabama, United States
University of Alabama at Birmingham
Birmingham, Alabama, United States
Arizona Heart Institute
Phoenix, Arizona, United States
St. Joseph's Hospital & Medical Center
Phoenix, Arizona, United States
El Camino Hospital
Mountain View, California, United States
Hoag Memorial Hospital
Newport Beach, California, United States
St. Joseph's Medical Center
Stockton, California, United States
Washington Hospital Center
Washington D.C., District of Columbia, United States
Holy Cross Hospital
Fort Lauderdale, Florida, United States
Lakeland Regional Medical Center
Lakeland, Florida, United States
...and 40 more locations
one-year clinical success
Time frame: 1 Year post procedure
late stroke, transient ischemic attack (TIA) and death.
Time frame: 1 year post procedure