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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT00967902
Registration number
NCT00967902
Ethics application status
Date submitted
26/08/2009
Date registered
28/08/2009
Date last updated
29/03/2016
Titles & IDs
Public title
Safety and Effectiveness Study of Combo Bio-engineered Sirolimus Eluting Stent
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Scientific title
The REMEDEE Study: A Prospective, Randomized Study to Evaluate the Safety and Efficacy of an Abluminal Sirolimus Coated Bio-engineered Stent (Combo Bio-engineered Sirolimus Eluting Stent)
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Secondary ID [1]
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VP-0427
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Universal Trial Number (UTN)
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Trial acronym
REMEDEE
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Coronary Artery Lesions
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Condition category
Condition code
Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Devices - coronary stenting
Experimental: Combo - The Combo Stent is composed of the OrbusNeich R stentâ„¢, with an abluminal coating of a bioabsorbable polymer matrix formulated with sirolimus for sustained release, and an anti-CD34 antibody cell capture coating on the luminal surface.
Active comparator: Taxus® Liberté® Stent - Commercially available product
Treatment: Devices: coronary stenting
Balloon dilatation of obstructive coronary artery disease with deployment of a metallic stent to scaffold the dilated lesion; stent incorporating sustained release of anti-proliferative agent to control neointimal proliferation and reocclusion; test device incorporates affinity surface for circulating EPCs
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Intervention code [1]
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Treatment: Devices
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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In-stent late lumen loss of the Combo Stent compared to the TAXUS® Liberté® DES
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Assessment method [1]
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Timepoint [1]
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9 months post-procedure.
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Secondary outcome [1]
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All-cause and cardiac mortality
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Assessment method [1]
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Timepoint [1]
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30 days, 9 months, 1, 2, 3, 4, and 5 year
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Secondary outcome [2]
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Myocardial infarction: Q-wave and non Q-wave, cumulative and individual
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Assessment method [2]
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Timepoint [2]
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30 days, 9 months, 1, 2, 3, 4, and 5 years
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Secondary outcome [3]
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Major Adverse Cardiac Event (MACE) defined as a composite of death, MI (Q-wave or non Q-wave), emergent CABG, or target lesion revascularization by repeat PTCA or CABG
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Assessment method [3]
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Timepoint [3]
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Hospital discharge, 30 days, 9 months, 1, 2, 3, 4 and 5 years post-procedure
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Secondary outcome [4]
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Vascular complications from index procedure
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Assessment method [4]
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Timepoint [4]
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Up to hospital discharge
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Secondary outcome [5]
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Rate of stent thrombosis, per ARC definition of definite and probable stent thrombosis further categorized as early, late or very late
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Assessment method [5]
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Timepoint [5]
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30 days, 9 months, 1, 2, 3, 4 and 5 years post-procedure
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Secondary outcome [6]
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Change in human anti-murine antibody (HAMA) plasma levels
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Assessment method [6]
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Timepoint [6]
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30 day and 9 month follow-up compared to baseline
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Secondary outcome [7]
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Device success, defined as attainment of <50% residual stenosis of the target lesion using the Combo Stent
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Assessment method [7]
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Timepoint [7]
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Index procedure
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Secondary outcome [8]
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Lesion success defined as attainment of < 50% residual stenosis using any percutaneous method
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Assessment method [8]
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Timepoint [8]
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Index procedure
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Secondary outcome [9]
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Procedure success defined as lesion success without the occurrence of in-hospital MACE
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Assessment method [9]
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Timepoint [9]
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Up to hospital discharge
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Secondary outcome [10]
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Clinically (ischemia)-driven target lesion revascularization
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Assessment method [10]
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Timepoint [10]
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30 days, 9 months, 1, 2, 3, 4 and 5 years
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Secondary outcome [11]
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Clinically (ischemia)-driven target vessel revascularization
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Assessment method [11]
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Timepoint [11]
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30 days, 9 months, 1, 2, 3, 4 and 5 years
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Secondary outcome [12]
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In-stent and in-segment angiographic binary restenosis
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Assessment method [12]
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Timepoint [12]
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9 months
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Secondary outcome [13]
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In-stent and in-segment minimum lumen diameter (MLD)
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Assessment method [13]
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Timepoint [13]
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9 months
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Secondary outcome [14]
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In-stent, proximal and distal late lumen loss
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Assessment method [14]
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Timepoint [14]
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9 months
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Secondary outcome [15]
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Neointimal hyperplasia volume and % in-stent volume obstruction as measured by intravascular ultrasound (IVUS) for patients receiving angiographic/IVUS follow-up
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Assessment method [15]
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Timepoint [15]
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9 months
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Secondary outcome [16]
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Target lesion failure (TLF) (defined as death, MI and ischemic target lesion revascularization (TLR))
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Assessment method [16]
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Timepoint [16]
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30 days, 9 months, 1, 2, 3, 4 and 5 years
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Eligibility
Key inclusion criteria
General Inclusion Criteria
* The patient must be =18 and = 80 years of age;
* Symptomatic ischemic heart disease (CCS class 1-4, Braunwald Class IB, IC, IIB, IIC, IIIB, IIIC, and/or objective evidence of myocardial ischemia);
* Acceptable candidate for CABG;
* The Patient is willing to comply with specified follow-up evaluations;
* The Patient or legally authorized representative has been informed of the nature of the study, agrees to its provisions and has been provided written informed consent, approved by the appropriate Medical Ethics Committee (MEC), Institutional Review Board (IRB), or Human Research Ethics Committee (HREC).
Angiographic
* Single de novo or non-stented restenotic lesion in the target vessel;
* Patients with two-vessel coronary disease, may have undergone successful treatment (<20% diameter stenosis by visual estimate) of the non-target vessel with approved devices up to and including the index procedure but must be prior to the index target vessel treatment. Any non-target vessel or lesion intended to be treated during the index procedure, cannot be an unprotected left main, ostial lesion, chronic total occlusion (CTO), heavily calcified, bifurcation, vein grafts, have angiographic evidence of thrombus, be anything requiring atherectomy, thrombectomy, or pre-treatment with anything other than balloon angioplasty;
* Target lesion located in a native coronary artery;
* Target lesion (maximum length is 20 mm by visual estimate) covered by a single stent maximum 23 mm length for Combo Stent, and 24 mm in length for TAXUS® Liberté® (stent coverage including at least 3 mm of healthy vessel is recommended). The lesion length should be measured after pre-dilation procedure;
* Reference vessel diameter must be =2.5 to = 3.5 mm by visual estimate. The vessel diameter should be measured after pre-dilation procedure and after intra-coronary nitroglycerin if spasm is suspected;
* Target lesion =50% and <100% stenosed by visual estimate.
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Minimum age
18
Years
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Maximum age
80
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
General
* Pregnant or nursing patients and those who plan pregnancy in the period up to 1 year following index procedure. Female patients of child-bearing potential must have a negative pregnancy test done within 7 days prior to the index procedure per site standard test;
* Patient has had a known diagnosis of acute myocardial infarction (AMI) within 72 hours preceding the index procedure (elevated troponin or CK-MB =2 times upper limit of normal) or >72 hours preceding the index procedure and CK and CK-MB have not returned to within normal limits at the time of procedure;
* The patient is currently experiencing clinical symptoms consistent with new onset AMI, such as nitrate unresponsive prolonged chest pain;
* Impaired renal function (serum creatinine >2.0 mg/dL or 177 µmol/l) or on dialysis;
* Platelet count <100,000 cells/mm3 or >700,000 cells/mm3 or a WBC <3,000 cells/mm3;
* Patient has a history of bleeding diathesis or coagulopathy or patients in whom anti-platelet and/or anticoagulant therapy is contraindicated;
* Patient requires low molecular weight heparin (LMWH) treatment post-procedure or has received a dose of LMWH =8 hours prior to index procedure;
* Patient has received any organ transplant or is on a waiting list for any organ transplant;
* Patient has other medical illness (e.g., cancer, known malignancy, or congestive heart failure) or known history of substance abuse (alcohol, cocaine, heroin etc.) that may cause non-compliance with the protocol, confound the data interpretation or is associated with a limited life expectancy (i.e., less than 1 year);
* Patient has a known hypersensitivity or contraindication to aspirin, heparin/bivalirudin, clopidogrel/ticlopidine, prasugrel, stainless steel alloy, sirolimus, paclitaxel and/or contrast sensitivity that cannot be adequately pre-medicated;
* Patient has previously received murine therapeutic antibodies and exhibited sensitization through the production of Human Anti-Murine Antibodies (HAMA);
* Patient presents with cardiogenic shock;
* Patient has current unstable cardiac arrhythmias that create hemodynamic instability;
* Patient has extensive peripheral vascular disease that precludes safe 6 French sheath insertion;
* Any significant medical condition which in the Investigator's opinion may interfere with the patient's optimal participation in the study;
* Currently participating in another investigational drug or device study or patient in inclusion in another investigational drug or device study during follow-up;
Angiographic
* Unprotected left main coronary artery disease with =50% stenosis;
* Ostial target lesion(s);
* Totally occluded target vessel (TIMI flow 0);
* Calcified target lesion(s) which cannot be successfully predilated;
* Target lesion has excessive tortuosity unsuitable for stent delivery and deployment;
* Angiographic evidence of thrombus in the target lesion(s);
* Target lesion involving bifurcation with a side branch =2.0 mm in diameter (either stenosis of both main vessel and major side branch or stenosis of just major side branch) that would require intervention of diseased side branch;
* A significant (>50%) stenosis proximal or distal to the target lesion that cannot be covered by same single stent;
* Diffuse distal disease to target lesion with impaired runoff;
* Left ventricular ejection fraction (LVEF) =30% (LVEF must be obtained within 6 months prior to the index procedure);
* Pre-treatment with devices other than balloon angioplasty;
* Prior stent within 10 mm of target lesion;
* Intervention (PCI or bypass) of another lesion performed within 6 months before or planned within 30 days following the index procedure.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/11/2009
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/09/2015
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Sample size
Target
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Accrual to date
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Final
180
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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John Hunter Hospital - Newcastle
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Recruitment postcode(s) [1]
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2300 - Newcastle
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
OrbusNeich
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
To demonstrate the safety and effectiveness of the Combo Bio-engineered Sirolimus Eluting Stent (Combo Stent) compared to the Taxus® Liberté® Stent in the treatment of coronary artery lesions.
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Trial website
https://clinicaltrials.gov/study/NCT00967902
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Trial related presentations / publications
Haude M, Lee SW, Worthley SG, Silber S, Verheye S, Erbs S, Rosli MA, Botelho R, Meredith I, Sim KH, Stella PR, Tan HC, Whitbourn R, Thambar S, Abizaid A, Koh TH, Den Heijer P, Parise H, Cristea E, Maehara A, Mehran R. The REMEDEE trial: a randomized comparison of a combination sirolimus-eluting endothelial progenitor cell capture stent with a paclitaxel-eluting stent. JACC Cardiovasc Interv. 2013 Apr;6(4):334-43. doi: 10.1016/j.jcin.2012.10.018. Epub 2013 Mar 20.
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Public notes
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Contacts
Principal investigator
Name
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Ian T Meredith, MBBS, PhD
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Address
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Monash University
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Type
Citations or Other Details
Journal
Haude M, Lee SW, Worthley SG, Silber S, Verheye S,...
[
More Details
]
Results not provided in
https://clinicaltrials.gov/study/NCT00967902
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