Single Coronary Vessel Disease
Conditions
Brief summary
The study is a pilot clinical trial for Sirolimus-eluting Iron Bioresorbable Coronary Scaffold System(IBS). The main purpose of this study is to evaluate the feasibility, preliminary safety and efficacy of IBS. To provide the basis for subsequent large-scale, multi-center, randomized controlled clinical trials of IBS.
Detailed description
* A prospective, non-randomized trial * Study population: 15 patients * Clinical follow up will be required at postoperative, 1 month, 6 months, 1 year, 2 years, 3 years, 4 years, 5 years; * All the subjects perform the angiography, Intra-vascular ultrasound (IVUS) and Optical coherence tomography (OCT) at 1 year and 3 years. * The primary study endpoint is target lesion failure (TLF) at 1 month post procedure; and imaging findings as the secondary study endpoint. To evaluate the feasibility, safety and performance of IBS.
Interventions
Implantation of Sirolimus-eluting Iron Bioresorbable Coronary Scaffold System (IBS)
Sponsors
Study design
Intervention model description
Single Group Assignment
Eligibility
Inclusion criteria
* All patients participating in this clinical trial must meet the following criteria: 1. Age of 18-75, males or non pregnancy females; 2. Subject must have evidence of myocardial ischemia (e.g., stable, unstable angina, post-infarct angina or silent ischemia) suitable for elective PCI; 3. One target lesion, and target lesion can be completely covered by a single stent; 4. Target lesion length ≤ 18 mm, target lesion diameter between 3.0 mm to 3.5 mm (visual); 5. Visual assessment of target lesion stenosis ≥70%, TIMI blood flow≥ 1; 6. Subject who understand the purpose of testing, voluntary and informed consent, patients undergoing invasive imaging follow-up.
Exclusion criteria
* Patients will be excluded if any of the following conditions apply: General: 1. Within 1 week of any acute myocardial infarction or myocardial enzymes did not return to normal; 2. Implantation of stent in target vessel within 1 year , patients with planned intervention again within six months; 3. Patients who performed coronary artery bypass (coronary artery bypass grafting); 4. Patients with contraindications for coronary artery bypass graft surgery; 5. Severe heart failure (NYHA class III and above) or left ventricular ejection fraction\<40% (ultrasonic or left ventricular angiography); 6. Preoperative renal function: serum creatinine \> 2.0 mg/dl or 177 mu mol/L; receiving hemodialysis; 7. Patients have ischemic stroke half a year before implantation, patients have transient ischemic attack 3 months before implantation, patients have high coagulation tendency judged by investigator or laboratory examination; 8. Bleeding, active gastrointestinal ulcers, brain hemorrhage or subarachnoid hemorrhage, contraindications on antiplatelet agents and anticoagulant therapy; patients would not allow to undergoing antithrombotic therapy; 9. Aspirin, clopidogrel, heparin, contrast agent, poly lactic acid polymer, rapamycin and metal allergies; 10. Patients who have a history of disease related to iron overload or iron disorder, such as hereditary hemochromatosis, etc; 11. The patient's life expectancy is less than 12 months; 12. Patient participated in other drug or medical device study and does not meet the primary study endpoint in clinical trials time frame; 13. Poor compliance and patients unable to complete the study in accordance with the requirements; 14. Patient with heart transplant; 15. The unstable arrhythmia, such as high risk ventricular extra systole and ventricular tachycardia; 16. Cancer needs chemotherapy; 17. Patients of immune suppression, autoimmune diseases, planned or undergoing immunosuppressive therapy; 18. Planning or being receiving long-term anticoagulant therapy, such as heparin, warfarin, etc; 19. With six months for elective surgery requires stop using aspirin and clopidogrel; 20. Blood test prompted platelet count \< 100 x 109/L, or \> 700 x 109/L, white blood cells \< 3 x 109/L, or abnormal liver function (ALT、AST 3 times greater than normal range); 21. Patients with diffuse peripheral vascular disease; cannot use 6F catheter; 22. Patients with valvular surgery in the past.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Study Device related Composite Endpoint (Target Lesion Failure) | 1 month after implantation | Target Lesion Failure is defined as the composited endpoints of including cardiac death, Target vessel related myocardial infarction (TV-MI) and clinical indicated target lesion revascularization (CI-TLR), also known as MACE (major adverse cardiac events). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinical Success | Hospitalized period postoperative within 7 days | Defined as based on lesion success, there is no major adverse cardiac events in the hospitalization period. |
| Performance Evaluation of IBS | Immediate postoperative | 4 class (Excellent, good, general, bad) to evaluate the push ability, performance of through the lesions, performance of cover the lesions, support force, withdraw ability. |
| Device related Composite Endpoint (DoCE) | 6 Month, 1 Year, 2 Years, 3 Years, 4 Years, 5 Years postprocedure | Target Lesion Failure, defined as the composited endpoints of including cardiac death, Target vessel related myocardial infarction (TV-MI) and clinical indicated target lesion revascularization (CI-TLR), also known as MACE (major adverse cardiac events). |
| Patient related Clinical Composite Endpoint (PoCE) | 30 Days, 6 Months, 1 Year, 2 Years, 3 Years, 4 Years, 5 Years postprocedure | Including all-cause mortality, all myocardial infarction and target lesion revascularization. |
| Stent Thrombosis defined by ARC | Acute(0-24 hours), Subacute(24 hours-30 days), Late(30 days-1 year),Very late(after 1 year) | Timing (acute, sub-acute, late and very late) Evidence (definite and probable) |
| Acute stent retraction | Immediate postoperative | Angiographic Endpoint |
| Immediate Success Rate | Immediate postoperative | 1. Device Success: Successfully transit and release the IBS at target lesion, then withdraw the delivery system. Immediate residual stenosis \< 30% and TIMI blood flow is class 3 (visual). 2. Lesion Success: Any method of intervention therapy, the residual stenosis of the target lesion \< 30% and TIMI blood flow is class 3(visual). |
| In-stent, in-segment, proximal and distal Diameter stenosis(DS) | 1 year, 3 years | Angiographic Endpoint |
| In-stent, in-segment, proximal and distal Late lumen loss (LLL) | 1 year, 3 years | Angiographic Endpoint |
| In-stent, in-segment, proximal and distal Angiographic defined restenosis (ABR) | 1 year, 3 years | Angiographic Endpoint |
| Vasomotion | 1 year, 3 years | Defined as the average diameter change of lumen diameter before and after using nitroglycerin. |
| Analysis of Morphometric, lesion composition and scaffold strut data obtained with OCT | : Immediate postoperative, 1 year, 3 years | Optical Coherence Tomography Endpoint |
| Analysis of Vascular and scaffold morphology obtained with IVUS | Immediate postoperative,1 year, 3 years | Intra-Vascular Ultrasound Endpoint |
| In-stent, in-segment, proximal and distal minimum lumen diameter (MLD) | Immediate postoperative, 1 year, 3 years | Angiographic Endpoint |
Countries
Malaysia