Safety and Clinical Performance of a Sirolimus-eluting Absorbable Metal Scaffold

Overview

Assessment of the clinical performance and the safety of the Magmaris Sirolimus-Eluting Resorbable Coronary Magnesium Scaffold in a cohort of patients in India with de novo coronary artery lesions.

Full Title of Study: “BIOTRONIK – Safety and Clinical Performance Of the Magmaris Drug Eluting Absorbable Metal Scaffold in a Cohort of Patients in India With de Novo Lesions in NatiVE Coronary Arteries”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: February 2018

Detailed Description

This is a prospective, multi-centre, single-arm, open label trial to assess the safety and clinical performance of Magmaris Drug Eluting Absorbable Metal Scaffold. A total of up to 110 patients with de novo lesions in native coronary arteries will be enrolled at up to 8 investigational sites in India. In-hospital clinical follow-up visits will take place at 1 and 6 months post procedure. The primary endpoint is target lesion failure (a composite of cardiac death, target vessel Q-wave or non-Q wave myocardial infarction, coronary artery bypass grafting, clinically driven target lesion revascularization) at 1 month post procedure.

Interventions

  • Device: Bioresorbable scaffold
    • Percutaneous coronary intervention (PCI)

Arms, Groups and Cohorts

  • Experimental: Bioresorbable scaffold
    • Percutaneous coronary intervention (PCI) with a sirolimus-eluting resorbable coronary magnesium scaffold

Clinical Trial Outcome Measures

Primary Measures

  • Target lesion failure
    • Time Frame: 1 month post-procedure
    • TLF is a composite of cardiac death, target vessel Q-wave or non-Q wave myocardial infarction (MI), coronary artery bypass graft (CABG), clinically driven target lesion revascularization (TLR)

Secondary Measures

  • Target lesion failure (TLF)
    • Time Frame: 6 months post-procedure
    • TLF is a composite of cardiac death, target vessel Q-wave or non-Q wave myocardial infarction (MI), coronary artery bypass graft (CABG), clinically driven target lesion revascularization (TLR)
  • Target vessel failure (TVF)
    • Time Frame: 1 and 6 months post-procedure
    • TVF is a composite of cardiac death, target vessel Q-wave or non-Q wave myocardial infarction (MI), coronary artery bypass graft (CABG), clinically driven target vessel revascularization (TVR)
  • Clinically driven target lesion revascularization
    • Time Frame: 1 and 6 months post-procedure
  • Cardiac death
    • Time Frame: 1 and 6 months post-procedure
  • Myocardial infarction
    • Time Frame: 1 and 6 months post-procedure
  • Scaffold thrombosis
    • Time Frame: 1 and 6 months post-procedure
    • Scaffold thrombosis is composite of definite and probable scaffold thrombosis according to ARC definition
  • Incidence of procedure success
    • Time Frame: 3 days (plus or minus 2 days)
    • Procedure Success is a composite of achievement of a final diameter stenosis of <30% by visual assessment or on-line quantitative coronary angiography, without the occurrence of death, Q-wave or non-Q-wave MI, or repeat revascularization of the target lesion during the hospital stay (3 days plus or minus 2 days)
  • Incidence of device success
    • Time Frame: Participants will be followed for the duration of index procedure, an expected average of 1 hour.
    • Device Success is a composite of a final residual diameter stenosis of <30% by visual assessment or on-line quantitative coronary angiography, using the assigned device only, successful delivery of the scaffold to the target lesion site in the coronary artery, appropriate scaffold deployment, successful removal of the device, safe removal of the device in case of deployment failure.

Participating in This Clinical Trial

Inclusion Criteria

1. Subject is ≥ 18 years and ≤ 80 years of age 2. Written subject informed consent available prior to percutaneous coronary intervention (PCI). Remark: Vulnerable subjects may not be enrolled in this trial 3. Subject with stable or unstable angina pectoris or documented silent ischemia 4. Subject eligible for PCI 5. Subject acceptable candidate for coronary artery bypass surgery 6. Subject with a maximum of two single de novo lesions in two different major epicardial vessels 7. Reference vessel diameter between 2.7-3.7 mm by visual estimation, depending on the scaffold size used 8. Target lesion length ≤ 21 mm by visual estimation, depending on the scaffold size used 9. Target lesion stenosis by visual estimation ≥ 50% – < 100% and TIMI flow ≥1 10. Eligible for Dual Anti Platelet Therapy (DAPT) Exclusion Criteria:

1. Pregnant or breast-feeding females or females who intend to become pregnant during the time of the study 2. Subject has clinical symptoms and/or electrocardiogram (ECG) changes consistent with acute ST elevation myocardial infarction (STEMI) within 72 hours prior to the index procedure. Note: Hemodynamically stable non-STEMI (NSTEMI) subjects are eligible for study enrollment 3. Subjects with a ≥2 fold CK level or in absence of CK a ≥3 fold CKMB level above the upper range limit within 24 hours prior to the index procedure 4. Left main coronary artery disease 5. Three-vessel coronary artery disease at time of procedure 6. Thrombus in target vessel 7. Subject is currently participating in another study with an investigational device or an investigational drug and has not reached the primary endpoint yet 8. Planned interventional treatment of any non-target vessel within 30 days post-procedure 9. Subject is on dialysis 10. Planned intervention of the target vessel after the index procedure 11. Ostial target lesion (within 3.0 mm of vessel origin) 12. Target lesion involves a side branch >2.0 mm in diameter 13. Documented left ventricular ejection fraction (LVEF) ≤ 30% 14. Heavily calcified lesion 15. Target lesion is located in or supplied by an arterial or venous bypass graft 16. The target lesion requires treatment with a device other than the pre-dilatation balloon prior to the Magmaris study device placement (including but not limited to directional coronary atherectomy, excimer laser, rotational atherectomy, etc.) 17. Unsuccessful pre-dilatation, defined as minimal lumen diameter smaller than the respective crossing profile of the Magmaris study device and angiographic complications (e.g. distal embolization, side branch closure, extensive dissections that can't be covered by a single scaffold), by visual estimation 18. Known allergies to: Acetylsalicylic Acid (ASA), Heparin, contrast medium, Sirolimus, Everolimus or similar drugs (i.e., ABT 578, Biolimus, Tacrolimus), PLLA, Silicon Carbide, Magnesium, Yttrium, Neodymium, Zirconium, Gadolinium, Dysprosium, Tantalum 19. Impaired renal function (serum creatinine > 2.5 mg/dl or 221 µmol/l) determined within 72 hours prior to index procedure 20. Subject is receiving oral or intravenous immunosuppressive therapy (inhaled steroids are not excluded) or has known life limiting immunosuppressive or autoimmune disease (e.g.,human immunodeficiency virus, systemic lupus erythematosus, but not including diabetes mellitus) 21. Proximal or distal to the target lesion located stenosis that might require future revascularization or impede run off detected during diagnostic angiography 22. Life expectancy less than 6 months 23. Planned surgery or dental surgical procedure within 6 months after index procedure 24. Subject with tortuous vessel that may impair scaffold placement in the region of obstruction or proximal to the lesion 25. In the investigators opinion subjects will not be able to comply with the follow-up requirements.

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 80 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Biotronik AG
  • Collaborator
    • CBCC-VIBGYOR Research Pvt. Ltd.
  • Provider of Information About this Clinical Study
    • Sponsor

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