SOLSTICE Trial in China
Primary Purpose
Coronary Artery Disease, Calcifications Vascular
Status
Active
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
Shockwave Coronary Intravascular Lithotripsy (IVL) System C2
Sponsored by
About this trial
This is an interventional treatment trial for Coronary Artery Disease
Eligibility Criteria
Inclusion Criteria:
General
- Subject ≥18 and ≤80 years of age,male or female.
- Subjects with native coronary artery disease (including stable or unstable angina and silent ischemia) suitable for PCI
Subject or legally authorized representative, signs a written Informed Consent form to participate in the study, prior to any study-mandated procedures
Angiographic
- Evidence of calcification at the lesion site by, a) angiography, with fluoroscopic radio-opacities noted without cardiac motion prior to contrast injection involving both sides of the arterial wall in at least one location and total length of calcium of at least 15 mm and extending partially into the target lesion, OR by b) OCT, with presence of ≥270 degrees of calcium on at least 1 cross section
- The lesion length must not exceed 40 mm
- The target vessel reference diameter must be ≥2.5 mm and ≤4.0 mm
de novo target lesion stenosis of protected LMCA, or LAD, RCA or LCX (or of their branches), per investigator's assessment with:
- Stenosis of ≥70% and <100% or
- Stenosis ≥50% and <70% (visually assessed) that is deemed qualified for PCI by investigator
- The target vessel must have TIMI flow 3 at baseline (visually assessed; may be assessed after pre-dilatation)
- Ability to pass a 0.014" guide wire across the lesion
Exclusion Criteria:
General
- Any comorbidity or condition which may reduce compliance with this protocol, including follow-up visits
- Subject experienced an acute MI (STEMI or non-STEMI) within 30 days prior to index procedure
- Subjects with cardiogenic shock or acute left heart failure; New York Heart Association (NYHA) class III or IV heart failure; left ventricular ejection fraction (LVEF) ≤ 35% within 6 months prior to the procedure (Note: if multiple LVEF assessments were performed, the measurement closest to index procedure will be chosen; it can be assessed in the procedure);
- History of a stroke or transient ischemic attack (TIA) within 6 months, or any prior intracranial hemorrhage or permanent neurologic deficit
- Uncontrolled diabetes defined as a HbA1c ≥10%
- Non-coronary interventional or surgical structural heart procedures (e.g., TAVR, MitraClip, LAA or PFO occlusion, etc.) within 30 days prior to the index procedure
- Subject refusing or not a candidate for emergency coronary artery bypass grafting (CABG) surgery
- Uncontrolled severe hypertension (systolic BP >180 mm Hg or diastolic BP >110 mm Hg)
- Subject is participating in another research study involving an investigational agent (pharmaceutical, biologic, or medical device) that has not reached the primary endpoint
- Subject is pregnant or nursing (a negative pregnancy test is required for women of child-bearing potential within 7 days prior to enrollment); Or plans to become pregnant within 13 months after the study procedure;
- Unable to tolerate dual antiplatelet therapy (i.e., aspirin, and either clopidogrel, prasugrel, or ticagrelor) for at least 6 months (for patients not on oral anticoagulation)
- Subject has an allergy to imaging contrast media which cannot be adequately pre-medicated
- Renal failure with serum creatinine >2.5 mg/dL or chronic dialysis
- Active peptic ulcer or upper gastrointestinal (GI) bleeding within 6 months
- Untreated pre-procedural hemoglobin <10 g/dL or intention to refuse blood transfusions if one should become necessary
- Coagulopathy, including but not limited to platelet count <100,000 or International Normalized ratio (INR) > 1.7 (INR is only required in subjects who have taken warfarin within 2 weeks of enrollment)
- Subject has a hypercoagulable disorder such as polycythemia vera, platelet count >750,000 or other disorders
- Biomarkers [troponin or CK-MB] greater than the upper laboratory normal limit within 72 hours prior to index procedure (note: if both biomarkers are available, both must be normal)
- Subject has an active systemic infection on the day of the index procedure with either fever, leukocytosis or requiring intravenous antibiotics
- Subjects with a life expectancy of less than 1 year
- Planned use of atherectomy, laser or scoring or cutting balloon, or any investigational device other than lithotripsy Angiographic
- Previous stent within the target vessel implanted within the last year
- Previous stent within 10 mm of the target lesion regardless of the timing of its implantation
- Angiographic evidence of a dissection (≥ grade C) in the target vessel at baseline or after guidewire passage
Lesions in non-target vessels requiring PCI as below should be excluded:
- 24 hours to 30 days prior to the study procedure if the procedure was unsuccessful or complicated; or
- In 24 hours prior to the study procedure
- >30 days after the study procedure
- Non-target lesion is including left main lesion with diameter stenosis ≥30%
- Target vessel is too tortuous to deliver a stent assessed by investigators.
- Definite or possible thrombus (by angiography or intravascular imaging) in the target vessel
- Evidence of aneurysm in target vessel within 10 mm of the target lesion
- Target lesion is an ostial location (LAD, LCX, or RCA, within 5 mm of ostium) or an unprotected left main lesion.
- Target lesion is a bifurcation with ostial diameter stenosis ≥30%
- Second lesion with >50% stenosis in the same target vessel as the target lesion including its side branches
- Target lesion is located in a native vessel that can only be reached by going through a saphenous vein or arterial bypass graft
- Other situations not suitable for enrollment assessed by investigators.
Sites / Locations
- Beijing Anzhen Hospital,Capital Medical University
- Beijing Friendship Hospital,Capital Medical University
- Chinese Peoples Liberation Army General Hospital
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
IVL group
Arm Description
Outcomes
Primary Outcome Measures
Procedural Success
defined as stent delivery with a residual stenosis <50% (core laboratory assessed, angiographically) and without in-hospital MACE
Freedom from major adverse cardiac events (MACE) within 30 days of the index procedure.
MACE is defined as:
Cardiac death; or
Myocardial Infarction (MI) defined as CK-MB level > 3 times the upper limit of lab normal (ULN) value with or without new pathologic Q wave at discharge (periprocedural MI) and using the Fourth Universal Definition of Myocardial Infarction beyond discharge (spontaneous MI); or
Target Vessel Revascularization (TVR) defined as revascularization at the target vessel (inclusive of the target lesion) after the completion of the index procedure
Secondary Outcome Measures
Full Information
NCT ID
NCT05433376
First Posted
June 15, 2022
Last Updated
June 21, 2022
Sponsor
Genesis Medtech Corporation
1. Study Identification
Unique Protocol Identification Number
NCT05433376
Brief Title
SOLSTICE Trial in China
Official Title
Clinical Trial of the ShOckwave Coronary Intravascular Lithotripsy (IVL) System Used to Treat CalcIfied Coronary ArtEries (SOLSTICE)
Study Type
Interventional
2. Study Status
Record Verification Date
June 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
April 15, 2021 (Actual)
Primary Completion Date
November 25, 2021 (Actual)
Study Completion Date
November 26, 2022 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Genesis Medtech Corporation
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
This is a small sample size clinical trial in Chinese population to assess the safety and effectiveness of the Shockwave Coronary Intravascular Lithotripsy (IVL) System to treat de novo, calcified, stenotic, coronary lesions prior to stenting.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Artery Disease, Calcifications Vascular
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Actual)
8. Arms, Groups, and Interventions
Arm Title
IVL group
Arm Type
Experimental
Intervention Type
Device
Intervention Name(s)
Shockwave Coronary Intravascular Lithotripsy (IVL) System C2
Intervention Description
lithotripsy-enabled, low-pressure dilatation balloon to modify severely calcified lesions
Primary Outcome Measure Information:
Title
Procedural Success
Description
defined as stent delivery with a residual stenosis <50% (core laboratory assessed, angiographically) and without in-hospital MACE
Time Frame
in 24 hours post-procedure or prior to discharge, whichever comes first
Title
Freedom from major adverse cardiac events (MACE) within 30 days of the index procedure.
Description
MACE is defined as:
Cardiac death; or
Myocardial Infarction (MI) defined as CK-MB level > 3 times the upper limit of lab normal (ULN) value with or without new pathologic Q wave at discharge (periprocedural MI) and using the Fourth Universal Definition of Myocardial Infarction beyond discharge (spontaneous MI); or
Target Vessel Revascularization (TVR) defined as revascularization at the target vessel (inclusive of the target lesion) after the completion of the index procedure
Time Frame
30 days post index procedure
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
General
Subject ≥18 and ≤80 years of age,male or female.
Subjects with native coronary artery disease (including stable or unstable angina and silent ischemia) suitable for PCI
Subject or legally authorized representative, signs a written Informed Consent form to participate in the study, prior to any study-mandated procedures
Angiographic
Evidence of calcification at the lesion site by, a) angiography, with fluoroscopic radio-opacities noted without cardiac motion prior to contrast injection involving both sides of the arterial wall in at least one location and total length of calcium of at least 15 mm and extending partially into the target lesion, OR by b) OCT, with presence of ≥270 degrees of calcium on at least 1 cross section
The lesion length must not exceed 40 mm
The target vessel reference diameter must be ≥2.5 mm and ≤4.0 mm
de novo target lesion stenosis of protected LMCA, or LAD, RCA or LCX (or of their branches), per investigator's assessment with:
Stenosis of ≥70% and <100% or
Stenosis ≥50% and <70% (visually assessed) that is deemed qualified for PCI by investigator
The target vessel must have TIMI flow 3 at baseline (visually assessed; may be assessed after pre-dilatation)
Ability to pass a 0.014" guide wire across the lesion
Exclusion Criteria:
General
Any comorbidity or condition which may reduce compliance with this protocol, including follow-up visits
Subject experienced an acute MI (STEMI or non-STEMI) within 30 days prior to index procedure
Subjects with cardiogenic shock or acute left heart failure; New York Heart Association (NYHA) class III or IV heart failure; left ventricular ejection fraction (LVEF) ≤ 35% within 6 months prior to the procedure (Note: if multiple LVEF assessments were performed, the measurement closest to index procedure will be chosen; it can be assessed in the procedure);
History of a stroke or transient ischemic attack (TIA) within 6 months, or any prior intracranial hemorrhage or permanent neurologic deficit
Uncontrolled diabetes defined as a HbA1c ≥10%
Non-coronary interventional or surgical structural heart procedures (e.g., TAVR, MitraClip, LAA or PFO occlusion, etc.) within 30 days prior to the index procedure
Subject refusing or not a candidate for emergency coronary artery bypass grafting (CABG) surgery
Uncontrolled severe hypertension (systolic BP >180 mm Hg or diastolic BP >110 mm Hg)
Subject is participating in another research study involving an investigational agent (pharmaceutical, biologic, or medical device) that has not reached the primary endpoint
Subject is pregnant or nursing (a negative pregnancy test is required for women of child-bearing potential within 7 days prior to enrollment); Or plans to become pregnant within 13 months after the study procedure;
Unable to tolerate dual antiplatelet therapy (i.e., aspirin, and either clopidogrel, prasugrel, or ticagrelor) for at least 6 months (for patients not on oral anticoagulation)
Subject has an allergy to imaging contrast media which cannot be adequately pre-medicated
Renal failure with serum creatinine >2.5 mg/dL or chronic dialysis
Active peptic ulcer or upper gastrointestinal (GI) bleeding within 6 months
Untreated pre-procedural hemoglobin <10 g/dL or intention to refuse blood transfusions if one should become necessary
Coagulopathy, including but not limited to platelet count <100,000 or International Normalized ratio (INR) > 1.7 (INR is only required in subjects who have taken warfarin within 2 weeks of enrollment)
Subject has a hypercoagulable disorder such as polycythemia vera, platelet count >750,000 or other disorders
Biomarkers [troponin or CK-MB] greater than the upper laboratory normal limit within 72 hours prior to index procedure (note: if both biomarkers are available, both must be normal)
Subject has an active systemic infection on the day of the index procedure with either fever, leukocytosis or requiring intravenous antibiotics
Subjects with a life expectancy of less than 1 year
Planned use of atherectomy, laser or scoring or cutting balloon, or any investigational device other than lithotripsy Angiographic
Previous stent within the target vessel implanted within the last year
Previous stent within 10 mm of the target lesion regardless of the timing of its implantation
Angiographic evidence of a dissection (≥ grade C) in the target vessel at baseline or after guidewire passage
Lesions in non-target vessels requiring PCI as below should be excluded:
24 hours to 30 days prior to the study procedure if the procedure was unsuccessful or complicated; or
In 24 hours prior to the study procedure
>30 days after the study procedure
Non-target lesion is including left main lesion with diameter stenosis ≥30%
Target vessel is too tortuous to deliver a stent assessed by investigators.
Definite or possible thrombus (by angiography or intravascular imaging) in the target vessel
Evidence of aneurysm in target vessel within 10 mm of the target lesion
Target lesion is an ostial location (LAD, LCX, or RCA, within 5 mm of ostium) or an unprotected left main lesion.
Target lesion is a bifurcation with ostial diameter stenosis ≥30%
Second lesion with >50% stenosis in the same target vessel as the target lesion including its side branches
Target lesion is located in a native vessel that can only be reached by going through a saphenous vein or arterial bypass graft
Other situations not suitable for enrollment assessed by investigators.
Facility Information:
Facility Name
Beijing Anzhen Hospital,Capital Medical University
City
Beijing
Country
China
Facility Name
Beijing Friendship Hospital,Capital Medical University
City
Beijing
Country
China
Facility Name
Chinese Peoples Liberation Army General Hospital
City
Beijing
Country
China
12. IPD Sharing Statement
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