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Coronary Intravascular Lithotripsy System in Patients With Coronary Artery Calcification (VIGOUR)

Primary Purpose

Coronary Artery Calcification

Status
Recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
Intravascular Lithotripsy System of Shanghai MicroPort Rhythm
Sponsored by
Shanghai MicroPort Rhythm MedTech Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Coronary Artery Calcification focused on measuring calcification, coronary artery

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Clinical Inclusion Criteria: Subjects aged between 18 and 85. Subjects who can undergo percutaneous coronary intervention (PCI). Subjects with asymptomatic evidence of ischemia, stable or unstable angina pectoris, or old myocardial infarction. Left Ventricular Ejection Fraction (LVEF) ≥30% as measured by echocardiography for subjects within 6 months before enrollment. (In case of multiple LVEF results, the data closest to the baseline procedure was taken.) Subjects who are able to understand the purpose of the trial, participate voluntarily or by proxy and indicate by signing the informed consent form that they recognize the risks and benefits described in the informed consent document and are willing to undergo clinical follow-up. Angiography Inclusion Criteria: There is only one target lesion that needs to be treated. The target lesion must be located in a de novo native coronary artery with a reference vessel diameter (RVD) ≥2.00 mm to ≤4.00 mm as visually measured. The target lesion angiography shows a stenosis rate ranging from ≥70% (visually measured) or ≥50% to <70% with symptoms of ischemia. Ischemic symptoms were defined as any of the following: Exercise stress test positive Fractional Flow Reserve (FFR) ≤ 0.8 or iFR < 0.9 Minimum lumen area (MLA) ≤ 4.0 mm2 by IVUS or OCT The target lesion length must be less than 40 mm (visually measured). The target lesion must meet one of the following : During angiography, clear hyperdense opacities can be observed on both sides of the arterial wall when the heart pulsates and does not pulsate Presence of calcium of ≥270°at one cross-section via IVUS or OCT Target lesion TIMI flow 3 prior to the use of the test device (at baseline or after balloon pre-dilatation). The lesion that 0.014 "guidewire can cross. Exclusion Criteria: General Exclusion Criteria: Subjects who present with AMI recently (within 7 days) Subjects who have hemodynamic instability or a severe reduction in activity tolerance (NYHA cardiac function Grade Ⅲ, Ⅳ). Subjects who have an intra-cardiac thrombus as shown by echocardiography within 30 days before enrollment. Subjects who have already received or are waiting for organ transplantation. Subjects who are receiving or scheduled to receive chemotherapy within 30 days before or after the baseline procedure. Subjects who have a platelet count < 60 x 10^9/L or > 750 x 10^9/L or other hemorrhagic diathesis, coagulation dysfunction, blood transfusion resistance. Subjects who have severe hepatic dysfunction (transaminases more than 3 times the upper limit of normal). Subjects who have chronic renal failure and a serum creatinine level > 2.5 mg/Dl (or 221µmol/L). Subjects who have active peptic ulcer diseases or active gastrointestinal (GI) bleeding within 6 months before enrollment. Subjects who are unable to receive dual antiplatelet therapy for at least 6 months due to various reasons. Subjects who experience cerebrovascular accident (CVA) or transient ischemic attack (TIA) within the past six months, or have permanent neurological defects that may cause nonconformity with the protocol. Subjects who plan to undergo rotational atherectomy, cutting balloon, scored balloon, or laser coronary atherectomy during the baseline procedure. Subjects who have received stent placement for target vessel (including collateral branches) within 12 months prior to the baseline procedure. Subjects who have received any type of PCI treatment for non-target vessels within 24 hours prior to the baseline procedure. Subjects who are scheduled to receive a cardiac intervention or cardiac surgery within 30 days of the index procedure. Subjects who have been treated with intracoronary brachytherapy at any time previously. Subjects who are allergic to investigational stent system or concomitant drugs required in the protocol (such as everolimus, sirolimus, or structure-related compounds; fluorine-containing polymers; antiplatelet agents such as aspirin, ticagrelor, or thienopyridines; contrast agent; narcotics). Subjects with other serious medical conditions (such as cancer) may shorten their life expectancy to less than 12 months. Subjects who plan to undergo a procedure that may lead to non-conformity with the protocol or confusion in data interpretation. Subjects who are participating in another investigational drug or device clinical trial in which the primary endpoint is still not reached, or intend to participate in another investigational drug or device clinical trial within 6 months after baseline procedure. Pregnant or breast-feeding subjects (women who may become pregnant must receive a pregnancy test within seven days prior to the baseline procedure). Subjects who are found to have poor compliance and unable to complete the trial as required as judged by the investigators. Angiography Exclusion Criteria: Subjects with target lesions meet the following criteria: Target lesions located within or involving 5 mm of the ostium of the left and right main coronary arteries (LAD/LCX/RCA); Target lesions that involve bifurcation lesions (bifurcation lesion ostial diameter stenosis greater than 30%); Entering through a great saphenous vein graft or an artery graft; Target lesions with thrombosis or suspected thrombosis; Target vessel with C-F type dissection according to NHLBI classification following pre-procedure angiography or guidewire crossing; In-stent restenosis involved in target lesions. Subjects with unprotected left main coronary artery diseases (diameter stenosis >30%). Subjects with other clinically significant lesions at target vessels (diameter stenosis >50%). The target vessel (including collateral) near the target lesion or within 10 mm (visually) from the distal end of the target lesion has received stent implantation at any time before baseline surgery. Subjects with lesions that guide wire cannot pass through or retrieve due to various reasons (such as serious distortion at the proximal target vessel).

Sites / Locations

  • The Second Affliated Hospital Ha'erbin Medical UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Intravascular Lithotripsy System

Arm Description

Subjects in experimental group will be treated with the Intravascular Lithotripsy System manufactured by Shanghai Microport Rhythm Co. Ltd.

Outcomes

Primary Outcome Measures

Procedure success
Procedure success is defined as the ability of intravascular lithotripsy (IVL) to produce residual diameter stenosis ≤30% after stenting with no evidence of in-hospital MACE (maximum of 7 days) (MACE: defined as the composite of cardiac death, myocardial infarction, and target vessel revascularization)

Secondary Outcome Measures

Device success
Device success is defined as delivery of the IVL catheter across the target lesion and delivery of lithotripsy without serious angiographic complications immediately after IVL.
Angiographic success
Angiographic success is defined as stent delivery with ≤30% residual stenosis and without serious angiographic complications.
MACE freedom rate at 30 days after the index procedure
MACE is defined as a composite of cardiac death, myocardial infarction[MI], and target vessel revascularization [TVR]. (Periprocedural MI is defined as peak post-PCI CK-MB level >3 x the upper limit of normal [ULN], both non-Q wave myocardial infarction or Q-wave myocardial infarction.)
Procedure-related serious complications
Procedure-related serious complications included severe dissection (Type D-F, according to NHLBI classification system), perforation, abrupt closure, and persistent slow flow/no-reflow during the baseline procedure.

Full Information

First Posted
April 5, 2023
Last Updated
April 5, 2023
Sponsor
Shanghai MicroPort Rhythm MedTech Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05818098
Brief Title
Coronary Intravascular Lithotripsy System in Patients With Coronary Artery Calcification (VIGOUR)
Official Title
A Prospective, Multicenter Clinical Trial in Evaluating the Safety and Efficacy of the Intravascular Lithotripsy System in Patients With Coronary Artery Calcification
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Recruiting
Study Start Date
March 29, 2023 (Actual)
Primary Completion Date
September 2023 (Anticipated)
Study Completion Date
March 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Shanghai MicroPort Rhythm MedTech Co., Ltd.

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 prospective and multicenter clinical investigation aiming to evaluate the safety and effectiveness of coronary intravascular lithotripsy system for the treatment of patients with coronary calcification.
Detailed Description
This trial is a prospective and multicenter clinical trial. 189 subjects are expected to be recruited in 20 research centers in China. All subjects with coronary calcified lesions participating in this clinical study must have only one lesion length of no more than 40 mm and located in an coronary artery with a diameter of ≥ 2.00 mm but ≤ 4.00 mm. All subjects receive clinical follow-up during hospitalization, 30 days and 6 months after surgery.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Artery Calcification
Keywords
calcification, coronary artery

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
189 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Intravascular Lithotripsy System
Arm Type
Experimental
Arm Description
Subjects in experimental group will be treated with the Intravascular Lithotripsy System manufactured by Shanghai Microport Rhythm Co. Ltd.
Intervention Type
Device
Intervention Name(s)
Intravascular Lithotripsy System of Shanghai MicroPort Rhythm
Intervention Description
The Intravascular Lithotripsy System is a single-use, sterile, disposable balloon angioplasty catheter that contains a series of unfocused, electrohydraulic lithotripsy emitters, which convert electrical energy into transient acoustic circumferential pressure pulses that disrupt both superficial and deep calcium within vascular plaque.
Primary Outcome Measure Information:
Title
Procedure success
Description
Procedure success is defined as the ability of intravascular lithotripsy (IVL) to produce residual diameter stenosis ≤30% after stenting with no evidence of in-hospital MACE (maximum of 7 days) (MACE: defined as the composite of cardiac death, myocardial infarction, and target vessel revascularization)
Time Frame
During hospitalization (up to 7 days after procedure)
Secondary Outcome Measure Information:
Title
Device success
Description
Device success is defined as delivery of the IVL catheter across the target lesion and delivery of lithotripsy without serious angiographic complications immediately after IVL.
Time Frame
Baseline procedure
Title
Angiographic success
Description
Angiographic success is defined as stent delivery with ≤30% residual stenosis and without serious angiographic complications.
Time Frame
Baseline procedure
Title
MACE freedom rate at 30 days after the index procedure
Description
MACE is defined as a composite of cardiac death, myocardial infarction[MI], and target vessel revascularization [TVR]. (Periprocedural MI is defined as peak post-PCI CK-MB level >3 x the upper limit of normal [ULN], both non-Q wave myocardial infarction or Q-wave myocardial infarction.)
Time Frame
within 30 days of baseline procedure
Title
Procedure-related serious complications
Description
Procedure-related serious complications included severe dissection (Type D-F, according to NHLBI classification system), perforation, abrupt closure, and persistent slow flow/no-reflow during the baseline procedure.
Time Frame
Baseline procedure

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Clinical Inclusion Criteria: Subjects aged between 18 and 85. Subjects who can undergo percutaneous coronary intervention (PCI). Subjects with asymptomatic evidence of ischemia, stable or unstable angina pectoris, or old myocardial infarction. Left Ventricular Ejection Fraction (LVEF) ≥30% as measured by echocardiography for subjects within 6 months before enrollment. (In case of multiple LVEF results, the data closest to the baseline procedure was taken.) Subjects who are able to understand the purpose of the trial, participate voluntarily or by proxy and indicate by signing the informed consent form that they recognize the risks and benefits described in the informed consent document and are willing to undergo clinical follow-up. Angiography Inclusion Criteria: There is only one target lesion that needs to be treated. The target lesion must be located in a de novo native coronary artery with a reference vessel diameter (RVD) ≥2.00 mm to ≤4.00 mm as visually measured. The target lesion angiography shows a stenosis rate ranging from ≥70% (visually measured) or ≥50% to <70% with symptoms of ischemia. Ischemic symptoms were defined as any of the following: Exercise stress test positive Fractional Flow Reserve (FFR) ≤ 0.8 or iFR < 0.9 Minimum lumen area (MLA) ≤ 4.0 mm2 by IVUS or OCT The target lesion length must be less than 40 mm (visually measured). The target lesion must meet one of the following : During angiography, clear hyperdense opacities can be observed on both sides of the arterial wall when the heart pulsates and does not pulsate Presence of calcium of ≥270°at one cross-section via IVUS or OCT Target lesion TIMI flow 3 prior to the use of the test device (at baseline or after balloon pre-dilatation). The lesion that 0.014 "guidewire can cross. Exclusion Criteria: General Exclusion Criteria: Subjects who present with AMI recently (within 7 days) Subjects who have hemodynamic instability or a severe reduction in activity tolerance (NYHA cardiac function Grade Ⅲ, Ⅳ). Subjects who have an intra-cardiac thrombus as shown by echocardiography within 30 days before enrollment. Subjects who have already received or are waiting for organ transplantation. Subjects who are receiving or scheduled to receive chemotherapy within 30 days before or after the baseline procedure. Subjects who have a platelet count < 60 x 10^9/L or > 750 x 10^9/L or other hemorrhagic diathesis, coagulation dysfunction, blood transfusion resistance. Subjects who have severe hepatic dysfunction (transaminases more than 3 times the upper limit of normal). Subjects who have chronic renal failure and a serum creatinine level > 2.5 mg/Dl (or 221µmol/L). Subjects who have active peptic ulcer diseases or active gastrointestinal (GI) bleeding within 6 months before enrollment. Subjects who are unable to receive dual antiplatelet therapy for at least 6 months due to various reasons. Subjects who experience cerebrovascular accident (CVA) or transient ischemic attack (TIA) within the past six months, or have permanent neurological defects that may cause nonconformity with the protocol. Subjects who plan to undergo rotational atherectomy, cutting balloon, scored balloon, or laser coronary atherectomy during the baseline procedure. Subjects who have received stent placement for target vessel (including collateral branches) within 12 months prior to the baseline procedure. Subjects who have received any type of PCI treatment for non-target vessels within 24 hours prior to the baseline procedure. Subjects who are scheduled to receive a cardiac intervention or cardiac surgery within 30 days of the index procedure. Subjects who have been treated with intracoronary brachytherapy at any time previously. Subjects who are allergic to investigational stent system or concomitant drugs required in the protocol (such as everolimus, sirolimus, or structure-related compounds; fluorine-containing polymers; antiplatelet agents such as aspirin, ticagrelor, or thienopyridines; contrast agent; narcotics). Subjects with other serious medical conditions (such as cancer) may shorten their life expectancy to less than 12 months. Subjects who plan to undergo a procedure that may lead to non-conformity with the protocol or confusion in data interpretation. Subjects who are participating in another investigational drug or device clinical trial in which the primary endpoint is still not reached, or intend to participate in another investigational drug or device clinical trial within 6 months after baseline procedure. Pregnant or breast-feeding subjects (women who may become pregnant must receive a pregnancy test within seven days prior to the baseline procedure). Subjects who are found to have poor compliance and unable to complete the trial as required as judged by the investigators. Angiography Exclusion Criteria: Subjects with target lesions meet the following criteria: Target lesions located within or involving 5 mm of the ostium of the left and right main coronary arteries (LAD/LCX/RCA); Target lesions that involve bifurcation lesions (bifurcation lesion ostial diameter stenosis greater than 30%); Entering through a great saphenous vein graft or an artery graft; Target lesions with thrombosis or suspected thrombosis; Target vessel with C-F type dissection according to NHLBI classification following pre-procedure angiography or guidewire crossing; In-stent restenosis involved in target lesions. Subjects with unprotected left main coronary artery diseases (diameter stenosis >30%). Subjects with other clinically significant lesions at target vessels (diameter stenosis >50%). The target vessel (including collateral) near the target lesion or within 10 mm (visually) from the distal end of the target lesion has received stent implantation at any time before baseline surgery. Subjects with lesions that guide wire cannot pass through or retrieve due to various reasons (such as serious distortion at the proximal target vessel).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Tingting Wu, M.D.
Phone
0086-021-38954600
Ext
50327
Email
TingTing.Wu2@microport.com
First Name & Middle Initial & Last Name or Official Title & Degree
Bo Yu, M.D.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bo Yu, M.D.
Organizational Affiliation
The Second Affiliated Hospital of Harbin Medical University
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Second Affliated Hospital Ha'erbin Medical University
City
Ha'erbin
State/Province
Heilongjiang
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yu Bo

12. IPD Sharing Statement

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Coronary Intravascular Lithotripsy System in Patients With Coronary Artery Calcification (VIGOUR)

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