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A Trial of DCB vs DES in the Treatment of de Novo Large Diameter Coronary Atherosclerotic Stenosis(LARGE ONE) (LARGE-ONE)

Primary Purpose

Coronary Artery Disease

Status
Recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
SeQuent® Please drug coating balloon(DCB),Firehawk family drug eluting stent(DES)
Sponsored by
Shanghai MicroPort Medical (Group) Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Coronary Artery Disease

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: CI1. Age of subject 18-75 years old; CI2. The subject (or legal guardian) understands and provides written informed consent to the test requirements and treatment procedures prior to performing any specific tests or procedures in the study; CI3. The subject is suitable for percutaneous coronary intervention (PCI); CI4. The subject had symptomatic coronary artery disease with objective evidence or asymptomatic ischemia; CI5. Subject is willing to submit to all subsequent evaluations required by the test protocol Angiogragh Inclusion AI1. At Maximum 2 target lesions with stenosis ≥50%, located in no more than 2 vessels with a visual reference vessel diameter (RVD) of ≥3.00 mm and ≤4.00 mm; AI2. The length of the target lesion must be≤35 mm (visually) and can be covered by one study stent or drug balloon; AI3. The first target lesion must be successfully predilated/pretreated without: Vascular tears affecting hemodynamics (TIMI blood grade ≤2); Coronary dissection classified as D, E and F(ARC); Residual stenosis > 30% after lesion preparation; Note: If Type C dissection occurs at lesion predilation/preparation, clinical investigators will determine whether the target lesion can be included based on the comprehensive situation of blood flow and patients risks . Type C dissection will be excluded from the OCT subgroup considering the risk of dissection extension for OCT operation. AI4. The anatomical conditions of the coronary artery were appropriate, and the study instrument could be transported to the appropriate location of the target lesion. Exclusion Criteria: CE1. Subjects with clinical symptoms and/or ECG findings consistent with the diagnosis of acute ST-segment elevation myocardial infarction (STEMI) within 7 days; CE2. Subject is known to be allergic to contrast agents (which cannot be fully pretreated) and/or concomitant medications required by the stent system or protocol (e.g., cobalt-chrome, platinum-chrome, stainless steel, rapamycin, paclitaxel and similar configuration compounds, drug coating carrier components, all P2Y12 receptor inhibitors, aspirin, etc.); CE3. Planned surgical treatment within 6 months after baseline surgery; CE4. Severe heart failure (NYHA Grade IV) or left ventricular ejection fraction <30% (ultrasound or left ventricular contrast); CE5. Previous renal impairment: serum creatinine >2.0mg/dL; Or on dialysis; CE6. Previous bleeding events (BARC III or V); CE7. Subject is receiving or indication of long-term anticoagulant therapy ; CE8. Subject has any of the following conditions (baseline assessment) : Other serious medical conditions that reduce subjects' life expectancy to less than 13 months (e.g., cancer, congestive heart failure); Subject has a current substance abuse problem (e.g., alcohol, cocaine, heroin, etc.); Subject plans to undergo surgical/intervention procedures that may result in non-compliance with protocol or confusing data interpretation; CE9. Subject has a history of bleeding tendency, coagulation disorders or refusal of blood transfusion; CE10. The subject is participating in a clinical trial of another investigational drug or device that does not meet its primary endpoint; CE11. Subjects are scheduled to participate in another investigational drug or device clinical trial within 13 months of baseline procedure; CE12. Subjects who intend to be pregnant within 13 months of baseline procedure (fertile and sexually active women should consent to use a reliable contraceptive method from screening to 13 months after baseline surgery); CE13. Subjects are pregnant or breastfeeding (fertile women with pregnancy possibility should undergo a pregnancy test within 7 days prior to baseline surgery). Angiogragh Exclusion AE1. Plan to treat 3 or more target lesions; AE2. Plan to treat more than 2 major epicardial vessels; AE3. A single lesion to be treated cannot be covered by a single stent or a single drug balloon; AE4. The subject had two target lesions in the same target vessel, and the distance between the two target lesions was ≤15mm (visual observation); AE5. Target lesions were located in the left main trunk; AE6. Target lesions were located within 3mm of the initial segment of the left anterior descending artery (LAD) or left circumflex artery (LCX). AE7. Target lesions were located in a saphenous vein, artery or artificial bypass graft; AE8. Target lesions need to be treated through a saphenous vein, artery or artificial bypass graft ; AE9. Target lesion blood flow grade of TIMI 0/1 before guide wire passes through ; AE10. Treatment of target lesions involves multi-stent strategy in complex lesions (e.g., bifurcated lesions require more than one stent); AE11. Target lesions involve previously in-stent restenosis lesions or overlap with previously implanted stents; AE12. Subject has unprotected left main coronary artery disease (>50% diameter stenosis); AE13. Subjects have received PCI for any type of target lesion (e.g., balloon dilation, stent placement, balloon dissection, etc.) within 12 months before baseline; AE14. Presence of thrombus or possible thrombus in the target lesion (visual); AE15. The target lesions were moderate to severe calcification lesions.

Sites / Locations

  • Jining Medical University Affiliated HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

DCB ARM

DES ARM

Arm Description

patients with large primary coronary artery lesions (3.0mm≤ vessel diameter ≤4.0mm, lesion length ≤35mm).

patients with large primary coronary artery lesions (3.0mm≤ vessel diameter ≤4.0mm, lesion length ≤35mm).

Outcomes

Primary Outcome Measures

Value of Luminal loss at 13month post procedure
defined as the difference between the minimum lumen diameter in the lesion segment immediately after use of the study instrument and the minimum lumen diameter at 13 months angiographic follow up .

Secondary Outcome Measures

Rate of Target Lesion Failure(TLF)
defined as the composite of cardiac death, target vessel-related myocardial infarction (MI)*, or ischemia-driven target lesion revascularization (TLR)
Rate of Major Adverse Cardiac Events(MACE )
The composite of cardiac death, any MI or ischemia-driven TLR, and stent thrombosis myocardial infarction (MI)*, or ischemia-driven target lesion revascularization (TLR)
Value of Neointimal Volume:
the total volume bounded by the stent and the lumen within the segment of interest. It can be calculated using the formula: [= Stent Volume - Lumen Volume]
Value of Stent Volume
Based on Simpson's rule, the stent volume is calculated as the total volume bounded by the stent within the segment of interest. In the absence of neointimal hyperplasia, malapposition, and tissue protrusion, the stent volume corresponds to the lumen volume.
Value of Lumen Volume
Based on Simpson's rule, the total volume bounded by the lumen within the segment of interest.

Full Information

First Posted
December 6, 2022
Last Updated
July 23, 2023
Sponsor
Shanghai MicroPort Medical (Group) Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05961787
Brief Title
A Trial of DCB vs DES in the Treatment of de Novo Large Diameter Coronary Atherosclerotic Stenosis(LARGE ONE)
Acronym
LARGE-ONE
Official Title
LARGE-ONE: A Prospective, Multicenter, Randomized Controlled Trial of the Use of Drug-coating Balloons(DCB) or Drug-eluting Stents(DES) in the Treatment of Large Diameter Coronary Atherosclerotic Lesions
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 30, 2022 (Actual)
Primary Completion Date
January 2025 (Anticipated)
Study Completion Date
January 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Shanghai MicroPort Medical (Group) Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
For the treatment of primary large-diameter coronary atherosclerosis through percutaneous coronary intervention (PCI), the use of a drug balloon (DCB) is not inferior to the placement of a drug-eluting stent (Firehawk™ family). * Large-diameter vessels were defined as vessels with a diameter of ≥3.00 mm and ≤ 4.0mm

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Artery Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
134 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
DCB ARM
Arm Type
Experimental
Arm Description
patients with large primary coronary artery lesions (3.0mm≤ vessel diameter ≤4.0mm, lesion length ≤35mm).
Arm Title
DES ARM
Arm Type
Active Comparator
Arm Description
patients with large primary coronary artery lesions (3.0mm≤ vessel diameter ≤4.0mm, lesion length ≤35mm).
Intervention Type
Device
Intervention Name(s)
SeQuent® Please drug coating balloon(DCB),Firehawk family drug eluting stent(DES)
Intervention Description
Investigation on DCB vs DES on Symptomatic or silent ischemic coronary artery disease with indications for PCI Lesions ≤35 mm in length (visual), diameter 3-4 mm. A maximum of 2 target lesions on 2 major epicardial coronary target vessels can be treated during baseline procedure. (e.g., one target lesion on one target vessel, or two target lesions on the same target vessel but separated ≥ 15 mm; Or 1 target lesion on each of the target vessels)
Primary Outcome Measure Information:
Title
Value of Luminal loss at 13month post procedure
Description
defined as the difference between the minimum lumen diameter in the lesion segment immediately after use of the study instrument and the minimum lumen diameter at 13 months angiographic follow up .
Time Frame
13 months
Secondary Outcome Measure Information:
Title
Rate of Target Lesion Failure(TLF)
Description
defined as the composite of cardiac death, target vessel-related myocardial infarction (MI)*, or ischemia-driven target lesion revascularization (TLR)
Time Frame
30 days, 6 months, 1and 2 years
Title
Rate of Major Adverse Cardiac Events(MACE )
Description
The composite of cardiac death, any MI or ischemia-driven TLR, and stent thrombosis myocardial infarction (MI)*, or ischemia-driven target lesion revascularization (TLR)
Time Frame
30 days, 6 months, 1and 2 years
Title
Value of Neointimal Volume:
Description
the total volume bounded by the stent and the lumen within the segment of interest. It can be calculated using the formula: [= Stent Volume - Lumen Volume]
Time Frame
3 months post procedure
Title
Value of Stent Volume
Description
Based on Simpson's rule, the stent volume is calculated as the total volume bounded by the stent within the segment of interest. In the absence of neointimal hyperplasia, malapposition, and tissue protrusion, the stent volume corresponds to the lumen volume.
Time Frame
3 months post procedure
Title
Value of Lumen Volume
Description
Based on Simpson's rule, the total volume bounded by the lumen within the segment of interest.
Time Frame
3 months post procedure

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: CI1. Age of subject 18-75 years old; CI2. The subject (or legal guardian) understands and provides written informed consent to the test requirements and treatment procedures prior to performing any specific tests or procedures in the study; CI3. The subject is suitable for percutaneous coronary intervention (PCI); CI4. The subject had symptomatic coronary artery disease with objective evidence or asymptomatic ischemia; CI5. Subject is willing to submit to all subsequent evaluations required by the test protocol Angiogragh Inclusion AI1. At Maximum 2 target lesions with stenosis ≥50%, located in no more than 2 vessels with a visual reference vessel diameter (RVD) of ≥3.00 mm and ≤4.00 mm; AI2. The length of the target lesion must be≤35 mm (visually) and can be covered by one study stent or drug balloon; AI3. The first target lesion must be successfully predilated/pretreated without: Vascular tears affecting hemodynamics (TIMI blood grade ≤2); Coronary dissection classified as D, E and F(ARC); Residual stenosis > 30% after lesion preparation; Note: If Type C dissection occurs at lesion predilation/preparation, clinical investigators will determine whether the target lesion can be included based on the comprehensive situation of blood flow and patients risks . Type C dissection will be excluded from the OCT subgroup considering the risk of dissection extension for OCT operation. AI4. The anatomical conditions of the coronary artery were appropriate, and the study instrument could be transported to the appropriate location of the target lesion. Exclusion Criteria: CE1. Subjects with clinical symptoms and/or ECG findings consistent with the diagnosis of acute ST-segment elevation myocardial infarction (STEMI) within 7 days; CE2. Subject is known to be allergic to contrast agents (which cannot be fully pretreated) and/or concomitant medications required by the stent system or protocol (e.g., cobalt-chrome, platinum-chrome, stainless steel, rapamycin, paclitaxel and similar configuration compounds, drug coating carrier components, all P2Y12 receptor inhibitors, aspirin, etc.); CE3. Planned surgical treatment within 6 months after baseline surgery; CE4. Severe heart failure (NYHA Grade IV) or left ventricular ejection fraction <30% (ultrasound or left ventricular contrast); CE5. Previous renal impairment: serum creatinine >2.0mg/dL; Or on dialysis; CE6. Previous bleeding events (BARC III or V); CE7. Subject is receiving or indication of long-term anticoagulant therapy ; CE8. Subject has any of the following conditions (baseline assessment) : Other serious medical conditions that reduce subjects' life expectancy to less than 13 months (e.g., cancer, congestive heart failure); Subject has a current substance abuse problem (e.g., alcohol, cocaine, heroin, etc.); Subject plans to undergo surgical/intervention procedures that may result in non-compliance with protocol or confusing data interpretation; CE9. Subject has a history of bleeding tendency, coagulation disorders or refusal of blood transfusion; CE10. The subject is participating in a clinical trial of another investigational drug or device that does not meet its primary endpoint; CE11. Subjects are scheduled to participate in another investigational drug or device clinical trial within 13 months of baseline procedure; CE12. Subjects who intend to be pregnant within 13 months of baseline procedure (fertile and sexually active women should consent to use a reliable contraceptive method from screening to 13 months after baseline surgery); CE13. Subjects are pregnant or breastfeeding (fertile women with pregnancy possibility should undergo a pregnancy test within 7 days prior to baseline surgery). Angiogragh Exclusion AE1. Plan to treat 3 or more target lesions; AE2. Plan to treat more than 2 major epicardial vessels; AE3. A single lesion to be treated cannot be covered by a single stent or a single drug balloon; AE4. The subject had two target lesions in the same target vessel, and the distance between the two target lesions was ≤15mm (visual observation); AE5. Target lesions were located in the left main trunk; AE6. Target lesions were located within 3mm of the initial segment of the left anterior descending artery (LAD) or left circumflex artery (LCX). AE7. Target lesions were located in a saphenous vein, artery or artificial bypass graft; AE8. Target lesions need to be treated through a saphenous vein, artery or artificial bypass graft ; AE9. Target lesion blood flow grade of TIMI 0/1 before guide wire passes through ; AE10. Treatment of target lesions involves multi-stent strategy in complex lesions (e.g., bifurcated lesions require more than one stent); AE11. Target lesions involve previously in-stent restenosis lesions or overlap with previously implanted stents; AE12. Subject has unprotected left main coronary artery disease (>50% diameter stenosis); AE13. Subjects have received PCI for any type of target lesion (e.g., balloon dilation, stent placement, balloon dissection, etc.) within 12 months before baseline; AE14. Presence of thrombus or possible thrombus in the target lesion (visual); AE15. The target lesions were moderate to severe calcification lesions.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Lijun Gan, doctoral
Phone
18505370616
Email
13792336453@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ming Zheng, Doctoral
Organizational Affiliation
Shanghai MicroPort Medical (Group) Co., Ltd.
Official's Role
Study Director
Facility Information:
Facility Name
Jining Medical University Affiliated Hospital
City
Jining
State/Province
Shandong
ZIP/Postal Code
272000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lijun Gan, doctoral
Phone
18505370616
Email
13792336453@163.com

12. IPD Sharing Statement

Learn more about this trial

A Trial of DCB vs DES in the Treatment of de Novo Large Diameter Coronary Atherosclerotic Stenosis(LARGE ONE)

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