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BARD® Study of LIFESTREAM™ Balloon Expandable Covered Stent Treating Iliac Arterial Occlusive Disease (BOLSTER)

Primary Purpose

Peripheral Artery Disease, Peripheral Vascular Disease, Arterial Occlusive Disease

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Percutaneous transluminal angioplasty (PTA)
LIFESTREAM™ covered stent
Sponsored by
C. R. Bard
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peripheral Artery Disease focused on measuring Lack of perfusion in the extremities, Atherosclerosis, Intermittent claudication, BOLSTER

Eligibility Criteria

21 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

CLINICAL INCLUSION CRITERIA:

  • The subject provides written informed consent using an Informed Consent Form approved by the Ethics Committee/ Institutional Review Board for the site.
  • Subject agrees to comply with the protocol-mandated follow-up procedures and visits.
  • Subject is a male or non-pregnant female ≥ 21 years old with an expected lifespan sufficient to allow for completion of all study procedures.
  • Subject has intermittent claudication (Rutherford Category 2-3) or ischemic rest pain (Rutherford Category 4).
  • Subject is able and willing to comply with any required medication regimen.

ANGIOGRAPHIC INCLUSION CRITERIA:

  • Subject has evidence of single, bilateral, or multiple de novo and/or restenotic (non-stented) lesion in the native common and/or external iliac artery that is ≥ 50% stenosed (including total occlusions).
  • The target lesion can be successfully crossed with a guide wire and pre-dilated with an appropriately sized PTA balloon.
  • The reference vessel diameter is between 4.5 mm -12.0 mm in diameter.
  • The target lesion is ≤ 100 mm in combined length (per side).
  • The subject has angiographic evidence of a patent (< 50% stenosis) profunda and/or superficial femoral artery (SFA) in the target limb.

CLINICAL EXCLUSION CRITERIA:

  • The subject is unable or unwilling to provide written informed consent or to conform to the study protocol follow-up procedures and visits.
  • The subject is or plans to become pregnant during the study.
  • The subject is asymptomatic, has mild claudication or critical limb ischemia with tissue loss described as Rutherford Category 0, 1, 5 or 6.
  • The subject has a vascular graft previously implanted in the native iliac vessel.
  • The subject suffered a hemorrhagic stroke or transient ischemic attack (TIA) within 3 months prior to the index procedure.
  • The subject has a known uncorrectable bleeding diathesis or active coagulopathy.
  • The subject has a serum creatinine ≥ 2.5 mg/dl or is on dialysis.
  • The subject has a known allergy or sensitivity to stainless steel (i.e., Nickel), ePTFE, or has intolerance to the antiplatelet, anticoagulant or thrombolytic medications required per the protocol.
  • The subject has a known allergy or sensitivity to contrast media, which cannot be adequately pre-medicated.
  • The subject had a prior vascular intervention within 30 days before or planned for within 30 days after the index procedure.
  • The subject has another medical condition, which may cause him/her to be non-compliant with the protocol, confound the data interpretation, or is associated with a life expectancy insufficient to allow for the completion of study procedures and follow-up.
  • The subject is currently participating in an investigational drug, biologic, or another device study.

ANGIOGRAPHIC EXCLUSION CRITERIA:

  • The subject has extensive peripheral vascular disease, which in the opinion of the Investigator, would preclude safe insertion of an introducer sheath. The ipsilateral common femoral artery should be patent (< 50% stenosis).
  • The target lesion requires treatment other than angioplasty to facilitate subject device delivery.
  • The subject has severe calcification of the target lesion, preventing inflation of PTA balloon.
  • The target lesion has been previously treated with a stent (bare or covered).
  • The subject has angiographic evidence of acute thrombus at the target lesion.
  • The target lesion involves the origin of the internal iliac artery such that successful treatment of the lesion would require the subject device to cross/occlude the side branch.
  • The target lesion located in the distal external iliac artery such that successful treatment of the lesion would require the subject device to cross/occlude side branches or be exposed to compressive forces associated with the close proximity to the common femoral artery.
  • The subject has an abdominal aortic aneurysm (AAA) contiguous to the iliac artery target lesion.
  • The subject has a pre-existing target iliac artery aneurysm or perforation or dissection of the target iliac artery prior to the initiation of the treatment for this study.

Sites / Locations

  • Arkansas Heart Hospital
  • Vascular and Interventional Specialists of Orange County
  • UC Davis Cardiovascular Medicine
  • Florida Research Network
  • Baptist Medical Center
  • Lakeland Regional Medical Center
  • Mount Sinai Medical Center
  • University of Massachusetts Worcester
  • Kansas City Vascular Foundation
  • CaroMont Regional Medical Center
  • North Carolina Heart and Vascular
  • Donald Guthrie Foundation
  • Univeristy of Texas Medical Branch
  • Swedish Health Services
  • Universitäts-Herzzentrum Freiburg-Bad Krozingen GmbH
  • Ev.Krankenhaus Königin Elisabeth
  • Praxis fur Interventionelle Angiologie
  • Universitaetsklinikum Leipzig
  • Bonifatius Hospital
  • Auckland Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

LIFESTREAM™

Arm Description

This is a single arm study. All subjects receive percutaneous transluminal angioplasty (PTA) and implantation of the LIFESTREAM™ covered stent.

Outcomes

Primary Outcome Measures

Number of Participants With Device and/or Procedure-Related Death or Myocardial Infarction (MI) Through 30 Days, or Any Target Lesion Revascularization (TLR), Target Limb(s) Major Amputation, or Restenosis Through 9-Months Post Index Procedure.
The primary endpoint is a composite safety and effectiveness measure defined as device and/or procedure-related death or myocardial infarction (MI) through 30 days, or any Target Lesion Revascularization (TLR), target limb(s) major amputation, or restenosis through 9-months post-index procedure.

Secondary Outcome Measures

Number of Participants With Major Adverse Events (MAEs) Through 9-Months Post Index Procedure.
Major Adverse Events (MAE) defined as device and/or procedure-related death or MI through 30 days, or any TLR or target limb(s) major amputation through 9-months post-index procedure. Major amputation is defined as an amputation at or above the ankle.
Number of Lesions With Acute Lesion Success
Acute Lesion Success defined as attainment of < 30% residual stenosis of the target lesion after the index procedure using any percutaneous method and/or non-investigational device (i.e., post-dilatation), as determined by an Independent Angiographic Core Lab.
Number of Participants With Acute Procedure Success
Acute Procedure Success defined as lesion success and no peri-procedural complications (death, stroke, myocardial infarction (MI), emergent surgical revascularization, significant distal embolization in target limb, and thrombosis of target vessel) prior to hospital discharge.
Number of Devices With Acute Technical Success at Index Procedure
Acute Technical Success defined as successful deployment of the LIFESTREAM™ Covered Stent at the intended location, as determined by the Investigator.
Number of Participants With Target Lesion Revascularization (TLR) at 6, 9, 12, 24, and 36 Months Post Index Procedure
Target Lesion Revascularization (TLR) is defined as the first revascularization procedure (e.g., PTA, atherectomy, etc.) of the target lesion(s) following the index procedure, as determined by an Independent Angiographic Core Lab. All Target Lesion Revascularizations (TLR) were Target Vessel Revascularizations (TVR) and therefore, the results presented in Outcome #6 and Outcome #7 are the same.
Number of Participants With Target Vessel Revascularization (TVR) Event at 6, 9, 12, 24, and 36 Months Post Index Procedure.
Target Vessel Revascularization (TVR) is defined as the first revascularization procedure (e.g. PTA, stenting, surgical bypass, etc.) in the target vessel(s) following the index procedure, as determined by an Independent Angiographic Core Lab. All Target Vessel Revascularizations (TVR) were Target Lesion Revascularizations (TLR) and therefore, the results presented in Outcome #6 and Outcome #7 are the same.
Number of Participants With Sustained Clinical Success at 30-Days and 9, 12, 24, and 36 Months Post Index Procedure
Sustained Clinical Success defined as sustained cumulative improvement from baseline value of ≥ 1 Rutherford Category23 at 30-days and 9, 12, 24, and 36-months post-index procedure, as determined by the Investigator.
Number of Participants With Primary Patency at 9, 12, 24, and 36 Months Post Index Procedure
Primary Patency at 9, 12, 24 and 36-months post-index procedure corresponding to PSVR ≤ 2.4.
Number of Participants With Assisted Primary Patency at 9, 12, 24, and 36 Months Post Index Procedure
Primary Assisted Patency at 9-, 12-, 24-, and 36-months post-index procedure corresponding to PSVR ≤ 2.4, as determined by an Independent DUS Core Lab. Primary Assisted Patency is independent of whether or not patency is re-established via an endovascular procedure following restenosis.
Number of Participants With Secondary Patency at 9, 12, 24, and 36 Months Post Index Procedure.
Secondary Patency is a measure of success at re-establishing patency following failure of the initial stent placement due to stenosis or re-occlusion. In this study, Secondary Patency was independent of whether or not patency was re-established via an endovascular procedure following restenosis or occlusion, and was analyzed for the Intent to Treat (ITT) population. Secondary patency is defined as a peak systolic velocity ratio (PSVR) ≤ 2.4, as determined by an independent Duplex Ultrasonography (DUS) Core Lab.
Change in Walking Impairment Questionnaire (WIQ) Scores at 30 Days, 9, 12, 24, and 36-Months Post Index Procedure Compared to Baseline.
The WIQ assesses 3 categories of activities that include 1) walking distance, 2) stair-climbing, and 3) walking speed. Each question requires participants to rate their degree of difficulty with the activity on a scale of 0 (unable) to 4 (no problem). Final scores range from 0% to 100%, with lower percentages indicating higher levels of difficulties with activities.The results below represent the mean differences in total Walking Impairment Questionnaire (WIQ) scores at 30 days,9, 12, 24, and 36 months compared to baseline assessment scores.

Full Information

First Posted
August 15, 2014
Last Updated
September 15, 2020
Sponsor
C. R. Bard
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1. Study Identification

Unique Protocol Identification Number
NCT02228564
Brief Title
BARD® Study of LIFESTREAM™ Balloon Expandable Covered Stent Treating Iliac Arterial Occlusive Disease
Acronym
BOLSTER
Official Title
A Prospective, Multi-Center, Non-Randomized, Single-Arm Study of the BARD® LIFESTREAM™ Balloon Expandable Vascular Covered Stent in the Treatment of Iliac Artery Occlusive Disease (BOLSTER)
Study Type
Interventional

2. Study Status

Record Verification Date
September 2020
Overall Recruitment Status
Completed
Study Start Date
September 2014 (undefined)
Primary Completion Date
December 2016 (Actual)
Study Completion Date
December 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
C. R. Bard

4. Oversight

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

5. Study Description

Brief Summary
Collect confirmatory evidence of the safety and effectiveness of the Balloon LIFESTREAM™ Stent Graft for the treatment of stenoses and occlusion in the iliac arteries.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peripheral Artery Disease, Peripheral Vascular Disease, Arterial Occlusive Disease
Keywords
Lack of perfusion in the extremities, Atherosclerosis, Intermittent claudication, BOLSTER

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
LIFESTREAM™
Arm Type
Experimental
Arm Description
This is a single arm study. All subjects receive percutaneous transluminal angioplasty (PTA) and implantation of the LIFESTREAM™ covered stent.
Intervention Type
Procedure
Intervention Name(s)
Percutaneous transluminal angioplasty (PTA)
Intervention Description
Percutaneous transluminal angioplasty (PTA) is a procedure that can open up a blocked blood vessel using a small, flexible plastic tube, or catheter, with a "balloon" at the end of it. When the tube is in place, it inflates to open the blood vessel, or artery, so that normal blood flow is restored.
Intervention Type
Device
Intervention Name(s)
LIFESTREAM™ covered stent
Intervention Description
Implantation of the LIFESTREAM™ covered stent
Primary Outcome Measure Information:
Title
Number of Participants With Device and/or Procedure-Related Death or Myocardial Infarction (MI) Through 30 Days, or Any Target Lesion Revascularization (TLR), Target Limb(s) Major Amputation, or Restenosis Through 9-Months Post Index Procedure.
Description
The primary endpoint is a composite safety and effectiveness measure defined as device and/or procedure-related death or myocardial infarction (MI) through 30 days, or any Target Lesion Revascularization (TLR), target limb(s) major amputation, or restenosis through 9-months post-index procedure.
Time Frame
9 months post index procedure
Secondary Outcome Measure Information:
Title
Number of Participants With Major Adverse Events (MAEs) Through 9-Months Post Index Procedure.
Description
Major Adverse Events (MAE) defined as device and/or procedure-related death or MI through 30 days, or any TLR or target limb(s) major amputation through 9-months post-index procedure. Major amputation is defined as an amputation at or above the ankle.
Time Frame
9 months post index procedure
Title
Number of Lesions With Acute Lesion Success
Description
Acute Lesion Success defined as attainment of < 30% residual stenosis of the target lesion after the index procedure using any percutaneous method and/or non-investigational device (i.e., post-dilatation), as determined by an Independent Angiographic Core Lab.
Time Frame
At time of Index Procedure
Title
Number of Participants With Acute Procedure Success
Description
Acute Procedure Success defined as lesion success and no peri-procedural complications (death, stroke, myocardial infarction (MI), emergent surgical revascularization, significant distal embolization in target limb, and thrombosis of target vessel) prior to hospital discharge.
Time Frame
At time of hospital discharge
Title
Number of Devices With Acute Technical Success at Index Procedure
Description
Acute Technical Success defined as successful deployment of the LIFESTREAM™ Covered Stent at the intended location, as determined by the Investigator.
Time Frame
At time of index procedure
Title
Number of Participants With Target Lesion Revascularization (TLR) at 6, 9, 12, 24, and 36 Months Post Index Procedure
Description
Target Lesion Revascularization (TLR) is defined as the first revascularization procedure (e.g., PTA, atherectomy, etc.) of the target lesion(s) following the index procedure, as determined by an Independent Angiographic Core Lab. All Target Lesion Revascularizations (TLR) were Target Vessel Revascularizations (TVR) and therefore, the results presented in Outcome #6 and Outcome #7 are the same.
Time Frame
6, 9, 12, 24, and 36 months post index procedure
Title
Number of Participants With Target Vessel Revascularization (TVR) Event at 6, 9, 12, 24, and 36 Months Post Index Procedure.
Description
Target Vessel Revascularization (TVR) is defined as the first revascularization procedure (e.g. PTA, stenting, surgical bypass, etc.) in the target vessel(s) following the index procedure, as determined by an Independent Angiographic Core Lab. All Target Vessel Revascularizations (TVR) were Target Lesion Revascularizations (TLR) and therefore, the results presented in Outcome #6 and Outcome #7 are the same.
Time Frame
6, 9, 12, 24, and 36 months post index procedure
Title
Number of Participants With Sustained Clinical Success at 30-Days and 9, 12, 24, and 36 Months Post Index Procedure
Description
Sustained Clinical Success defined as sustained cumulative improvement from baseline value of ≥ 1 Rutherford Category23 at 30-days and 9, 12, 24, and 36-months post-index procedure, as determined by the Investigator.
Time Frame
30 days, and 9, 12, 24, and 36 months post index procedure
Title
Number of Participants With Primary Patency at 9, 12, 24, and 36 Months Post Index Procedure
Description
Primary Patency at 9, 12, 24 and 36-months post-index procedure corresponding to PSVR ≤ 2.4.
Time Frame
9, 12, 24 and 36 months post index procedure
Title
Number of Participants With Assisted Primary Patency at 9, 12, 24, and 36 Months Post Index Procedure
Description
Primary Assisted Patency at 9-, 12-, 24-, and 36-months post-index procedure corresponding to PSVR ≤ 2.4, as determined by an Independent DUS Core Lab. Primary Assisted Patency is independent of whether or not patency is re-established via an endovascular procedure following restenosis.
Time Frame
9, 12, 24, and 36 months post index procedure
Title
Number of Participants With Secondary Patency at 9, 12, 24, and 36 Months Post Index Procedure.
Description
Secondary Patency is a measure of success at re-establishing patency following failure of the initial stent placement due to stenosis or re-occlusion. In this study, Secondary Patency was independent of whether or not patency was re-established via an endovascular procedure following restenosis or occlusion, and was analyzed for the Intent to Treat (ITT) population. Secondary patency is defined as a peak systolic velocity ratio (PSVR) ≤ 2.4, as determined by an independent Duplex Ultrasonography (DUS) Core Lab.
Time Frame
9,12, 24, and 36 months post index procedure
Title
Change in Walking Impairment Questionnaire (WIQ) Scores at 30 Days, 9, 12, 24, and 36-Months Post Index Procedure Compared to Baseline.
Description
The WIQ assesses 3 categories of activities that include 1) walking distance, 2) stair-climbing, and 3) walking speed. Each question requires participants to rate their degree of difficulty with the activity on a scale of 0 (unable) to 4 (no problem). Final scores range from 0% to 100%, with lower percentages indicating higher levels of difficulties with activities.The results below represent the mean differences in total Walking Impairment Questionnaire (WIQ) scores at 30 days,9, 12, 24, and 36 months compared to baseline assessment scores.
Time Frame
30 Days, 9, 12, 24, and 36 months post index procedure compared to baseline.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
CLINICAL INCLUSION CRITERIA: The subject provides written informed consent using an Informed Consent Form approved by the Ethics Committee/ Institutional Review Board for the site. Subject agrees to comply with the protocol-mandated follow-up procedures and visits. Subject is a male or non-pregnant female ≥ 21 years old with an expected lifespan sufficient to allow for completion of all study procedures. Subject has intermittent claudication (Rutherford Category 2-3) or ischemic rest pain (Rutherford Category 4). Subject is able and willing to comply with any required medication regimen. ANGIOGRAPHIC INCLUSION CRITERIA: Subject has evidence of single, bilateral, or multiple de novo and/or restenotic (non-stented) lesion in the native common and/or external iliac artery that is ≥ 50% stenosed (including total occlusions). The target lesion can be successfully crossed with a guide wire and pre-dilated with an appropriately sized PTA balloon. The reference vessel diameter is between 4.5 mm -12.0 mm in diameter. The target lesion is ≤ 100 mm in combined length (per side). The subject has angiographic evidence of a patent (< 50% stenosis) profunda and/or superficial femoral artery (SFA) in the target limb. CLINICAL EXCLUSION CRITERIA: The subject is unable or unwilling to provide written informed consent or to conform to the study protocol follow-up procedures and visits. The subject is or plans to become pregnant during the study. The subject is asymptomatic, has mild claudication or critical limb ischemia with tissue loss described as Rutherford Category 0, 1, 5 or 6. The subject has a vascular graft previously implanted in the native iliac vessel. The subject suffered a hemorrhagic stroke or transient ischemic attack (TIA) within 3 months prior to the index procedure. The subject has a known uncorrectable bleeding diathesis or active coagulopathy. The subject has a serum creatinine ≥ 2.5 mg/dl or is on dialysis. The subject has a known allergy or sensitivity to stainless steel (i.e., Nickel), ePTFE, or has intolerance to the antiplatelet, anticoagulant or thrombolytic medications required per the protocol. The subject has a known allergy or sensitivity to contrast media, which cannot be adequately pre-medicated. The subject had a prior vascular intervention within 30 days before or planned for within 30 days after the index procedure. The subject has another medical condition, which may cause him/her to be non-compliant with the protocol, confound the data interpretation, or is associated with a life expectancy insufficient to allow for the completion of study procedures and follow-up. The subject is currently participating in an investigational drug, biologic, or another device study. ANGIOGRAPHIC EXCLUSION CRITERIA: The subject has extensive peripheral vascular disease, which in the opinion of the Investigator, would preclude safe insertion of an introducer sheath. The ipsilateral common femoral artery should be patent (< 50% stenosis). The target lesion requires treatment other than angioplasty to facilitate subject device delivery. The subject has severe calcification of the target lesion, preventing inflation of PTA balloon. The target lesion has been previously treated with a stent (bare or covered). The subject has angiographic evidence of acute thrombus at the target lesion. The target lesion involves the origin of the internal iliac artery such that successful treatment of the lesion would require the subject device to cross/occlude the side branch. The target lesion located in the distal external iliac artery such that successful treatment of the lesion would require the subject device to cross/occlude side branches or be exposed to compressive forces associated with the close proximity to the common femoral artery. The subject has an abdominal aortic aneurysm (AAA) contiguous to the iliac artery target lesion. The subject has a pre-existing target iliac artery aneurysm or perforation or dissection of the target iliac artery prior to the initiation of the treatment for this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
John R Laird, M.D.
Organizational Affiliation
U. C. Davis Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Arkansas Heart Hospital
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72211
Country
United States
Facility Name
Vascular and Interventional Specialists of Orange County
City
Orange
State/Province
California
ZIP/Postal Code
91107
Country
United States
Facility Name
UC Davis Cardiovascular Medicine
City
Sacramento
State/Province
California
ZIP/Postal Code
95817
Country
United States
Facility Name
Florida Research Network
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32605
Country
United States
Facility Name
Baptist Medical Center
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32207
Country
United States
Facility Name
Lakeland Regional Medical Center
City
Lakeland
State/Province
Florida
ZIP/Postal Code
33805
Country
United States
Facility Name
Mount Sinai Medical Center
City
Miami
State/Province
Florida
ZIP/Postal Code
33140
Country
United States
Facility Name
University of Massachusetts Worcester
City
Worcester
State/Province
Massachusetts
ZIP/Postal Code
01655
Country
United States
Facility Name
Kansas City Vascular Foundation
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64116
Country
United States
Facility Name
CaroMont Regional Medical Center
City
Gastonia
State/Province
North Carolina
ZIP/Postal Code
28054
Country
United States
Facility Name
North Carolina Heart and Vascular
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27607
Country
United States
Facility Name
Donald Guthrie Foundation
City
Sayre
State/Province
Pennsylvania
ZIP/Postal Code
18840
Country
United States
Facility Name
Univeristy of Texas Medical Branch
City
Galveston
State/Province
Texas
ZIP/Postal Code
77550
Country
United States
Facility Name
Swedish Health Services
City
Seattle
State/Province
Washington
ZIP/Postal Code
98122
Country
United States
Facility Name
Universitäts-Herzzentrum Freiburg-Bad Krozingen GmbH
City
Bad Krozingen
ZIP/Postal Code
79189
Country
Germany
Facility Name
Ev.Krankenhaus Königin Elisabeth
City
Berlin
ZIP/Postal Code
10365
Country
Germany
Facility Name
Praxis fur Interventionelle Angiologie
City
Kaiserslautern
ZIP/Postal Code
67657
Country
Germany
Facility Name
Universitaetsklinikum Leipzig
City
Leipzig
ZIP/Postal Code
04289
Country
Germany
Facility Name
Bonifatius Hospital
City
Lingen
ZIP/Postal Code
49808
Country
Germany
Facility Name
Auckland Hospital
City
Auckland
Country
New Zealand

12. IPD Sharing Statement

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BARD® Study of LIFESTREAM™ Balloon Expandable Covered Stent Treating Iliac Arterial Occlusive Disease

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