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Optical Frequency Domain Imaging (OFDI) Assessed Strut Coverage of New Terumo DES (DISCOVERY123)

Primary Purpose

Coronary Artery Disease

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
TCD-10023 drug eluting stent
Sponsored by
Terumo Europe N.V.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Coronary Artery Disease focused on measuring Drug eluting stents, coronary artery disease, Percutaneous Coronary Intervention, Tomography, Optical Coherence

Eligibility Criteria

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

Inclusion Criteria:

  • Patient is at least 18 years old
  • Patients is a suitable candidate for Percutaneous Coronary Intervention (PCI)
  • Patient has multi-vessel disease with ≥2 de-novo lesions in native coronary arteries suitable for treatment with TCD-10023 DES
  • Target lesions are suitable for OFDI examination;
  • Patient requires staged procedure between 3-5 weeks after baseline procedure, according to investigator's judgement
  • Target vessel reference diameter is between 2.5 - 4.0 mm (visual assessment)
  • Patient has provided written informed consent
  • Patient is affiliated to social security or equivalent system (France only)

Exclusion Criteria:

  • - Patient has known allergy to sirolimus, cobalt, chromium, nickel, or contrast agent (that cannot be adequately premedicated)
  • Patient is not a suitable candidate for use of Dual Anti-Platelet Therapy (DAPT) because of active or recent bleedings or for use of vitamin K antagonist, like warfarin, dabigatran, rivaroxaban or acenocoumarol;
  • Patient is presenting with ST-segment elevated MI (STEMI) at baseline procedure
  • Patient has Killip-class > 1 at admission
  • Patient is in cardiogenic shock
  • Patient is a female of childbearing potential
  • Patient has life expectancy of less then 1 year
  • Patient is expected to undergo major surgery within 3 months
  • Patient has Left Main disease ≥ 50%
  • Target lesion at bifurcation requiring 2 stents technique
  • Target lesions are severely calcified
  • Target lesion is located within 3 mm of aorta-ostium
  • Patient has renal failure defined as estimated Glomerular Filtration Rate (eGFR) <50 mL/min/1.73m²
  • Target lesions require preparation other than balloon pre-dilatation
  • Patient is currently participating in an investigational drug or device study that has not completed the primary endpoint or that clinically interferes with the current study endpoints; Note: Trials requiring extended follow-up for products that were investigational, but have become commercially available since then, are not considered investigational trials
  • In the Investigator's opinion patient has (a) co-morbid condition(s) that could limit the patient's ability to participate in the study, compliance with follow-up requirements or impact the scientific integrity of the study
  • Patient is under judicial protection (France only)

Sites / Locations

  • Cardiovascular Institute Paris Sud (ICPS)
  • CHU Rangueil
  • LMU
  • MCL
  • Erasmus
  • Maasstadziekenhuis

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

TCD-10023 drug eluting stent

Arm Description

All patients will be treated with the new Drug eluting stent TCD-10023

Outcomes

Primary Outcome Measures

OFDI assessed percent stent strut coverage

Secondary Outcome Measures

% stent strut coverage
% stented lesions with >10% uncovered struts
% of stented lesions with >20% uncovered stent struts
% of acquired mal-apposed stent struts
amount (mm³) of in-stent intimal hyperplasia
amount (mm³)of in-segment hyperplasia
neo-intimal thickness (µm)
in-stent late lumen loss (mm) assessed by Quantitative Coronary Angiography (QCA)
In-segment late lumen loss (mm) assessed by QCA
Target Lesion revascularization (TLR)
Target Lesion Failure (TLF - composite of cardiac death, Myocardial infarction, TLR
Target Vessel Revascularization (TVR)
Major Cardiac Adverse Events (MACE) defined as cardiac death, Q wave and non-Q wave Myocardial Infarction (MI) , emergent coronary artery bypass surgery, or target vessel revascularization (TVR)
Stent thrombosis

Full Information

First Posted
April 29, 2013
Last Updated
October 6, 2019
Sponsor
Terumo Europe N.V.
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1. Study Identification

Unique Protocol Identification Number
NCT01844843
Brief Title
Optical Frequency Domain Imaging (OFDI) Assessed Strut Coverage of New Terumo DES
Acronym
DISCOVERY123
Official Title
Evaluation With OFDI of Strut Coverage of Terumo New Drug Eluting Stent (Development Code TCD-10023) With Biodegradable Polymer at 1, 2 and 3 Months
Study Type
Interventional

2. Study Status

Record Verification Date
October 2019
Overall Recruitment Status
Completed
Study Start Date
January 2014 (undefined)
Primary Completion Date
June 2016 (Actual)
Study Completion Date
June 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Terumo Europe N.V.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Purpose of this study is to evaluate, after implantation of a drug eluting stent (DES), coverage of the stent struts by new tissue. The evaluation will be performed by means of intravascular imaging technology (optical frequency domain imaging, OFDI). Renewed tissue coverage over the implanted stent struts prevents direct contact between blood and metal/polymer, which could lead to adverse events: patients need to take blood-thinning drugs to prevent these events. Ous new stent has drug and polymer only on the outside of the stent, and the polymer is degraded by the body leaving a bare metal stent after 3-4 months. This should allow fast coverage of the struts, and might allow to reduce duration of the supportive medical treatment. Our hypothesis is that <20% of the struts remain uncovered at 3 months after implantation, as assessed by OFDI.
Detailed Description
We will enroll patients with multiple coronary lesions, which, as is routine practice, will be treated with the new DES in 2 sessions (second one approximately 3-5 weeks after the first one). We will assess lesions by OFDI after the implantation and at the time of 3 months follow-up, when we will ask patients to undergo a coronary angiography. Patients will then have a follow-up contact at 1 year after initial implantation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Artery Disease
Keywords
Drug eluting stents, coronary artery disease, Percutaneous Coronary Intervention, Tomography, Optical Coherence

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
TCD-10023 drug eluting stent
Arm Type
Experimental
Arm Description
All patients will be treated with the new Drug eluting stent TCD-10023
Intervention Type
Device
Intervention Name(s)
TCD-10023 drug eluting stent
Intervention Description
Implantation of new drug eluting stent in coronary artery lesions
Primary Outcome Measure Information:
Title
OFDI assessed percent stent strut coverage
Time Frame
3 months post procedure.
Secondary Outcome Measure Information:
Title
% stent strut coverage
Time Frame
at 1 and 2 months
Title
% stented lesions with >10% uncovered struts
Time Frame
at 1, 2, 3 months
Title
% of stented lesions with >20% uncovered stent struts
Time Frame
at 1, 2, 3 months
Title
% of acquired mal-apposed stent struts
Time Frame
at 1, 2, 3 months
Title
amount (mm³) of in-stent intimal hyperplasia
Time Frame
at 1, 2, 3 months
Title
amount (mm³)of in-segment hyperplasia
Time Frame
at 1, 2, 3 months
Title
neo-intimal thickness (µm)
Time Frame
at 1, 2, 3 months
Title
in-stent late lumen loss (mm) assessed by Quantitative Coronary Angiography (QCA)
Time Frame
at 3 months
Title
In-segment late lumen loss (mm) assessed by QCA
Time Frame
at 3 months
Title
Target Lesion revascularization (TLR)
Time Frame
at 1, 3, 12 months
Title
Target Lesion Failure (TLF - composite of cardiac death, Myocardial infarction, TLR
Time Frame
at 1, 3, 12 months
Title
Target Vessel Revascularization (TVR)
Time Frame
at 1, 3, 12 months
Title
Major Cardiac Adverse Events (MACE) defined as cardiac death, Q wave and non-Q wave Myocardial Infarction (MI) , emergent coronary artery bypass surgery, or target vessel revascularization (TVR)
Time Frame
at 1, 3, 12 months
Title
Stent thrombosis
Time Frame
at 1, 3 and 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient is at least 18 years old Patients is a suitable candidate for Percutaneous Coronary Intervention (PCI) Patient has multi-vessel disease with ≥2 de-novo lesions in native coronary arteries suitable for treatment with TCD-10023 DES Target lesions are suitable for OFDI examination; Patient requires staged procedure between 3-5 weeks after baseline procedure, according to investigator's judgement Target vessel reference diameter is between 2.5 - 4.0 mm (visual assessment) Patient has provided written informed consent Patient is affiliated to social security or equivalent system (France only) Exclusion Criteria: - Patient has known allergy to sirolimus, cobalt, chromium, nickel, or contrast agent (that cannot be adequately premedicated) Patient is not a suitable candidate for use of Dual Anti-Platelet Therapy (DAPT) because of active or recent bleedings or for use of vitamin K antagonist, like warfarin, dabigatran, rivaroxaban or acenocoumarol; Patient is presenting with ST-segment elevated MI (STEMI) at baseline procedure Patient has Killip-class > 1 at admission Patient is in cardiogenic shock Patient is a female of childbearing potential Patient has life expectancy of less then 1 year Patient is expected to undergo major surgery within 3 months Patient has Left Main disease ≥ 50% Target lesion at bifurcation requiring 2 stents technique Target lesions are severely calcified Target lesion is located within 3 mm of aorta-ostium Patient has renal failure defined as estimated Glomerular Filtration Rate (eGFR) <50 mL/min/1.73m² Target lesions require preparation other than balloon pre-dilatation Patient is currently participating in an investigational drug or device study that has not completed the primary endpoint or that clinically interferes with the current study endpoints; Note: Trials requiring extended follow-up for products that were investigational, but have become commercially available since then, are not considered investigational trials In the Investigator's opinion patient has (a) co-morbid condition(s) that could limit the patient's ability to participate in the study, compliance with follow-up requirements or impact the scientific integrity of the study Patient is under judicial protection (France only)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Pieter Smits, MD
Organizational Affiliation
Maasstad hospital, Rotterdam, the Netherlands
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Bernard Chevalier, MD
Organizational Affiliation
Cardiovascular Institute Paris Sud, Massy, France
Official's Role
Study Chair
Facility Information:
Facility Name
Cardiovascular Institute Paris Sud (ICPS)
City
Massy
ZIP/Postal Code
91300
Country
France
Facility Name
CHU Rangueil
City
Toulouse
ZIP/Postal Code
31059
Country
France
Facility Name
LMU
City
Munchen
ZIP/Postal Code
81377
Country
Germany
Facility Name
MCL
City
Leeuwarden
ZIP/Postal Code
8934 ad
Country
Netherlands
Facility Name
Erasmus
City
Rotterdam
ZIP/Postal Code
3015 CE
Country
Netherlands
Facility Name
Maasstadziekenhuis
City
Rotterdam
Country
Netherlands

12. IPD Sharing Statement

Citations:
PubMed Identifier
29246909
Citation
Chevalier B, Smits PC, Carrie D, Mehilli J, Van Boven AJ, Regar E, Sawaya FJ, Chamie D, Kraaijeveld AO, Hovasse T, Vlachojannis GJ. Serial Assessment of Strut Coverage of Biodegradable Polymer Drug-Eluting Stent at 1, 2, and 3 Months After Stent Implantation by Optical Frequency Domain Imaging: The DISCOVERY 1TO3 Study (Evaluation With OFDI of Strut Coverage of Terumo New Drug Eluting Stent With Biodegradable Polymer at 1, 2, and 3 Months). Circ Cardiovasc Interv. 2017 Dec;10(12):e004801. doi: 10.1161/CIRCINTERVENTIONS.116.004801.
Results Reference
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Optical Frequency Domain Imaging (OFDI) Assessed Strut Coverage of New Terumo DES

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