A Prospective Multicenter Single Arm Study to Assess the Safety and Effectiveness of the Orsiro Mission 48-mm Sirolimus-Eluting Coronary Stent System for the Treatment of Subjects With Atherosclerotic Lesion(s)
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- Teleflex
- 入组人数
- 150
- 试验地点
- 34
- 主要终点
- Target Lesion Failure (TLF) rate at 12 months post-index procedure
研究概览
简要总结
The purpose of the study is to assess the safety and efficacy of the Orsiro® Mission 48- mm Sirolimus-Eluting Coronary Stent System in the treatment of subjects with atherosclerotic lesion(s) >36 mm and ≤ 44 mm in length (by visual estimate) in the native coronary arteries with a reference vessel diameter of 2.25 mm to 4.0 mm.
Patients enrolled in the United States will be followed for 2 years post index procedure with follow-up visits at 1, 6, 12 months and 2 years post index procedure. Patients enrolled outside of the United States will be followed through 5 years post index procedure with additional follow-up visits at 3 and 5 years post index procedure.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Subject is ≥ 18 years of age
- •Subject is able to understand the nature of the study and provide written informed consent.
- •For sites outside of the United States: Note: For subjects presenting with STEMI and not in a position to read, interpret and sign the informed consent form, oral informed consent is required.
- •Subject is an acceptable candidate for percutaneous coronary intervention (PCI) according to the applicable guidelines.
- •Subject is an acceptable candidate for CABG.
- •Subject is eligible for dual antiplatelet therapy (DAPT) according to guidelines.
- •Subject has clinical evidence of ischemic heart disease, stable or unstable angina pectoris or documented silent ischemia.
- •Subject is willing and able to comply with study follow-up requirements.
- •Angiographic inclusion criteria:
- •Subject has only one target lesion in a native coronary artery to be treated with the investigational device.
- •Note: One additional non-target lesion may be treated with a non-investigational treatment (e.g. stent, balloon angioplasty, atherectomy) with the exception of brachytherapy, if it is located in a different coronary artery. The non-target lesion must be treated first and must be deemed an angiographic success. (Angiographic success is defined by a residual diameter stenosis < 30% with TIMI 3 flow, as visually assessed by the physician, without the presence of prolonged chest pain or ECG changes consistent with MI.)
- •Note: Multiple focal stenoses will be considered as a single lesion if they are amenable to treatment with a single study device.
- •Target lesion must be > 36 mm and ≤ 44 mm in length by operator visual estimate and must be amenable to treatment with a single study device.
- •Target vessel must have a reference vessel diameter of 2.25-4.0 mm by operator visual estimate.
- •For sites in United States: Target lesion must be de novo or restenotic lesion in native coronary artery; restenotic lesion must have been treated with a standard PTCA only.
- •For sites outside of the United States: Target lesion can be de novo, restenotic or in-stent restenotic, and must be located in a native coronary artery.
- •Target lesion must have angiographic evidence of ≥ 50% and < 100% stenosis (by operator visual estimate which may be assisted by QCA / IVUS / OCT). Target lesion stenosis < 70% should have clinical justification for treatment as per local standards.
- •Target vessel must have a Thrombolysis In Myocardial Infarction (TIMI) flow >
- •For sites outside of the United States: Note: For STEMI, TIMI flow > 1 prior to stent implantation (after opening the vessel with a guide wire or a balloon).
排除标准
- •For sites in United States only: Subject has clinical symptoms and/or electrocardiogram (ECG) changes consistent with acute ST elevation myocardial infarction (STEMI) within 72 hours prior to the index procedure.
- •Note: Hemodynamically stable non-STEMI (NSTEMI) subjects are eligible for study enrollment.
- •Subject is hemodynamically unstable.
- •Subject is pregnant and/or breastfeeding or intends to become pregnant during the duration of the study.
- •Subject has a known allergy to contrast medium that cannot be adequately pre-medicated, or any known allergy to thienopyridine, aspirin, both heparin and bivalirudin, L-605 cobalt-chromium (Co-Cr) alloy or one of its major elements (cobalt, chromium, tungsten and nickel), acrylic, fluoropolymers, silicon carbide, PLLA or sirolimus.
- •Revascularization of any target vessel within 12 months prior to the index procedure or previous PCI of any non-target vessel within <72 hours prior to the index procedure.
- •Future planned PCI (including staged procedure) or CABG after the index procedure.
- •Planned surgery or dental surgical procedure within 6 months of index procedure unless dual antiplatelet therapy can be maintained throughout the peri-surgical period.
- •History of a stroke or transient ischemic attack (TIA) within 6 months prior to the index procedure.
- •Subjects with active bleeding disorders, active coagulopathy, or any other reason, who are ineligible for DAPT.
- •Subject will refuse blood transfusions.
- •Subject has a left ventricular ejection fraction (LVEF) < 30% within 6 months prior to or during the index procedure that was documented by any method.
- •Subject is dialysis dependent or has impaired renal function (i.e., serum creatinine > 2.5 mg/dL or 221 µmol/L, determined within 7 days prior to the index procedure).
- •Subject has a documented white blood cell count < 3,000 white blood cells/mm3 or a documented platelet count < 100,000 platelets/mm3 or > 700,000 platelets/mm
- •Subject is receiving oral or intravenous immunosuppressive therapy (inhaled steroids are permitted) or has known life-limiting immunosuppressive or autoimmune disease (e.g., human immunodeficiency virus, systemic lupus erythematosus; diabetes mellitus is permitted).
- •Subject is receiving or scheduled to receive chemotherapy within 30 days before or after the index procedure or has a malignancy that is not in remission.
- •Subjects under oral anticoagulation therapy (OAC) prior to index procedure unless DAPT + OAC (i.e. triple therapy) can be maintained according to guidelines.
- •Subject has life expectancy of < 1 year.
- •Subject is currently participating or plans to participate in another clinical investigation with an investigational device or an investigational drug.
- •In the investigator's opinion, subject will not be able to comply with the follow-up requirements.
- •Angiographic exclusion criteria:
- •Target lesion is excluded if it meets any of the following criteria:
- •Lesion is located within or treated through a saphenous vein graft or arterial graft.
- •Lesion location is within the left main coronary artery.
- •Lesion location is within 3 mm of the origin of the left anterior descending (LAD) or left circumflex (LCX) coronary arteries.
- •Involves a side branch of > 2.0 mm in diameter that requires a two-device strategy after pre-dilatation.
- •Lesion is totally occluded (100% stenosis).
- •For sites in United States only: Lesion is a restenotic lesion that was previously treated with a bare metal or drug eluting stent (in-stent restenosis).
- •Target vessel/lesion is excessively tortuous/angulated or is severely calcified, that would prevent complete inflation of an angioplasty balloon. This assessment should be based on visual estimation.
- •Site sites in the United States: Target vessel has angiographic evidence of thrombus.
- •For sites outside of the United States: Target vessel has angiographic evidence of unresolved large thrombus burden despite of thrombus aspiration.
- •Note: Thrombus aspiration is left at the discretion of the implanting physician.
- •Target vessel was treated with brachytherapy any time prior to the index procedure.
- •Unsuccessful target lesion pre-dilatation, defined as residual stenosis > 50% (by visual estimation) and/or angiographic complications (e.g., distal embolization, side branch closure, dissection greater than National Heart, Lung, Blood Institute type C), and/or, for sites outside of the United States, coronary aneurysms.
- •Non-target lesion is excluded if it meets any of the following criteria:
- •Any of the target lesion angiographic exclusion criteria except for 1c
- •Lesion is located within the target vessel.
- •Lesion is > 36 mm by operator visual estimate.
- •Lesion requires additional, unplanned stents to treat a complication.
- •Lesion treatment is not deemed an angiographic success. (Angiographic success is defined by a residual diameter stenosis < 30% with TIMI 3 flow, as visually assessed by the physician, without the presence of prolonged chest pain or ECG changes consistent with MI.)
研究组 & 干预措施
Orsiro Mission 48-mm Sirolimus-Eluting Coronary Stent System
干预措施: Orsiro Mission 48-mm Sirolimus-Eluting Coronary Stent System (Device)
结局指标
主要结局
Target Lesion Failure (TLF) rate at 12 months post-index procedure
时间窗: 12 months
The primary endpoint will be target lesion failure (TLF) rate at 12 months post-index procedure. TLF is defined as a composite of cardiac death, target vessel Q-wave or non-Q-wave myocardial infarction (TV-MI), or clinically driven target lesion revascularization (CD-TLR).
次要结局
- Device success(Hospital Discharge (6-24 hours post-index procedure))
- Procedure success(Hospital Discharge (6-24 hours post-index procedure))
- All-cause death(1, 6, 12 months and 2, 3, and 5 years post-index procedure)
- Any myocardial infarction (MI)(1, 6, 12 months and 2, 3, and 5 years post-index procedure)
- Cardiac death or myocardial infarction (MI)(1, 6, 12 months and 2, 3, and 5 years post-index procedure)
- Major cardiac adverse events (MACE) and individual MACE components(1, 6, 12 months and 2, 3, and 5 years post-index procedure)
- Target lesion failure (TLF) and individual TLF components(1, 6, 12 months and 2, 3, and 5 years post-index procedure)
- Target vessel failure (TVF) and individual TVF components(1, 6, 12 months and 2, 3, and 5 years post-index procedure)
- Target lesion revascularization (TLR)(1, 6, 12 months and 2, 3, and 5 years post-index procedure)
- Target vessel revascularization (TVR)(1, 6, 12 months and 2, 3, and 5 years post-index procedure)
- Stent thrombosis(1, 6, 12 months and 2, 3, and 5 years post-index procedure)
