To compare the safety, effectiveness and performance of TM ABSORB bioabsorbable everolimus eluting vascular scaffold against XIENCE PRIME TM everolimus eluting coronary stent system in treating people with ischemic heart disease caused by de novo…
ID
Source
Brief title
Condition
- Coronary artery disorders
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
• Vasomotion assessed by change in Mean Lumen Diameter between pre- and
post-nitrate at 3 years (superiority)
• Minimum Lumen Diameter (MLD) at 3 years post nitrate minus MLD post procedure
post nitrate (non-inferiority, reflex to superiority)
Secondary outcome
-) Acute success, including stent success (lesion analysis) and procedural
success (subject analysis)
-) Clinical endpoints (after 30 days, 180 days, 1-5 years follow up),
including: death (cardiac, vascular, not cardiovascular), myocardial infarction
(MI: QMI and NQMI) , revascularization
-) Composite endpoints, including: Death / MI all, Cardiac death
-) Scaffold-/stenttrombose, incl timing (acute, subacute, late and very late)
-) Quality of Life (QoL)
Background summary
The ABSORB II Randomized Controlled Trial (RCT) is designed to continue the
safety and efficacy of the ABSORB scaffold to evaluate and to compare XIENCE
PRIME. To date, no direct comparison between drugeluting absorbable metal
stents and drugeluting performed. In addition, the evaluation of the scaffold
ABSORB currently limited to relatively simple low complex lesions. The
treatment in this randomized trial will be subjects with a longer length
lesions, wherein overlapping stents and smaller target vessels in the target
group.
Study objective
To compare the safety, effectiveness and performance of TM ABSORB bioabsorbable
everolimus eluting vascular scaffold against XIENCE PRIME TM everolimus eluting
coronary stent system in treating people with ischemic heart disease caused by
de novo native coronary artery lesions.
In three participating sites in The Netherlands patients who are scheduled for
a re-catheterisation after 3 years will be asked to participate in a sub-study
called Physiological sub-study (Pressure/Velocity measurement), a total of 30
patiënts will be asked. The aim of this sub-study is to provide physiological
information on the microvasculature function of the patients that participate
in the Absorb II study.
Study design
The ABSORB II Randomized Controlled Trial (RCT) is a prospective, randomized
(2:1; ABSORB versus XIENCE PRIME), active-controlled, single-blind, parallel
two-arm, multicenter clinical trial. A total of about 501 people (334 in the
ABSORB group and 167 in the XIENCE PRIME group) will be randomized in
approximately 40 locations in Europe. The test can treat up to two de novo
native coronary artery lesions, each in different major epicardial coronary
arteries, with a Dmax by online QCA >= 2.25 mm to <= 3.3 mm and lesion length <=
48 mm.
Intervention
Patients randomised in the scaffold group are treated with a bioabsorbable
scaffold, the control group patients with a Xience stent. During the procedure
also IVUS and lipiscan (Erasmus) imaging will be performed. Follow-up visits
include exercise testings, blood tests, QoL, diary, MSCT (scaffold group), and
angiography.
Study burden and risks
The potential risks do not differ from the risks associated with routine stent
procedures as described in the brochure of the Dutch Heart Foundation.
Death 0.2-0.5%
Myocardial infarction during the intervention
hematoma (groin / arterial sheath)
Major bleeding caused by the administration of anticoagulants during or after
treatment.
in addition to this, it's important to note that patients undergo during
follow-up phase a repeat angio. the risk of this repeat angio is also mentioned
in the brochure of the Heart Foundation
Park Lane, Culliganlaan 2B
Diegem 1831
BE
Park Lane, Culliganlaan 2B
Diegem 1831
BE
Listed location countries
Age
Inclusion criteria
• Subject must be at least 18 years of age and less than 85 years of age.
• Subject must agree not to participate in any other clinical investigation for a period of three years following the index procedure. This includes clinical trials of medications and invasive procedures. Questionnairebased studies, or other studies that are non-invasive and do not require medication are allowed.
• Subject is able to verbally confirm understanding of risks, benefits and treatment alternatives of receiving the ABSORB scaffold and he/she or his/her legally authorized representative provides written informed consent prior to any Clinical Investigation related procedure, as approved by the appropriate Ethics Committee
• Subject must have evidence of myocardial ischemia (e.g., stable or unstable angina, silent ischemia).
• Subject must be an acceptable candidate for coronary artery bypass graft (CABG) surgery
• Subject must agree to undergo all clinical investigation plan-required follow-up visits, exercise testing, blood draw as well as adherence to ESC Guidelines and completion of quality of life questionnaires and of a subject diary to collect information including but not limited to tobacco usage, food intake, daily exercise and body weight.;Angiographic Inclusion Criteria
• One or two de novo native lesions each located in a different epicardial vessel.
• If two treatable lesions meet the eligibility criteria, they must be in separate major epicardial vessels (LAD with septal and diagonal branches, LCX with obtuse marginal and/or ramus intermedius branches and RCA and any of its branches).
• Target lesion(s) must have a visually estimated diameter stenosis of >=50% and <100% with a TIMI flow of >= 1.
• Lesion(s) must be located in a native coronary artery with Dmax by online QCA of >= 2.25 mm and <= 3.3 mm.
• Lesion(s) must be located in a native coronary artery with lesion(s) length by on-line QCA of <= 48 mm.
• Percutaneous interventions for lesions in a non-target vessel are allowed if done >=30 days prior to or if planned to be done 2 years after the index procedure.
• Percutaneous intervention for lesions in the target vessel are allowed if done >6 months prior to or if planned to be done 2 years after the index procedure.
Exclusion criteria
General Exclusion Criteria
• Known hypersensitivity or contraindication to aspirin, both heparin and bivalirudin,
antiplatelet medications specified for use in the study (clopidogrel and prasugrel and
ticlopidine, inclusive), everolimus, poly (L-lactide), poly (DL-lactide), cobalt, chromium,
nickel, tungsten, acrylic and fluoro polymers or contrast sensitivity that cannot be
adequately pre-medicated.
• Subject has a known diagnosis of acute myocardial infarction (AMI) at any time
preceding the index procedure and relevant cardiac enzymes (according to local standard
hospital practice) have not returned within normal limits at the time of procedure.
• Evidence of ongoing acute myocardial infarction in ECG prior to procedure
• Subject has current unstable arrhythmias.
• Left ventricular ejection fraction (LVEF) < 30%.
• Subject has received a heart transplant or any other organ transplant or is on a waiting list
for any organ transplant.
• Subject is receiving or scheduled to receive chemotherapy for malignancy within 30 days
prior to or after the procedure.
• Subject is receiving immunosuppressant therapy and/or has known immunosuppressive
or autoimmune disease (e.g. human immunodeficiency virus, systemic lupus
erythematosus, rheumatoid arthritis, severe asthma requiring immunosuppressive
medication, etc.).
• Subject is receiving chronic anticoagulation therapy that can not be stopped and restarted
according to local hospital standard procedures.
• Elective surgery is planned within 2 years after the procedure that will require
discontinuing either aspirin, clopidogrel, prasugrel or ticlopidine.
• Subject has a platelet count <100,000 cells/mm3 or >700,000 cells/mm3, a WBC of
<3,000 cells/mm3, or documented or suspected liver disease (including laboratory
evidence of hepatitis)
• Known renal insufficiency (e.g., eGFR <60 ml/kg/m2 or serum creatinine level of >2.5
mg/dL, or subject on dialysis).
• History of bleeding diathesis or coagulopathy or will refuse blood transfusions.
• Subject has had a cerebrovascular accident (CVA) or transient ischemic neurological
attack (TIA) within the past 6 months.
• Pregnant or nursing subjects and those who plan pregnancy in the period up to 3 years
following index procedure. (Female subjects of child-bearing potential must have a
negative pregnancy test done within 28 days prior to the index procedure and
contraception must be used during participation in this trial)
• Other medical illness (e.g., cancer or congestive heart failure) or known history of
substance abuse (alcohol, cocaine, heroin etc.) as per physician judgment that may cause
non-compliance with the protocol or confound the data interpretation or is associated
with a limited life expectancy.
• Subject is already participating in another clinical investigation that has not yet reached
its primary endpoint.
• Subject is belonging to a vulnerable population (per investigator*s judgment, e.g.,
subordinate hospital staff or sponsor staff) or subject unable to read or write.;Angiographic Exclusion Criteria
• Target lesion which prevents adequate (residual stenosis at target lesion(s) is <= 40% by
visual assessment) coronary pre-dilatation.
• Target lesion in left main trunk.
• Aorto-ostial target lesion (within 3 mm of the aorta junction).
• Target lesion located within 2 mm of the origin of the LAD or LCX.
• Target lesion located distal to a diseased (vessel irregularity per angiogram and >20%
stenosed lesion) arterial or saphenous vein graft.
• Target lesion involving a bifurcation lesion with side branch >=2 mm in diameter, or with
a side branch <2mm in diameter requiring protection guide wire or dilatation.
• Total occlusion (TIMI flow 0), prior to wire crossing
• Excessive tortuosity (>= two 45° angles), or extreme angulation (>=90 °) proximal to or
within the target lesion.
• Restenotic from previous intervention
• Heavy calcification proximal to or within the target lesion.
• Target lesion involves myocardial bridge.
• Target vessel contains thrombus as indicated in the angiographic images.
• Additionally clinically significant lesion(s) (>= 40% diameter stenosis by visual
assessment) for which PCI may be required <2 years after the index procedure.
• Subject has received brachytherapy in any epicardial vessel (including side branches)
• Subject has a high probability that a procedure other than pre-dilatation and study device
implantation and (if necessary) post-dilatation will be required at the time of index
procedure for treatment of the target vessel (e.g. atherectomy, cutting balloon)
Design
Recruitment
Medical products/devices used
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
Register | ID |
---|---|
CCMO | NL37001.078.11 |