Polymer-free Sirolimus Eluting Stent: Real-world Investigation of Safety and Outcomes (POLARIS)
POLARIS : POLymer-free Sirolimus Eluting Stent: Real-world Investigation of Safety and Outcomes
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
BACKGROUND. Newer-generation drug-eluting stents (DES) remain associated with late stent-related adverse events at approximately 2% per year, driven by neoatherosclerosis, delayed endothelial healing, and chronic inflammation attributable to permanent polymer coatings. Polymer-free DES were developed to remove this substrate. The polymer-free sirolimus-based submicron carrier-eluting stent Focus np (Abluminus np, Concept Medical, Tampa, FL, USA) (after: study device) is a novel polymer-free sirolimus-eluting stent built on a thin-strut (73 micrometres) cobalt-chromium platform, with drug delivery via biodegradable phospholipid submicron carriers (200-300 nm) confined to the abluminal surface, and a proprietary fusion coating extending sirolimus up to 5 mm beyond the stent edges. The device received CE marking on 24 January 2020. Only limited non-randomized Indian clinical data exist; no Western clinical data have been published.
OBJECTIVES. Primary: to evaluate device-oriented safety and efficacy (TLF at 12 months) of the stent in an all-comer population undergoing PCI at Geneva University Hospitals. Secondary: TLF at 2 and 5 years; individual components of TLF (cardiac death, target vessel MI, clinically indicated target lesion revascularisation) at 30 days, 12 months, 2 years, and 5 years; patient-oriented composite endpoint (all-cause death, any MI, any revascularisation); stent thrombosis (definite / probable, ARC-2, with temporal classification); target vessel failure; major bleeding (BARC 3 or 5); all-cause mortality; and late lumen loss when angiographic follow-up is available.
DESIGN. Prospective, single-centre, single-arm observational registry (Category A research with human subjects per the Swiss Human Research Act). Hybrid enrolment: retrospective identification from January 2021, prospective consent, and prospective follow-up at 30 days, 12 months, 2 years, and 5 years via medical records and telephone interview.
POPULATION. All consecutive adult patients (>= 18 years) treated with at least one study device stent at Geneva University Hospitals since January 2021, with an indication for PCI according to current European or American guidelines, able to provide written informed consent, and with sufficient knowledge of French, German, English, or Italian.
STATISTICS. Exploratory, descriptive analysis. Binary endpoints with Clopper-Pearson 95% confidence intervals; time-to-event analysis by Kaplan-Meier with Greenwood 95% CIs. Pre-specified exploratory subgroup analyses (sex, clinical presentation, diabetes, age, lesion complexity, stent length) presented as forest plots without between-group p-values. Sensitivity analyses include per-protocol, complete-case, landmark (30 days to 12 months), Fine-Gray competing-risk, and tipping point analyses. Analyses in Python (lifelines, pandas, scipy, statsmodels). Reporting follows STROBE.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Juan F Iglesias, MD, FESC, FACC
- Phone Number: +41 22 372 72 00
- Email: juanFernando.Iglesias@hug.ch
Study Contact Backup
- Name: Dorian Garin, MD
- Email: dorian.garin@hug.ch
Study Locations
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Geneva, Switzerland, 1211
- Geneva University Hospitals (HUG) - Service of Cardiology
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Contact:
- Juan F Iglesias, MD, FESC, FACC
- Phone Number: +41 22 372 72 00
- Email: juanFernando.Iglesias@hug.ch
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Contact:
- Dorian Garin, MD
- Email: dorian.garin@hug.ch
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Principal Investigator:
- Juan F Iglesias, MD, FESC, FACC
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Sub-Investigator:
- Dorian Garin, MD
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Age >= 18 years at the time of the index procedure.
- Percutaneous coronary intervention performed at Geneva University Hospitals between January 2021 and December 2025.
- Implantation of at least one study device
- Indication for PCI according to current European or American guidelines.
- Able and willing to provide written informed consent.
- Sufficient knowledge of French, German, English, or Italian to understand the patient information document.
Exclusion Criteria:
- Documented refusal to participate in research through opt-out from general consent.
- Inability to provide informed consent (cognitive impairment or other).
- Inability to be contacted for informed consent (no valid contact information, or unreachable after three contact attempts).
- Life expectancy less than 12 months due to non-cardiac comorbidities at the time of consent.
- Participation in another clinical trial that would interfere with the endpoints of this registry.
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
POLARIS cohort
Consecutive adult patients who received at least one polymer-free sirolimus-eluting stent during PCI at Geneva University Hospitals between January 2021 and December 2025.
No study-mandated procedures; clinical care follows standard institutional practice.
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Thin-strut (73 micrometres) cobalt-chromium coronary stent with polymer-free submicron phospholipid carriers (200-300 nm) delivering sirolimus exclusively to the abluminal surface, and fusion coating extending sirolimus deposition up to 5 mm beyond the stent edges.
CE-marked 24 January 2020.
Available diameters 2.25-4.0
mm and lengths 8-40 mm.
Manufactured by Concept Medical, Tampa, FL, USA.
Implantation and peri-procedural care follow operator discretion and institutional standard of care.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Target Lesion Failure (TLF)
Time Frame: 12 months
|
Device-oriented composite of cardiac death, target vessel myocardial infarction, and clinically indicated target lesion revascularisation, defined per Academic Research Consortium-2 (ARC-2) criteria.
Binary categorical variable analysed by time-to-first-event method.
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12 months
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Target Lesion Failure (TLF) at 2 and 5 years
Time Frame: 2 years; 5 years
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Same ARC-2 composite definition as primary endpoint, assessed at 2 and 5 years.
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2 years; 5 years
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Cardiac death
Time Frame: 30 days; 12 months; 2 years; 5 years
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30 days; 12 months; 2 years; 5 years
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|
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Target vessel myocardial infarction
Time Frame: 30 days; 12 months; 2 years; 5 years
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Myocardial infarction attributable to the target vessel, defined per ARC-2 and the 4th Universal Definition of Myocardial Infarction.
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30 days; 12 months; 2 years; 5 years
|
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Clinically indicated target lesion revascularisation
Time Frame: 30 days; 12 months; 2 years; 5 years
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30 days; 12 months; 2 years; 5 years
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|
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Patient-oriented composite endpoint (POCE)
Time Frame: 12 months; 2 years; 5 years
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Composite of all-cause death, any myocardial infarction, and any revascularisation.
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12 months; 2 years; 5 years
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Definite or probable stent thrombosis (ARC-2)
Time Frame: Acute (0-24h), subacute (1-30d), late (30d-1y), very late (>1y), up to 5 years
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Acute (0-24h), subacute (1-30d), late (30d-1y), very late (>1y), up to 5 years
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Target vessel failure (TVF)
Time Frame: 12 months; 2 years; 5 years
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Composite of cardiac death, target vessel myocardial infarction, and clinically indicated target vessel revascularisation.
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12 months; 2 years; 5 years
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Major bleeding (BARC type 3 or 5)
Time Frame: 12 months; 2 years; 5 years
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12 months; 2 years; 5 years
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All-cause mortality
Time Frame: 12 months; 2 years; 5 years
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12 months; 2 years; 5 years
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Late lumen loss (mm)
Time Frame: At clinically indicated follow-up angiography, up to 5 years
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In-stent late lumen loss by quantitative coronary angiography, assessed only in patients undergoing clinically indicated follow-up angiography.
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At clinically indicated follow-up angiography, up to 5 years
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Juan F Iglesias, MD, FESC, FACC, Geneva University Hospitals (HUG), Interventional Cardiology Unit
- Study Director: Dorian Garin, MD, Geneva University Hospitals (HUG), Department of Cardiology
Publications and helpful links
General Publications
- Mehran R, Rao SV, Bhatt DL, Gibson CM, Caixeta A, Eikelboom J, Kaul S, Wiviott SD, Menon V, Nikolsky E, Serebruany V, Valgimigli M, Vranckx P, Taggart D, Sabik JF, Cutlip DE, Krucoff MW, Ohman EM, Steg PG, White H. Standardized bleeding definitions for cardiovascular clinical trials: a consensus report from the Bleeding Academic Research Consortium. Circulation. 2011 Jun 14;123(23):2736-47. doi: 10.1161/CIRCULATIONAHA.110.009449. No abstract available.
- Garcia-Garcia HM, McFadden EP, Farb A, Mehran R, Stone GW, Spertus J, Onuma Y, Morel MA, van Es GA, Zuckerman B, Fearon WF, Taggart D, Kappetein AP, Krucoff MW, Vranckx P, Windecker S, Cutlip D, Serruys PW; Academic Research Consortium. Standardized End Point Definitions for Coronary Intervention Trials: The Academic Research Consortium-2 Consensus Document. Circulation. 2018 Jun 12;137(24):2635-2650. doi: 10.1161/CIRCULATIONAHA.117.029289.
- Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD; ESC Scientific Document Group. Fourth universal definition of myocardial infarction (2018). Eur Heart J. 2019 Jan 14;40(3):237-269. doi: 10.1093/eurheartj/ehy462. No abstract available.
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Vascular Diseases
- Cardiovascular Diseases
- Pathologic Processes
- Heart Diseases
- Infarction
- Necrosis
- Arteriosclerosis
- Arterial Occlusive Diseases
- Coronary Disease
- Myocardial Ischemia
- Ischemia
- Pathological Conditions, Signs and Symptoms
- Coronary Artery Disease
- Myocardial Infarction
- Acute Coronary Syndrome
Other Study ID Numbers
Other Study ID Numbers
- POLARIS (Alias Study Number)
- POLARIS v1 04.03.2026 (Other Identifier: Sponsor-Investigator protocol version)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ANALYTIC_CODE
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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