Clinical Study Protocol - Debris Interventional Removal in ACS (DESIRE-ACS) (DESIRE-ACS)

DebriS Interventional REmoval in ACS (DESIRE-ACS) Study to Assess the Safety and Performance of the ECA Bell Balloon in Subjects Undergoing Coronary Percutaneous Interventions.

DebriS Interventional REmoval in ACS (DESIRE-ACS) Study to assess the safety and performance of the ECA Bell balloon in subjects undergoing coronary percutaneous interventions.

Study Overview

• Status: Unknown
• Conditions: Coronary Disease; Acute Coronary Syndrome; Coronary Occlusion
• Intervention / Treatment: Device: Bell Balloon Catheter

Detailed Description

Coronary arterial disease (CAD) is defined as obstruction of blood flow into the coronary arteries (i.e. the arteries that supply blood to the heart muscle). Patients with symptoms of coronary artery disease usually suffer from stable angina pectoris (chest pain or discomfort), unstable angina pectoris, or a myocardial infarction (heart attack). The symptoms range from mild angina, to moderate or severe angina.

In some cases of CAD the blood vessel is chronically totally blocked (total occlusion), stopping blood flow through the blocked blood vessel. In these cases a minimally invasive treatment or a surgery may be needed. "Minimally invasive procedures" consist of angioplasty or stent placement. The procedure is performed under local anesthetic with the patient lying on their back.

Angioplasty is a routine, well known, non-surgical procedure that is performed by making a small incision of the skin in the groin through which a catheter (narrow tube) and a guidewire (a thin metal wire) are inserted to reach the blocked artery. After reaching the blocked artery and crossing the blockage with a guidewire, a tiny balloon is inflated inside the artery to open the blockage. During the course of this procedure small pieces of the material that is causing the blockage may break off and be carried by the blood stream to other parts of the body where they may lodge and cause damage by blocking the blood flow . The Bell Balloon Catheter is designed to help the physician capture some of this material that may have broken off.

• Study Type: Interventional
• Enrollment (Anticipated): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Israel
  • Jerusalem, Israel, 9103102
    • Recruiting
    • Shaare Zedek Medical Center
    • Contact: Giora Weisz, Prof., MD; Phone Number: 972.2.6555.975; Email: cardio@szmc.org.il

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

Clinical criteria

1. Subject is ≥18 years of age.
2. Subject with acute coronary syndrome (STEMI or NSTEMI).
3. Candidate for percutaneous coronary intervention (PCI) in native coronary artery.
4. Anticipated patient life expectancy of at least 1 year since enrollment.
5. Subject is male or a non-pregnant female.
6. Subject has provided written informed consent.
7. Subject is able and willing to adhere to the required follow-up visits and testing.

Angiographic Criteria

1. Lesions amendable to PCI.
2. Angiographically thrombotic-appearing lesion that amenable to PCI.
3. Lesion(s) is located within the native vessel and has ≥ 50% but <100% stenosis.
4. The target lesion should be at least 10mm proximal to the proximal edge of a stented lesion.
5. Only a single lesion will be treated by the investigational device.
6. Vessel has thrombolysis in myocardial infarction (TIMI) grade 1 or higher flow before the use of the investigational device.
7. Reference vessel diameter, where the Bell balloon is to be placed, is 3-4mm in diameter by angiographic visual estimation.

Exclusion Criteria:

Clinical Criteria

1. Women except those whose menstrual periods have not occurred for more than one year after menopause or those who have had sterilization surgery (tubal ligation) or hysterectomy
2. Known contraindication to the use of heparin or bivalirum (Angiomax).
3. Known contraindication to the use of dual anti-platelet therapy
4. Known hypersensitivity to contrast media which cannot be adequately pretreated.
5. Subject has renal insufficiency, defined as baseline creatinine level ≥ 2.0 mg/dl.
6. Subject has a known history of neutropenia (WBC <3,000/mm3) or significant anemia.
7. Subjects has a known history of coagulopathy or thrombophilia [prothrombin International Normalized Ratio (INR)>1.5, Platelet count<80,000/ μL], that has not resolved or has required treatment in the past 6 months.
8. Major bleeding within 6 months of index procedure.
9. A planned invasive surgical procedure within 30 days.
10. Undergone cardiac surgery within the past 30 days or has a planned surgical procedure within 30 days from study procedure
11. Left ventricular ejection fraction < 25%
12. The patient is in cardiogenic shock or hemodynamic unstable
13. Cerebrovascular Accident (CVA) or TIA within the past 6 months.
14. Exclusions that preclude placement of the bell balloon per the Instruction for Use
15. Subject not capable of understanding and signing the Informed Consent form.

Angiographic Criteria

1. Anatomical exclusions that preclude placement of the bell balloon per the Instruction for Use.
2. Target lesion inside or within 10mm of a prior stent
3. Target lesion distal to a prior placed stent
4. Severe calcification at the lesion site or proximal to it.
5. Aorto-ostial lesions
6. Bifurcation lesions (side branch diameter ≥ 2.0mm)
7. Severe coronary artery tortuosity (Angulation >450)
8. Target lesion is totally occluded, or Thrombolysis in Acute MI (TIMI flow 0) despite pre-dilatation with small caliber balloon
9. Coronary artery spasm in the absence of a significant stenosis

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Bell Balloon Catheter; The Bell Balloon Catheter is designed to help the physician capture some of this material that may have broken off.

Device: Bell Balloon Catheter; An angioplasty procedure to open the blockage in blood vessels will be performed. Standard angioplasty procedure includes local analgesia of the groin area and a small cut through which the procedure will be performed. An introducer sheath (thin tube) will be inserted. The Bell Balloon dilatation will then be inserted. The Bell Balloon works in fashion similar to standard balloon with the same physical and behavioral characteristics. Upon deflation, debris from the blockage is withdrawn into the cavity formed between the deflated balloon and its outer capsule. Then balloon is retracted and retrieved through the guiding catheter, together with the captured debris and trap it between the outer surface of the balloon and the inner surface of the membrane.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The rate of major adverse cardiac events (MACE)	Defined as a composite of cardiac death, all myocardial infarction (Q wave and non-Q wave), and target lesion revascularization (PCI and CABG)	Up to 30 (+/-7) days post procedure
Angiographic and Device Success	Defined as patent vessel with stenosis <50% with a final TIMI flow grade 3 (visually assessed by angiography) without side branch loss, flow-limiting dissection, or angiographic thrombus and embolic material retrieval.; Thrombolysis In Myocardial Infarction (TIMI) flow grade at the end of the revascularization procedure, compared to baseline.; ST resolution level in patients with ST-Elevation Myocardial Infarction (STEMI).; Myocardial Blush Grade (MBG) at the end of procedure, compared to baseline	During procedure and up to 30 (+/-7) days post procedure
Performance - Device success	Defined as ability to deliver, deploy, and intact retract retrieval of the study device and retrieve embolic material	During procedure and up to 30 (+/-7) days post procedure

Collaborators and Investigators

• Sponsor: Angioslide Ltd.
• Investigators: Principal Investigator: Giora Weisz, Prof. M.D, Chairman, Department of Cardiology. Shaare Zedek Medical Center, Jerusalem Israel

Study record dates

Study Major Dates

• Study Start: July 1, 2015
• Primary Completion (Anticipated): December 1, 2015
• Study Completion (Anticipated): March 1, 2016

Study Registration Dates

• First Submitted: December 22, 2014
• First Submitted That Met QC Criteria: December 22, 2014
• First Posted (Estimate): December 25, 2014

Study Record Updates

• Last Update Posted (Estimate): July 28, 2015
• Last Update Submitted That Met QC Criteria: July 26, 2015
• Last Verified: July 1, 2015

More Information

Terms related to this study

• Keywords: Acute Coronary Syndrome, Coronary Occlusion, catheter
• Additional Relevant MeSH Terms: Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Vascular Diseases; Coronary Disease; Acute Coronary Syndrome; Coronary Occlusion
• Other Study ID Numbers: CP-0013.CTIL