- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04936191
Dynamic Change of Coronary Artery Curvature (DC3)
Dynamic Change of Coronary Artery Curvature After Adaptive Remodeling
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Coronary artery disease (CAD) is the most common type of heart disease and the leading cause of death worldwide. Percutaneous coronary intervention and coronary artery bypass graft are the guideline suggested treatment. Drug-eluting stents (DES) is the guideline suggested treatment options. Percutaneous coronary intervention with DES provides not just acute luminal gains, but also good long-term patency and clinical outcomes. However, in-stent neoatherosclerosis, very late stent thrombosis, and endothelial dysfunction remained important long-term issues. In addition, metallic stent encages the vessel segment, limits its remodeling and vasomotor function. The original vessel geometry, curvature, tortuosity, and wall shear stress, which are associated with plaque formation are also changed permanently by stent implantation. Although bioresorbable scaffolds attempted to address these issues by providing structural support to the vessel early on, followed by resorption, randomized trials showed that, prior to their resorption, they were less safe and effective than contemporary DES. Since that, the novel DES, DynamX Bioadaptor, is designed to improve these limitations.
The novel DES, DynamX Bioadaptor, is designed to restore normal pulsatility and adaptive remodeling in blood vessels after stent implantation. It is a cobalt-chromium stent with a biodegradable polymer coating that releases novolimus. Segments of the stent are held together by the polymer coating, which is designed to be fully absorbed in 6 months. After degradation of polymer, the stent struts unlink and uncage the stented segment. Pilot study demonstrated vessel uncaging and restoration of cyclic pulsatility 12 months after DynamX Bioadaptor implantation. Adaptive remodeling 12 months after DynamX Bioadaptor implantation will restore flexibility and natural geometry of the stented vessel segment. Thus, the dynamic beat-to-beat (cardiac cycle) changes of curvature and tortuosity will be more pronounced in the DynamX Bioadaptor group compared with that in the permanent metallic Elixir DESyne DES group. The DynamX Bioadaptor can potentially restore the vessel geometry and improve outcomes. The present randomized control study is designed to investigate the differences of dynamic coronary artery geometry changes after DynamX Bioadaptor and permanent metallic DES implantation, using coronary computed tomography angiography (CCTA) as an evaluation tool.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Hsien-Li Kao, MD
- Phone Number: 62152 +886-2-23123456
- Email: hsienli_kao@yahoo.com
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patient is ≥ 20 years old.
- Written informed consent can be obtained.
- The enrolled coronary vessel only has one target coronary lesion required stenting.
- The target coronary lesion is 50 to 100% stenosis and stenting is required.
- Coronary artery de novo lesion requiring implantation of a single drug eluting stent with length ≥ 32 mm.
- Patients are able to tolerate dual antiplatelets for at least six months.
Exclusion Criteria:
- Patient is unwilling to join this study.
- Patients have end-stage renal disease under dialysis, chronic kidney disease (serum creatine > 1.5 mg/dL), symptomatic heart failure, active cancer, high bleeding risk, ST elevation myocardial infarction or hemodynamic unstable non-ST elevation myocardial infarction.
- Coronary lesion with following features: heavily calcification, ostial lesion, lesions requiring post-stenting side branch dilatation and lesions required more than one stent to treat.
- The left ventricular ejection fraction is ≤ 40%.
- No scheduled operation within six months after the coronary stenting is allowed unless continuous dual antiplatelet use is acceptable.
- Patients are unsuitable or unable to receive CCTA.
- Pregnant women or women with breast feeding or suitable pregnant women without contraception during the study period.
- Patient is currently participating another interventional trial.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: DynamX Bioadaptor
Patients were randomized during the percutaneous coronary intervention before stent implantation and assigned to the study arm using an electronic spreadsheet indicating the group assignment by random numbers.
The patients will be 1:1 randomized to 2 groups: DynamX Bioadaptor and DESyne DES groups.
|
Patients received percutaneous coronary intervention in a similar way to a traditional DES.
Patients first receive radial artery or femoral artery cannulation with anticoagulation during the intervention.
All coronary angiograms are carefully measured by at least 2 orthographic views and performed under the same standard conditions.
After adequate predilatation of the target lesion, the coronary stenting will be performed.
All patients will receive a loading dose of acetylsalicylic acid and a P2Y12 inhibitor pre-procedure followed by dual antiplatelet therapy for at least 6 months.
Other Names:
|
Active Comparator: DESyne Drug-eluting Stent
Patients were randomized during the percutaneous coronary intervention before stent implantation and assigned to the study arm using an electronic spreadsheet indicating the group assignment by random numbers.
The patients will be 1:1 randomized to 2 groups: DynamX Bioadaptor and DESyne DES groups.
|
Patients received percutaneous coronary intervention in a similar way to a traditional DES.
Patients first receive radial artery or femoral artery cannulation with anticoagulation during the intervention.
All coronary angiograms are carefully measured by at least 2 orthographic views and performed under the same standard conditions.
After adequate predilatation of the target lesion, the coronary stenting will be performed.
All patients will receive a loading dose of acetylsalicylic acid and a P2Y12 inhibitor pre-procedure followed by dual antiplatelet therapy for at least 6 months.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The differences of vessel curvature change and tortuosity
Time Frame: 12 months ± 2 weeks
|
The differences of vessel curvature change during systolic-diastolic phases, 12 months ± 2 weeks after DynamX Bioadaptor or Elixir DESyne DES implantation, measured by CCTA.
|
12 months ± 2 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The differences of vessel tortuosity change
Time Frame: 12 months ± 2 weeks
|
The differences of vessel tortuosity change during systolic-diastolic phases, 12 months ± 2 weeks after DynamX Bioadaptor or Elixir DESyne DES implantation, measured by CCTA.
|
12 months ± 2 weeks
|
New plaque formation related in-stent/in-segment restenosis
Time Frame: 12 months ± 2 weeks
|
In-stent/in-segment restenosis 12 months ± 2 weeks after DynamX Bioadaptor or Elixir DESyne DES implantation, measured by CCTA.
|
12 months ± 2 weeks
|
Collaborators and Investigators
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 202101142DIPA
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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Fundación EPICRecruitingCoronary Artery Disease | Coronary Disease | Coronary Occlusion | Left Main Coronary Artery Disease | Coronary Artery StenosisSpain
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San Luigi Gonzaga HospitalRecruitingCoronary Disease | STEMI | Coronary Artery Ectasia | Right Coronary Artery Occlusion | Right Coronary Artery StenosisSpain, Italy
Clinical Trials on DynamX Bioadaptor
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Elixir Medical CorporationRecruiting
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Elixir Medical CorporationCompleted
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Elixir Medical CorporationIstituto Clinico HumanitasActive, not recruitingCoronary Artery Disease | Chronic Total Occlusion of Coronary Artery | Multi Vessel Coronary Artery Disease | Bifurcation of Coronary Artery | Long Lesions Coronary Artery DiseaseItaly
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Elixir Medical CorporationUppsala UniversityActive, not recruitingCoronary Artery Disease | Ischemic Heart DiseaseSweden
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Elixir Medical CorporationCompletedCoronary Artery DiseaseNew Zealand