Prospective Evaluation for Receiving SynFlow 3.0 Interventional Circulatory Support in High-risk PCI: A Randomized Controlled Trial (PERSIST Ⅲ)

Safety and Efficacy of the SynFlow 3.0 Percutaneous Transvalvular Ventricular Assist System in Patients Undergoing High-Risk PCI: A Prospective, Multicenter, Randomized Controlled, Non-inferiority Trial (PERSIST Ⅲ Study)

This study is conducted to compare the effectiveness of a new percutaneous mechanical circulatory support device called SynFlow 3.0 with VA-ECMO in high-risk percutaneous coronary intervetnion(PCI) patients. The objective of this study is to see if SynFlow 3.0 can provide similar or better support during high-risk PCI compared to VA-ECMO.

Specifically, the following questions is to be answered in this study:

Can SynFlow 3.0 provide sufficient hemodynamic support for patients during high-risk PCI and the effect be similar to VA-ECMO? Does SynFlow 3.0 offer other clinical benefits compared to VA-ECMO? By answering these questions, it will be determined if SynFlow 3.0 can be a viable alternative to VA-ECMO for patients undergoing high-risk PCI.

Study Overview

• Status: Completed
• Conditions: Coronary Arterial Disease (CAD); High Risk PCI
• Intervention / Treatment: Device: SynFlow 3.0 circulatory support; Procedure: percutaneous coronary intervention; Device: VA-ECMO circulatory support

Detailed Description

The study is a prospective, multicenter, randomized controlled trial under the Good Clinical Principles(GCP) carried out in more than 15 research centers over China. Patients with 3-vessel disease, unprotected left main coronary artery disease or last patent conduit and severly depressed left ventricular function (LVEF≤35%) will be enrolled and undergo non-emergent PCI, and be randomized 1:1 to receive either the SynFlow 3.0 or VA-ECMO support during the PCI. The primary endpoint is the incidence of 30-day major adverse events.

• Study Type: Interventional
• Enrollment (Actual): 222
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Shanghai Municipality
    • Shanghai, Shanghai Municipality, China, 200032
      • Zhongshan Hospital Affiliated to Fudan University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. The investigator assesses that the subject requires coronary revascularization, but CABG is considered as high-risk or the subject refuses CABG. The investigator considers the subject may benefit from PCI.
2. Left ventricular ejection fraction (LVEF) ≤ 35%.

3. Coronary angiography (CAG) or coronary computed tomography angiography (CTA) shows any of the following conditions:

   1. last patent conduit (occluded vessel diameter ≥ 2.5 mm).
   2. unprotected left main (LM) coronary artery disease.
   3. Three-vessel disease (stenosis ≥ 70%). *Three-vessel disease is defined as at least one significant stenosis (≥ 70%) lesion in all three major epicardial coronary artery territories: left anterior descending artery (LAD) and/or its branches, left circumflex artery (LCX) and/or its branches, and right coronary artery (RCA) and/or its branches. In the case of left coronary artery dominance, a lesion in the LAD and the proximal LCX qualified as three-vessel disease.
4. The subject is able to understand the purpose of the trial and sign the informed consent form, and is likely to be compliant to and willing to receive the clinical follow up after discharge.

Exclusion Criteria:

1. STEMI within 24 hours.
2. Cardiac arrest within 24 hours.
3. Cardiogenic shock (CS) or acute decompensation of chronic heart failure (Cardiogenic shock is defined as systemic hypotension [systolic blood pressure <90 mmHg or requiring inotropes/vasopressors to maintain systolic blood pressure >90 mmHg] and any of the followings: ongoing need for inotropes/vasopressors before entering the catheterization lab, any clinical evidence of end-organ hypoperfusion, or use of IABP or other circulatory support devices).
4. History of stroke or TIA within one month prior to the procedure.
5. Contraindications to or inability to place pVAD and ECMO (including but not limited to: left ventricular thrombus, presence of a mechanical aortic valve or cardiac contractile device, moderate to severe aortic stenosis, moderate to severe aortic regurgitation, stents in peripheral access or severe peripheral vascular disease such as tortuosity and dissection which impedes device placement, aortic dissection, aortic aneurysm, or severe abnormalities of ascending aorta or aortic arch , hematological diseases causing fragility of blood cells or hemolysis , hypertrophic obstructive cardiomyopathy).
6. Presence or suspicion of active systemic infection.
7. Known contraindications to heparin (including heparin-induced thrombocytopenia), contrast agents, or study-required medications (e.g., aspirin, clopidogrel).
8. Uncorrectable coagulopathy prior to the procedure, including platelet count ≤75×10^9^/L or INR ≥2.0.
9. Liver dysfunction: liver enzymes and bilirubin of more than 3 times the upper limit of the normal value.
10. Renal dysfunction: undergoing dialysis or serum creatinine ≥4 mg/dL (353.6 µmol/L).
11. Severe right heart failure or severe tricuspid regurgitation.
12. Pregnant or lactating women, or women planning pregnancy during the trial.
13. Participation in another drug or medical device clinical trial without reaching the primary endpoint.
14. Other conditions deemed by the investigator as unsuitable for participation in this trial.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: SynFlow3.0; The patients will undergo PCI and use SynFlow3.0 as hemodynamic supoort during the PCI	Device: SynFlow 3.0 circulatory support; The SynFlow 3.0 is a novel percutaneous left ventricular-assist device that can provide temporary hemodynamic support during high-risk procedure.; Procedure: percutaneous coronary intervention; The percutaneous coronary intervention is a percutaneous endovascular intervention technique that can restore coronary blood flow by various intervention methods such as angioplasty and stent implantation.
Active Comparator: V-A ECMO; The patient will receive PCI and use V-A ECMO as hemodynamic support during the PCI	Procedure: percutaneous coronary intervention; The percutaneous coronary intervention is a percutaneous endovascular intervention technique that can restore coronary blood flow by various intervention methods such as angioplasty and stent implantation.; Device: VA-ECMO circulatory support; Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a percutaneous mechanical circulatory support device that can provide short-term hemodynamic support during high-risk PCI.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Incidence of Major Adverse Events (MAE)	Up to 30 days

Secondary Outcome Measures

Outcome Measure	Time Frame
Incidence of MAE	Up to 90 days
Incidence of major adverse cardiac and cerebral events (MACCE)	Up to 30 days, up to 90days
the change of left ventricular ejection fraction (LVEF) compared to baseline	before discharge, at 30±7 days, at 90±14 days
the change of New York Heart Association (NYHA) class compared to baseline	before discharge, at 30±7 days, at 90±14 days
Total length of hospital stay	Up to 30 days
ICU/CCU length of stay	Up to 30 days
Incidence of adverse events	Up to 90 days
Incidence of serious adverse events	Up to 90 days

Collaborators and Investigators

• Sponsor: ForQaly Medical (Shanghai) Co., Ltd
• Investigators: Principal Investigator: Jianan Wang, Phd, Second Affiliated Hospital, School of Medicine, Zhejiang University; Principal Investigator: Dan Song, Phd, Wuhan Asia Heart Hospital; Principal Investigator: Bo Luan, Phd, Liaoning Provincial People's Hospital; Principal Investigator: Chuanyu Gao, Phd, Fuwai Huazhong Cardiovascular Hospital; Principal Investigator: Cheng Zhang, Phd, Qilu Hospital of Shandong University; Principal Investigator: Jingping Wang, Phd, Shanxi Cardiovascular Hospital; Principal Investigator: Zuyi Yuan, Phd, First Affiliated Hospital Xi'an Jiaotong University; Principal Investigator: Yining Yang, Phd, People's Hospital of Xinjiang Uygur Autonomous Region; Principal Investigator: Yan Wang, Xiamen Cardiovascular Hospital; Principal Investigator: Ming Bai, Phd, LanZhou University; Principal Investigator: Renqiang Yang, Phd, Second Affiliated Hospital of Nanchang University; Principal Investigator: Jiancheng Xiu, Phd, Nanfang Hospital, Southern Medical University; Principal Investigator: Jianhong Tao, Phd, Sichuan Academy of Medical Sciences; Principal Investigator: Min Dai, Phd, Mianyang Central Hospital; Principal Investigator: Lin Zhao, Phd, Beijing Chao Yang Hospital; Principal Investigator: Yan Li, Phd, The Second Affiliated Hospital of Air Force Medical University; Principal Investigator: Yansong Guo, Phd, Fujian Provincial Hospital; Study Chair: Yundai Chen, Phd, First Medical Center of the General Hospital of the People's Liberation Army; Study Chair: Junbo Ge, Phd, Shanghai Zhongshan Hospital

Study record dates

Study Major Dates

• Study Start (Actual): September 10, 2024
• Primary Completion (Actual): May 27, 2025
• Study Completion (Actual): August 13, 2025

Study Registration Dates

• First Submitted: February 19, 2025
• First Submitted That Met QC Criteria: February 28, 2025
• First Posted (Actual): March 3, 2025

Study Record Updates

• Last Update Posted (Estimated): August 29, 2025
• Last Update Submitted That Met QC Criteria: August 28, 2025
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Surgical Procedures, Operative; Endovascular Procedures; Vascular Surgical Procedures; Cardiovascular Surgical Procedures; Minimally Invasive Surgical Procedures; Percutaneous Coronary Intervention
• Other Study ID Numbers: HRPR002

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No