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Feasibility Trial Evaluating Efficacy and Safety of Solitaire™ Thrombus Retrieval Device in the Management of Refractory Thrombus in Patients With Acute Coronary Syndrome (Solitaire)

29 december 2020 uppdaterad av: Paul Ong
The study is designed as a multicentre open label prospective feasibility trial to capture preliminary efficacy and safety information on Solitaire device to plan an appropriate pivotal study.

Studieöversikt

Status

Okänd

Betingelser

Intervention / Behandling

Detaljerad beskrivning

We hypothesize that Solitaire device could be effectively and safely used as an adjunctive interventional technique in ACS patients found to have refractory thrombus during PCI.

  1. Primary Objectives To evaluate intra-procedure efficacy of using Solitaire in ACS patients with refractory thrombus.
  2. Secondary Objectives To evaluate clinical efficacy of using Solitaire in ACS patients with refractory thrombus, up to one year post-procedure.

To evaluate safety of using Solitaire in ACS patients with refractory thrombus.

The target enrolment is 51 patients diagnosed with STEMI, NSTEMI or UA and found to have refractory thrombus during PCI. Eligible patients will be identified at the ED or Inpatient ward of the 5 participating hospitals. The projected enrolment period is for two years and follow up for one year. A screening log will be maintained at each site to keep record of patients who were eligible for the study but not enrolled, to establish any selection bias.

Studietyp

Interventionell

Inskrivning (Förväntat)

51

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Singapore
      • Singapore, Singapore, 768828
        • Rekrytering
        • Khoo Teck Puat Hospital
        • Kontakt:
        • Huvudutredare:
          • Dr Syed Saqib Imran
      • Singapore, Singapore, 119074
        • Rekrytering
        • National University Heart Centre Singapore (NUHCS)
        • Kontakt:
        • Huvudutredare:
          • Dr Joshua LOH
      • Singapore, Singapore, 308433
        • Rekrytering
        • Tan Tock Seng Hospital (TTSH)
        • Kontakt:
        • Huvudutredare:
          • Dr Paul Jau Lueng Ong
      • Singapore, Singapore, 529889
        • Rekrytering
        • Changi General Hospital (CGH) Changi General Hospital
        • Kontakt:
        • Huvudutredare:
          • Dr Yew Seong Goh
    • Singaproe
      • Singapore, Singaproe, Singapore, 169609
        • Rekrytering
        • National Heart Centre Singapore (NHCS)
        • Kontakt:
        • Huvudutredare:
          • Dr Aaron Sung Lung Wong

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

22 år till 80 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

Subjects meeting all of the inclusion criteria listed below will be included in this study:

  1. Index event of ST segment elevation or non-ST segment elevation MI or Unstable Angina defined as:

    1. Presentation to hospital with symptoms of myocardial ischemia (Chest pain or angina equivalent) lasting for ≥10 minutes at rest

      AND 1 of the following:

    2. Persistent ST segment elevation ≥1mm (0.1 mV) in two or more contiguous limb leads or ≥2mm (0.2 mV) in ) in one or more contiguous precordial leads OR
    3. New or presumed new left bundle branch block (LBBB) OR
    4. ST segment depression ≥1mm (0.1 mV) in two or more contiguous leads (not known to be pre-existing or due to a known cause such as LV hypertrophy or digoxin) OR
    5. Troponin T or I greater than the laboratory upper normal limit.

  2. Referred for urgent or emergency PCI AND Thrombus burden of TG 4 or above OR TIMI flow grade of 1 or less in at least one native infarct related artery following either

    1. Manual aspiration thrombectomy OR
    2. Balloon Angioplasty OR
    3. AngioJet RT OR
    4. Patient having deferred PCI due to heavy thrombus but continue to demonstrate recalcitrant thrombus upon repeat angiography.

Exclusion Criteria:

Subjects meeting any of the exclusion criteria listed below will be excluded from this study:

  1. Age ≤ 21 years
  2. Cardiogenic shock
  3. killip class 3 or above at presentation

  4. Known relative contraindications for the use of Solitaire:

    1. Prior stent in infarct related artery
    2. Significant proximal stenosis OR Ostial lesion at angiography
    3. Extensive calcification
  5. Life expectancy less than six months due to non-cardiac condition
  6. Participants categorised as vulnerable subjects (ex: prisoners, pregnant women, and mentally disabled persons)
  7. Patients at high risk of being lost to follow up (ex: non-residents)
  8. Participation in any study with an investigational drug or device within the last 30 days
  9. Patients who are unable to provide informed consent prior to any procedure .

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Övrig: open label
open label prospective feasibility trial.
Enhet: Solitaire™ thrombus retrieval device
After consent has been obtained, interventional cardiologist selects the proper solitaire device size per device-specific instructions for use. Adjunctive intervention with Solitaire will be done with a maximum of 2 device deployments. Do not perform more than three recovery attempts in the same vessel using the devices (Maximum of 2 attempts per device per subject). Do not reposition each device more than two times. TIMI flow, thrombus grade and myocardial blush grade will be assessed immediately upon completion of procedure. If recanalization is deemed inadequate by the interventional cardiologist, rescue treatment will follow as per current clinical practice. All other procedures followed will be as clinically indicated.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Rate of successful recanalization defined as an immediate post-procedure Thrombolysis in Myocardial Infarction (TIMI) flow of 2 or 3.
Tidsram: immediate post-procedure
Primary Efficacy Endpoint
immediate post-procedure
Occurrence of any stroke
Tidsram: immediate post-procedure up to 30 days
Occurrence of any stroke, defined as the presence of a new focal neurologic deficit thought to be vascular in origin, with signs or symptoms lasting more than 24 hours, from immediate post-procedure up to 30 days.
immediate post-procedure up to 30 days
Incidence of study device-related Serious Adverse Events (SAEs) up to 30 days.
Tidsram: up to 30 days
Primary Safety Endpoint
up to 30 days
Incidence of emboli in new territory (ENT) at 24 hrs ± 8 hrs post procedure (ENT: Embolization territories outside of the target downstream territory).
Tidsram: at 24 hours ± 8 hours post procedure
Primary Safety Endpoint
at 24 hours ± 8 hours post procedure

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Rate of successful thrombus resolution defined as an immediate post-procedure thrombus burden of thrombus grade (TG) 1 or less
Tidsram: immediate post-procedure
Secondary Endpoints
immediate post-procedure
Rate of successful recanalization defined as a reduction in corrected TIMI frame count after use of the Solitaire device.
Tidsram: immediate post-procedure
Secondary Endpoints
immediate post-procedure
Rate of successful myocardial perfusion defined as an immediate post-procedure myocardial blush grade (MBG) of 2 or more
Tidsram: immediate post-procedure
Secondary Endpoints
immediate post-procedure
Rate of device success defined as successful delivery and retrieval of the device without complication
Tidsram: immediate post- procedure
Secondary Endpoints
immediate post- procedure
Occurrence of major adverse cardiac and cerebrovascular events (MACCE)
Tidsram: up to one year post-procedure
Occurrence of major adverse cardiac and cerebrovascular events (MACCE), defined as composite of all cause death, myocardial infarction, target vessel revascularisation or stroke, up to one year post-procedure.
up to one year post-procedure
All-cause mortality through 90 days post procedure.
Tidsram: 90 days post procedure
Secondary Endpoints
90 days post procedure

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Paul Ong

Utredare

  • Huvudutredare: Paul Jau Lueng Ong, Paul Ong Jau Lueng

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

16 juli 2019

Primärt slutförande (Förväntat)

30 juni 2022

Avslutad studie (Förväntat)

30 september 2022

Studieregistreringsdatum

Först inskickad

28 oktober 2020

Först inskickad som uppfyllde QC-kriterierna

29 december 2020

Första postat (Faktisk)

31 december 2020

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

31 december 2020

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

29 december 2020

Senast verifierad

1 december 2020

Mer information

Termer relaterade till denna studie

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • DSRB 2018/00865

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Ja

produkt tillverkad i och exporterad från U.S.A.

Ja

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