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A Trial of DCB vs DES in the Treatment of de Novo Large Diameter Coronary Atherosclerotic Stenosis(LARGE ONE)

A Trial of DCB vs DES in the Treatment of de Novo Large Diameter Coronary Atherosclerotic Stenosis(LARGE ONE)

Recruiting
18-75 years
All
Phase N/A

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Overview

For the treatment of primary large-diameter coronary atherosclerosis through percutaneous coronary intervention (PCI), the use of a drug balloon (DCB) is not inferior to the placement of a drug-eluting stent (Firehawk™ family).

  • Large-diameter vessels were defined as vessels with a diameter of ≥3.00 mm and ≤ 4.0mm

Eligibility

Inclusion Criteria:

CI1. Age of subject 18-75 years old;

        CI2. The subject (or legal guardian) understands and provides written informed consent to
        the test requirements and treatment procedures prior to performing any specific tests or
        procedures in the study;
        CI3. The subject is suitable for percutaneous coronary intervention (PCI);
        CI4. The subject had symptomatic coronary artery disease with objective evidence or
        asymptomatic ischemia;
        CI5. Subject is willing to submit to all subsequent evaluations required by the test
        protocol
        Angiogragh Inclusion
        AI1. At Maximum 2 target lesions with stenosis ≥50%, located in no more than 2 vessels with
        a visual reference vessel diameter (RVD) of ≥3.00 mm and ≤4.00 mm;
        AI2. The length of the target lesion must be≤35 mm (visually) and can be covered by one
        study stent or drug balloon;
        AI3. The first target lesion must be successfully predilated/pretreated without:
          1. Vascular tears affecting hemodynamics (TIMI blood grade ≤2);
          2. Coronary dissection classified as D, E and F(ARC);
          3. Residual stenosis > 30% after lesion preparation;
        Note: If Type C dissection occurs at lesion predilation/preparation, clinical investigators
        will determine whether the target lesion can be included based on the comprehensive
        situation of blood flow and patients risks . Type C dissection will be excluded from the
        OCT subgroup considering the risk of dissection extension for OCT operation.
        AI4. The anatomical conditions of the coronary artery were appropriate, and the study
        instrument could be transported to the appropriate location of the target lesion.
        Exclusion Criteria:
        CE1. Subjects with clinical symptoms and/or ECG findings consistent with the diagnosis of
        acute ST-segment elevation myocardial infarction (STEMI) within 7 days;
        CE2. Subject is known to be allergic to contrast agents (which cannot be fully pretreated)
        and/or concomitant medications required by the stent system or protocol (e.g.,
        cobalt-chrome, platinum-chrome, stainless steel, rapamycin, paclitaxel and similar
        configuration compounds, drug coating carrier components, all P2Y12 receptor inhibitors,
        aspirin, etc.);
        CE3. Planned surgical treatment within 6 months after baseline surgery;
        CE4. Severe heart failure (NYHA Grade IV) or left ventricular ejection fraction <30%
        (ultrasound or left ventricular contrast);
        CE5. Previous renal impairment: serum creatinine >2.0mg/dL; Or on dialysis;
        CE6. Previous bleeding events (BARC III or V);
        CE7. Subject is receiving or indication of long-term anticoagulant therapy ;
        CE8. Subject has any of the following conditions (baseline assessment) :
          -  Other serious medical conditions that reduce subjects' life expectancy to less than 13
             months (e.g., cancer, congestive heart failure);
          -  Subject has a current substance abuse problem (e.g., alcohol, cocaine, heroin, etc.);
          -  Subject plans to undergo surgical/intervention procedures that may result in
             non-compliance with protocol or confusing data interpretation;
        CE9. Subject has a history of bleeding tendency, coagulation disorders or refusal of blood
        transfusion;
        CE10. The subject is participating in a clinical trial of another investigational drug or
        device that does not meet its primary endpoint;
        CE11. Subjects are scheduled to participate in another investigational drug or device
        clinical trial within 13 months of baseline procedure;
        CE12. Subjects who intend to be pregnant within 13 months of baseline procedure (fertile
        and sexually active women should consent to use a reliable contraceptive method from
        screening to 13 months after baseline surgery);
        CE13. Subjects are pregnant or breastfeeding (fertile women with pregnancy possibility
        should undergo a pregnancy test within 7 days prior to baseline surgery).
        Angiogragh Exclusion
        AE1. Plan to treat 3 or more target lesions;
        AE2. Plan to treat more than 2 major epicardial vessels;
        AE3. A single lesion to be treated cannot be covered by a single stent or a single drug
        balloon;
        AE4. The subject had two target lesions in the same target vessel, and the distance between
        the two target lesions was ≤15mm (visual observation);
        AE5. Target lesions were located in the left main trunk;
        AE6. Target lesions were located within 3mm of the initial segment of the left anterior
        descending artery (LAD) or left circumflex artery (LCX).
        AE7. Target lesions were located in a saphenous vein, artery or artificial bypass graft;
        AE8. Target lesions need to be treated through a saphenous vein, artery or artificial
        bypass graft ;
        AE9. Target lesion blood flow grade of TIMI 0/1 before guide wire passes through ;
        AE10. Treatment of target lesions involves multi-stent strategy in complex lesions (e.g.,
        bifurcated lesions require more than one stent);
        AE11. Target lesions involve previously in-stent restenosis lesions or overlap with
        previously implanted stents;
        AE12. Subject has unprotected left main coronary artery disease (>50% diameter stenosis);
        AE13. Subjects have received PCI for any type of target lesion (e.g., balloon dilation,
        stent placement, balloon dissection, etc.) within 12 months before baseline;
        AE14. Presence of thrombus or possible thrombus in the target lesion (visual);
        AE15. The target lesions were moderate to severe calcification lesions.

Study details
    Coronary Artery Disease

NCT05961787

Shanghai MicroPort Medical (Group) Co., Ltd.

27 January 2024

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