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

NCT ID: NCT04692402

Last Updated: 2020-12-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

51 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-07-16

Study Completion Date

2022-09-30

Brief Summary

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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.

Detailed Description

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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.

Conditions

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Refractory Thrombus in Patients With Acute Coronary Syndrome

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Investigator initiated multicentre open label prospective feasibility trial.

Study Groups

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open label

open label prospective feasibility trial.

Group Type OTHER

Solitaire™ thrombus retrieval device

Intervention Type 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.

Interventions

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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.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

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

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 .
Minimum Eligible Age

22 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Paul Ong

OTHER

Sponsor Role lead

Responsible Party

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Paul Ong

Consultant Cardiologist and Cathlab Director

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Paul Jau Lueng Ong

Role: PRINCIPAL_INVESTIGATOR

Paul Ong Jau Lueng

Locations

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National Heart Centre Singapore (NHCS)

Singapore, Singaproe, Singapore

Site Status RECRUITING

National University Heart Centre Singapore (NUHCS)

Singapore, , Singapore

Site Status RECRUITING

Tan Tock Seng Hospital (TTSH)

Singapore, , Singapore

Site Status RECRUITING

Changi General Hospital (CGH) Changi General Hospital

Singapore, , Singapore

Site Status RECRUITING

Khoo Teck Puat Hospital

Singapore, , Singapore

Site Status RECRUITING

Countries

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Singapore

Central Contacts

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cathy Haiyan li, Master Degree

Role: CONTACT

Phone: +65 63578388

Email: [email protected]

Iswarya Jayakumar, Degree

Role: CONTACT

Phone: 63578326

Email: [email protected]

Facility Contacts

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Aishah Toh

Role: primary

Jolene Leong

Role: primary

Haiyan Li

Role: primary

Li Li

Role: primary

Boon Khim Lim

Role: primary

Other Identifiers

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DSRB 2018/00865

Identifier Type: -

Identifier Source: org_study_id